Lemsip Max Day and Night Cold and Flu Relief Capsules

Pack size	16 capsules, 24 capsules

Two capsule types for round-the-clock cold and flu relief in adults

Lemsip Max Day and Night Cold and Flu Relief Capsules are a combination pack. Firstly, they contain two distinct capsule types designed for daytime and night-time use.

Also, the Day capsules (red and yellow) contain paracetamol 500mg, caffeine 25mg, and phenylephrine hydrochloride 6.1mg. Firstly, the caffeine helps combat the drowsy, wiped-out feeling that often comes with cold and flu.

However, the Night capsules (red and blue) contain paracetamol 500mg and phenylephrine hydrochloride 6.1mg only. Firstly, the caffeine has been removed so the capsules don’t disturb sleep.

Furthermore, an important point about the Night capsules: they do NOT contain a sedating antihistamine. Firstly, unlike Night Nurse (which contains promethazine), Lemsip Max Night capsules will not actively help you sleep. They simply avoid keeping you awake.

Above all, adults and children 16 and over take 2 capsules per dose. Firstly, this delivers a full 1000mg paracetamol per dose, the maximum single adult dose.

Also, do not take more than 4 doses (8 capsules) in 24 hours. This is regardless of which type (Day or Night) you use.

However, Lemsip Max Day and Night Capsules are for adults only. Firstly, they are not licensed for children under 16.

Furthermore, these capsules do not contain guaifenesin. Firstly, they are not designed for a chesty productive cough. Beechams All in One Tablets or Benylin Chesty Cough are better options if you have a productive cough.

Above all, do not combine with any other paracetamol-containing product. Firstly, this includes plain paracetamol, co-codamol, and many other cold and flu remedies.

Also, several medical conditions and other medicines are contraindications. The SmPC lists hypertension, heart disease, hyperthyroidism, diabetes, phaeochromocytoma, closed-angle glaucoma, and prostatic hypertrophy as contraindications.

At Courier Pharmacy, our team can help you decide whether Lemsip Max Day and Night Capsules fit your symptoms, your medicines, and your medical history.

When to see a doctor rather than self-treat

Lemsip Max Day and Night Capsules are for short-term self-care of adult cold and flu symptoms. However, some situations need medical assessment rather than continued over-the-counter treatment.

Sudden severe headache, seizures, sudden confusion, visual disturbance, or slurred speech. Stop and call 999 (rare risk of PRES or RCVS relevant to decongestants)
Chest pain, breathlessness, palpitations, or one-sided weakness. Call 999
Symptoms not improving after 5 days, or getting worse
Chesty productive cough with phlegm (these capsules don’t contain an expectorant)
Cough lasting more than 3 weeks, cough with blood, or thick coloured phlegm with high fever
Thick coloured nasal discharge with high fever, severe facial pain, or dental pain (possible bacterial sinusitis)
Signs of paracetamol overdose (nausea, vomiting, abdominal pain, drowsiness). Contact NHS 111 or A&E even if you feel well
Facial swelling, throat swelling, hives, or difficulty breathing. Call 999 (possible severe allergic reaction)
Severe or widespread skin rash with pustules, blistering, or peeling. Stop and seek urgent help
Difficulty passing urine, particularly in men over 50 (possible acute urinary retention from phenylephrine)
If you are pregnant, breastfeeding, over 60, take blood thinners, or have hypertension, heart disease, diabetes, hyperthyroidism, glaucoma, prostate enlargement, or kidney or liver disease, don’t take these without pharmacist or GP advice
If you take an MAOI antidepressant, tricyclic antidepressant, beta-blocker, or another decongestant, these capsules are contraindicated

Five key takeaways

Lemsip Max Day and Night Capsules are a combination pack with two capsule types. Day capsules contain paracetamol 500mg, caffeine 25mg, and phenylephrine 6.1mg. Night capsules contain paracetamol 500mg and phenylephrine 6.1mg (no caffeine, no sedating antihistamine).
Age 16 and over only. Dose: 2 capsules every 4-6 hours. Maximum 8 capsules (4 doses) in 24 hours total. Maximum 5 days without medical advice.
Night capsules do NOT contain a sedating antihistamine. They avoid keeping you awake (no caffeine) but do not actively promote sleep. Night Nurse is the alternative if you need an actively sedating product.
Not for chesty productive cough (no expectorant). Contraindicated in hypertension, heart disease, diabetes, hyperthyroidism, phaeochromocytoma, closed-angle glaucoma, prostatic hypertrophy, and with MAOIs, tricyclic antidepressants, beta-blockers, or other decongestants.
Available as GSL (smaller packs) or Pharmacy medicine P (larger packs). Do not combine with other paracetamol products, other decongestants, or (in Day capsules) other caffeine sources.

What are Lemsip Max Day and Night Cold and Flu Relief Capsules: overview

Where Lemsip Max Day and Night Capsules fit

Cold and flu symptoms often disrupt both daytime function and night-time sleep. Firstly, a single-product approach forces a compromise.

Also, Lemsip Max Day and Night offers a two-capsule solution: caffeinated Day for alertness, caffeine-free Night for undisturbed sleep.

However, this is not a fully sedating night-time product. Firstly, no antihistamine means no active help with falling asleep. Night Nurse is the standard actively-sedating option.

Lemsip Max Day and Night Capsules vs Lemsip Max Cold and Flu Capsules

Lemsip Max Cold and Flu Capsules (single product) contain paracetamol 500mg, caffeine 25mg, and phenylephrine 6.1mg per capsule. Firstly, they are essentially the Day formulation only.

Also, Lemsip Max Day and Night Capsules add the caffeine-free Night option for evening use.

However, if you only take doses during the day, the single product may suit better. If cold and flu symptoms are keeping you up at night, the Day and Night pack is more appropriate.

Lemsip Max Day and Night Capsules vs Night Nurse

Night Nurse contains paracetamol 1000mg, promethazine 20mg (sedating antihistamine), and dextromethorphan 15mg (cough suppressant) per 20ml dose. Firstly, it is designed to actively help you sleep.

Also, Lemsip Max Night capsules do NOT contain a sedating antihistamine. They only avoid keeping you awake, they do not actively make you drowsy.

However, Night Nurse is more effective if sleeplessness is a major cold and flu problem. It is also useful for a night-time dry cough (dextromethorphan is a suppressant).

Furthermore, Night Nurse is a liquid; Lemsip Max Night is a capsule.

Lemsip Max Day and Night Capsules vs Beechams All in One Tablets

Beechams All in One Tablets contain paracetamol 250mg, guaifenesin 100mg (expectorant), and phenylephrine 5mg per tablet. Firstly, Beechams adds guaifenesin for chesty productive cough.

Also, Beechams is licensed from age 12; Lemsip Max Day and Night from age 16.

However, Beechams All in One does not have a separate day/night format. Beechams is better for chesty productive cough in a wider age range; Lemsip Max Day and Night is better for round-the-clock relief without cough component.

Lemsip Max Day and Night Capsules vs Day Nurse and Night Nurse

Day Nurse and Night Nurse are the traditional Vicks separate products. Day Nurse contains paracetamol + pholcodine (cough suppressant) + pseudoephedrine. Night Nurse contains paracetamol + promethazine + dextromethorphan.

Firstly, Day Nurse and Night Nurse are liquids; Lemsip Max Day and Night are capsules.

Also, Day Nurse and Night Nurse include cough suppressants for dry cough. Lemsip Max does not.

However, Lemsip Max Day and Night Capsules are more portable (capsules vs bottle) and simpler (no sedating antihistamine or opioid cough suppressant).

When simpler options are better

If you only have one main symptom, a single-active product is often better. Firstly, this avoids taking active ingredients you don’t need.

Also, plain paracetamol is enough for pain and fever alone. Sudafed alone is enough for congestion alone.

However, combined products like Lemsip Max Day and Night Capsules are convenient when you have multiple simultaneous symptoms and want round-the-clock coverage.

Short-term use only

Lemsip Max Day and Night Capsules are licensed for short-term (up to 5 days) symptom relief. Firstly, symptoms persisting beyond this need medical assessment.

Also, prolonged decongestant use raises cardiovascular strain. Prolonged paracetamol use raises liver strain, particularly with alcohol or existing liver problems.

Self-medication with pharmacy support

Larger packs are Pharmacy medicines (P) requiring pharmacist involvement. Firstly, this ensures the product fits your symptoms and situation.

Also, the pharmacist can confirm you are not on MAOI antidepressants, tricyclic antidepressants, beta-blockers, or other interacting medicines.

However, if this product is not right for you, we will explain why. We will then suggest safer options.

Why choose Courier Pharmacy for your Lemsip Max Day and Night Capsules

Registered, independent, and patient-led

Courier Pharmacy is a UK-registered independent pharmacy. The General Pharmaceutical Council regulates us.

Firstly, even for a well-known product like Lemsip Max, pharmacist support matters. A short conversation can prevent avoidable harm.

Also, we treat every request as a chance to check that the product fits your situation. This is not a simple retail transaction.

Dr Ada Jex-Cori, our brand pharmacist

Our brand pharmacist is Dr Ada Jex-Cori. She represents the spirit of what we do. Named for Ada Lovelace, Sophia Jex-Blake, and Gerty Cori, she stands for evidence-led, unafraid-of-questions medicine. Her message is straightforward. You’re not broken. The system is. We’re here to change that.

Dr Ada Jex Cori with coupon code AJC10 courierpharmacy.co.uk

Care that keeps showing up

Purchases are not one-off transactions when done properly. Firstly, we are here to answer follow-up questions if the product is not working as expected.

Also, if you notice unexpected side effects or your symptoms change, contact us. If symptoms persist beyond 5 days, we can help you think through the next step.

Buy Lemsip Max Day and Night Cold and Flu Relief Capsules from Courier Pharmacy

Lemsip Max Day and Night Capsules are available at courierpharmacy.co.uk in typical pack sizes of 16 or 24 capsules. Smaller packs are GSL; larger packs are Pharmacy medicines (P).

Add Lemsip Max Day and Night Capsules to your basket in your chosen pack size
Larger P packs include a brief pharmacist suitability check before supply
Your order is dispensed and dispatched promptly
Follow the pack directions carefully. Contact us if you have questions

If this product is not right for your situation, we will explain why. Options include Lemsip Max Cold and Flu Capsules (Day formulation only), Night Nurse (actively sedating for night), Beechams All in One Tablets (adds guaifenesin for chesty cough), plain paracetamol with a separate decongestant, or a GP appointment.

Above all, we will not dispense a product that is not suitable for you just because it was requested.

Customer journey at courierpharmacy.co.uk

Summary

A combination pack for adults with two capsule types: caffeinated Day capsules and caffeine-free Night capsules.
Adult dose: 2 capsules every 4-6 hours (max 8 in 24h = 4g paracetamol). Age 16 and over only. Max 5 days without medical advice.
Day capsules: paracetamol + caffeine + phenylephrine. Night capsules: paracetamol + phenylephrine (no caffeine, no sedating antihistamine).
Not for chesty productive cough (no expectorant like guaifenesin).
Contraindications include cardiovascular disease, diabetes, hyperthyroidism, glaucoma, phaeochromocytoma, prostate enlargement, and use with MAOIs, tricyclics, beta-blockers, or other decongestants.

Active ingredients in Lemsip Max Day and Night Cold and Flu Relief Capsules

Paracetamol 500mg per capsule (1000mg per adult dose)

Paracetamol is a widely-used analgesic (pain reliever) and antipyretic (fever reducer). It has been in clinical use since the 1950s.

Firstly, the exact mechanism is not fully understood. It is thought to act primarily on the central nervous system, reducing prostaglandin production in the brain and spinal cord.

Also, at the 1000mg per adult dose (2 capsules), paracetamol provides substantial pain relief and reduces fever. This is the maximum single adult dose.

However, paracetamol has a narrow safety margin in overdose. Doses just above the maximum can cause serious liver damage.

Furthermore, total daily paracetamol from all sources must not exceed 4g (4000mg) in adults. Lemsip Max at maximum dose (8 capsules) delivers exactly 4000mg per 24 hours, so no additional paracetamol from any other source is safe.

Caffeine 25mg per Day capsule (50mg per Day dose)

Caffeine is a mild central nervous system stimulant. Firstly, at 50mg per Day dose, it provides mild alertness comparable to a small cup of coffee.

Also, caffeine can enhance paracetamol's pain-relieving effect.

However, the Night capsules contain no caffeine. Firstly, this is why they should not disturb sleep.

Furthermore, the total daily caffeine from all Day doses (maximum 3-4 doses) can reach 150-200mg. This is significant but well within safe limits for most adults.

Phenylephrine hydrochloride 6.1mg per capsule (12.2mg per adult dose)

Phenylephrine is a synthetic sympathomimetic decongestant. It acts as a selective alpha-1 adrenergic receptor agonist.

Firstly, at 12.2mg per adult dose, it narrows blood vessels in the nasal and sinus lining. This reduces swelling and improves airflow.

However, phenylephrine's effectiveness at oral doses has been debated. Some evidence suggests it is a weaker decongestant than pseudoephedrine, though it is widely used.

Also, phenylephrine is not controlled under the Misuse of Drugs Regulations. This is why phenylephrine-containing products have no pack size limits.

Furthermore, phenylephrine has cardiovascular effects similar to pseudoephedrine. Contraindications and cautions for cardiovascular disease still apply.

Why the Day and Night formulation choice

The Day capsules add caffeine for alertness during working hours. Firstly, this counteracts cold and flu drowsiness.

Also, the Night capsules remove the caffeine so the same paracetamol and phenylephrine relief does not disturb sleep.

However, the Night capsules do NOT add a sedating antihistamine. Firstly, this is a deliberate design choice. Some patients want a non-sedating night option; others prefer actively sedating products like Night Nurse.

What are Lemsip Max Day and Night Cold and Flu Relief Capsules for?

Cold, flu, and sinusitis symptoms in adults

Lemsip Max Day and Night Capsules are licensed for the relief of cold and flu symptoms and the pain and congestion of sinusitis in adults 16 and over. Firstly, this includes aches and pains, headache, blocked nose, sore throat, chills, and feverishness.

Also, the two-capsule format allows convenient round-the-clock dosing.

However, these capsules do not treat the underlying viral infection. Colds usually resolve on their own in 7-10 days.

Daytime alertness during cold and flu

The caffeine content in Day capsules helps counteract the drowsy, wiped-out feeling that often accompanies cold and flu. Firstly, this supports daytime function at work or home.

Also, caffeine mildly enhances paracetamol's pain-relieving effect.

However, if you are caffeine-sensitive or want to avoid caffeine altogether, plain paracetamol with a separate decongestant may suit better.

Undisturbed sleep with continued symptom relief

The Night capsules provide the same paracetamol and decongestant relief as Day capsules but without caffeine. Firstly, this means night-time doses should not disturb sleep.

However, the Night capsules will not actively help you sleep. Firstly, they contain no sedating antihistamine.

Also, if sleeplessness is a significant problem due to your cold or flu symptoms, Night Nurse (which contains promethazine) is the standard actively-sedating option.

What Lemsip Max Day and Night Capsules aren't for

These capsules are not for chesty productive cough. Firstly, they contain no expectorant. A product with guaifenesin (Beechams All in One) fits better.

Also, they are not for dry tickly cough. Firstly, they contain no cough suppressant. Products with pholcodine, dextromethorphan, or codeine linctus fit better.

However, they are not for children under 16, chronic cough, chronic congestion, or use during pregnancy or breastfeeding without medical advice.

Furthermore, if you have hypertension, heart disease, hyperthyroidism, diabetes, glaucoma, or take an MAOI antidepressant, tricyclic antidepressant, or beta-blocker, do not use these capsules.

How do Lemsip Max Day and Night Cold and Flu Relief Capsules work?

Paracetamol's analgesic and antipyretic action

Paracetamol works mainly on the central nervous system. Firstly, it is thought to reduce prostaglandin production in the brain and spinal cord.

Also, this reduces pain perception and lowers the raised body temperature set-point during infection.

However, paracetamol has minimal anti-inflammatory effect in peripheral tissues. This is why it is a weaker anti-inflammatory than ibuprofen or aspirin.

Furthermore, paracetamol does not cause the stomach irritation, cardiovascular strain, or platelet effects associated with NSAIDs.

Caffeine's stimulant and analgesic-enhancing action (Day capsules)

Caffeine acts as a mild central nervous system stimulant. Firstly, it blocks adenosine receptors in the brain, reducing the drowsy feeling.

Also, caffeine can slightly enhance paracetamol's pain-relieving effect through mechanisms not fully understood.

However, the caffeine content in a Day dose (50mg) is modest, roughly equivalent to a small cup of coffee.

Phenylephrine's alpha-adrenergic action

Phenylephrine narrows blood vessels in the nasal and sinus lining. Firstly, it binds to alpha-1 adrenergic receptors on the vessel walls.

Also, this makes the vessels tighten (vasoconstriction), reducing the swelling that causes a blocked nose. Sinus drainage improves too.

However, phenylephrine acts throughout the body, not just in the nose. This is why cardiovascular contraindications and cautions apply.

Furthermore, phenylephrine is a weaker oral decongestant than pseudoephedrine but is widely used because it is not subject to Misuse of Drugs Regulations pack size limits.

Why no sedating antihistamine in Night capsules

Night Nurse contains promethazine, a sedating antihistamine that actively helps you sleep. Lemsip Max Night capsules deliberately do not include this.

Firstly, some patients want a night-time cold and flu product that does not cause morning grogginess or drowsy-driving risk.

However, this design means the Night capsules do not actively help you sleep. If you want an actively sedating night product, choose Night Nurse instead.

How to take Lemsip Max Day and Night Cold and Flu Relief Capsules

Adult and 16+ dose

Adults and children aged 16 and over take 2 capsules with water every 4-6 hours as needed. Firstly, this delivers 1000mg paracetamol, 12.2mg phenylephrine (and 50mg caffeine in Day capsules) per dose.

Also, do not exceed 4 doses (8 capsules) in any 24-hour period. This maximum daily dose delivers 4000mg paracetamol, at the daily paracetamol maximum.

However, do not take more often than every 4 hours. Leave at least 4 hours between doses.

Furthermore, do not take these capsules for more than 5 days without medical advice.

When to use Day capsules

Use Day capsules for daytime doses. Firstly, the caffeine content helps counteract cold and flu drowsiness during working hours.

Also, take the last Day dose no later than around 4-6 hours before bedtime. This prevents the caffeine from interfering with sleep.

However, if you are caffeine-sensitive, consider whether the Day capsules suit you. Two Day capsules deliver 50mg caffeine, roughly equivalent to a small cup of coffee.

When to use Night capsules

Use Night capsules for the evening and bedtime dose. Firstly, they provide the same paracetamol and decongestant relief as Day capsules but without caffeine.

Also, take the Night dose about 30-60 minutes before bedtime for peak effect during the night.

However, the Night capsules do NOT contain a sedating antihistamine. Firstly, they will not actively help you sleep. If sleeplessness is a problem due to your cold or flu, Night Nurse (which contains promethazine) is the standard actively-sedating option.

Children under 16 (not for use)

Lemsip Max Day and Night Capsules are not for children under 16. Firstly, the 1000mg paracetamol per dose exceeds the paediatric-appropriate amount.

Also, for cold and flu symptoms in children under 16, paediatric paracetamol suspension (Calpol) or ibuprofen for pain and fever, plus saline nasal drops or spray for congestion, are the standard approach.

How to swallow the capsules

Swallow each capsule whole with a full glass of water. Firstly, do not chew the capsules.

Also, the capsules can be taken with or without food. Taking with food may reduce mild stomach upset.

How quickly they work

Paracetamol usually starts to reduce pain and fever within 30 to 60 minutes. Firstly, caffeine can slightly speed this up in Day capsules.

Also, phenylephrine's decongestant effect starts within about 30 minutes.

However, peak pain and fever relief is reached at 1-2 hours. The effect usually lasts around 4-6 hours per dose.

Missed doses and stopping

These capsules are taken as needed, not on a fixed schedule. Firstly, there is no missed-dose concern in the usual sense.

Also, you can stop the capsules whenever your symptoms have resolved. There is no need to taper.

However, if you find yourself needing them for more than 5 days, medical assessment is warranted.

Do not combine with other paracetamol products

Above all, do not take Lemsip Max Day and Night Capsules alongside any other product containing paracetamol. Firstly, this includes plain paracetamol, Panadol, Anadin Extra, Beechams All in One, Day Nurse, Night Nurse, Sinutab, Nurofen Plus, co-codamol, and co-dydramol.

Also, paracetamol overdose from combined products is a common cause of accidental liver damage. Always check the ingredient labels.

Do not combine with other decongestants

Do not combine with any other decongestant. Firstly, this includes oral products (Sudafed tablets, Actifed, Nurofen Cold and Flu, Beechams cold products) and nasal sprays (Sudafed Blocked Nose, Otrivine).

Also, combining these overloads the sympathomimetic dose and raises cardiovascular risk.

Caffeine and Day capsules

Day capsules contain caffeine 25mg per capsule (50mg per dose). Firstly, do not add significant additional caffeine (large coffees, energy drinks, other caffeine-containing medicines).

Also, excessive caffeine can cause palpitations, jitteriness, and disturbed sleep.

However, moderate caffeine intake (a cup of tea or coffee) alongside Day capsules is not usually a problem for most adults.

Overdose

Above all, if you take more than the maximum dose, seek medical advice immediately even if you feel well. Firstly, paracetamol overdose can cause serious liver damage that develops over 24-72 hours.

Also, symptoms of paracetamol overdose may be delayed. Do not wait for symptoms to appear.

However, phenylephrine overdose can cause severe hypertension, confusion, and (rarely) seizures or cardiac arrhythmias.

Furthermore, contact NHS 111 or attend A&E for urgent assessment. Take the packet with you.

Warnings and precautions for Lemsip Max Day and Night Cold and Flu Relief Capsules

MHRA safety alert relevant to decongestants, PRES and RCVS

Above all, the MHRA issued a safety alert in February 2024 for pseudoephedrine-containing medicines. It highlighted rare but serious cases of PRES and RCVS.

Firstly, PRES stands for posterior reversible encephalopathy syndrome. RCVS stands for reversible cerebral vasoconstriction syndrome.

Also, although the specific alert focused on pseudoephedrine, phenylephrine has similar vasoconstricting properties. Symptoms to watch for include sudden severe headache, seizures, sudden confusion, visual disturbances, or slurred speech.

However, if any of these develop while taking these capsules, stop immediately. Seek urgent medical assessment (call 999 for severe symptoms).

Cardiovascular disease, contraindicated

These capsules are contraindicated in hypertension and heart disease. Firstly, phenylephrine's vasoconstricting effect can worsen these conditions.

Also, the caffeine in Day capsules can add to cardiovascular strain.

However, if you take any regular medicine for high blood pressure or heart conditions, disclose this before buying.

Diabetes, contraindicated

These capsules are contraindicated in diabetes. Firstly, phenylephrine can raise blood glucose levels through its sympathomimetic effects.

However, if you have diabetes and need cold or flu symptom relief, ask the pharmacist for safer options.

Hyperthyroidism, contraindicated

Patients with an overactive thyroid should not use these capsules. Firstly, sympathomimetic drugs and caffeine can compound the effects of excess thyroid hormone.

Phaeochromocytoma, contraindicated

Contraindicated in phaeochromocytoma (a rare tumour that affects heart rate and blood pressure). Firstly, phenylephrine can precipitate serious cardiovascular events in these patients.

Closed-angle glaucoma, contraindicated

These capsules are contraindicated in closed-angle glaucoma. Firstly, phenylephrine can precipitate an acute glaucoma attack in susceptible patients.

Prostatic hypertrophy, contraindicated

Contraindicated in enlargement of the prostate gland. Firstly, phenylephrine can worsen urinary retention.

Severe kidney or liver disease, contraindicated

Contraindicated in hepatic impairment (including alcoholic liver disease) or severe renal impairment. Firstly, paracetamol is metabolised by the liver, and severe impairment raises toxicity risk.

Also, phenylephrine and caffeine are also affected by liver and kidney function.

MAOI antidepressants, contraindicated

Above all, do not take these capsules if you are on an MAOI antidepressant, or within 14 days of stopping one.

Also, MAOIs include phenelzine, isocarboxazid, tranylcypromine, and moclobemide. Rasagiline and selegiline (Parkinson's medicines) carry the same concern.

However, the combination of an MAOI with phenylephrine can cause hypertensive crisis, a life-threatening rise in blood pressure.

Tricyclic antidepressants, contraindicated

Do not take with tricyclic antidepressants (amitriptyline, nortriptyline, imipramine, clomipramine).

Also, tricyclics can enhance the pressor effect of phenylephrine, raising blood pressure and cardiac arrhythmia risk.

Beta-blockers, contraindicated

Do not take with beta-blockers (propranolol, atenolol, bisoprolol, metoprolol). The combination with phenylephrine can cause paradoxical high blood pressure.

Other decongestants, contraindicated

Do not combine with any other sympathomimetic decongestant. Firstly, this includes pseudoephedrine, phenylephrine, ephedrine, oxymetazoline, or xylometazoline (both oral products and nasal sprays).

Also, combining these overloads the sympathomimetic dose.

Additional caffeine intake

The Day capsules already contain caffeine. Firstly, avoid excessive additional caffeine (large coffees, energy drinks, other caffeine-containing medicines) alongside Day doses.

However, moderate caffeine (a cup of tea or coffee) is usually not a problem for most adults.

Paracetamol overdose and HAGMA with flucloxacillin

Paracetamol overdose can cause serious liver damage. Firstly, doses just above the maximum can be harmful.

Also, high anion gap metabolic acidosis (HAGMA) due to pyroglutamic acidosis has been reported when paracetamol is used with flucloxacillin (an antibiotic), especially in severe illness, severe renal impairment, sepsis, or malnutrition.

However, if you are taking flucloxacillin or have any of these conditions, discuss with the pharmacist or GP before use.

Alcohol, caution

Avoid alcohol while taking these capsules. Firstly, alcohol raises the risk of paracetamol-related liver injury, particularly with regular use.

Also, alcohol has its own cardiovascular effects that can add to phenylephrine's blood-pressure-raising effect.

Pregnancy, not recommended

These capsules are not recommended during pregnancy without medical advice. Firstly, the safety of phenylephrine and higher-dose caffeine during pregnancy has not been fully established.

However, paracetamol alone at the lowest effective dose is generally preferred for pain and fever in pregnancy. Ask your midwife, GP, or pharmacist.

Breastfeeding, not without medical advice

These capsules should not be used in breastfeeding without medical advice. Firstly, paracetamol, phenylephrine, and caffeine are all excreted in breast milk.

However, discuss with your GP or pharmacist for individual advice.

Elderly patients, caution

Use with caution in adults over 60. Firstly, older adults are more sensitive to phenylephrine's cardiovascular effects.

Also, older adults may be more sensitive to caffeine's stimulant effects (jitteriness, sleep disturbance).

Duration of use, short-term only

Do not take these capsules for more than 5 days without medical advice. Firstly, ongoing symptoms need medical assessment.

Side effects of Lemsip Max Day and Night Cold and Flu Relief Capsules

Common side effects

Common side effects come from the different actives. Firstly, from phenylephrine: mild palpitations, mild restlessness, or mild headache.

Also, from caffeine (Day capsules only): jitteriness, palpitations, or sleep disturbance if taken too late.

However, paracetamol at recommended doses is generally well tolerated. Rarely, allergic skin reactions can occur.

Less common but significant side effects

Some side effects need attention. Firstly, palpitations or a noticeable rise in blood pressure warrant stopping the capsules.

Also, unusual bruising or bleeding may indicate a rare paracetamol-related blood disorder. Seek medical advice.

However, difficulty passing urine (particularly in men over 50) may indicate developing acute urinary retention from phenylephrine.

Serious side effects requiring urgent help

Above all, seek urgent medical help for signs of severe cardiovascular events. These include sudden severe headache, chest pain, one-sided weakness, or difficulty speaking. Call 999.

Also, signs of severe allergic reaction (facial or throat swelling, breathing difficulty, widespread rash) need 999.

Furthermore, signs of paracetamol overdose (nausea, vomiting, abdominal pain, drowsiness, confusion) need urgent assessment even if only slightly above the maximum dose.

However, severe skin reactions with pustules, blistering, or peeling need urgent assessment.

Yellow Card reporting

Anyone can report a suspected side effect to any medicine via the MHRA Yellow Card scheme: https://yellowcard.mhra.gov.uk/

Drug interactions with Lemsip Max Day and Night Cold and Flu Relief Capsules

MAOI antidepressants, contraindicated

Above all, do not take these capsules if you are on an MAOI antidepressant, or within 14 days of stopping one.

Also, MAOIs include phenelzine, isocarboxazid, tranylcypromine, and moclobemide. Rasagiline and selegiline (Parkinson's medicines) and linezolid (an antibiotic) carry the same concern.

Tricyclic antidepressants, contraindicated

Do not take with tricyclic antidepressants. Firstly, tricyclics can enhance the pressor effect of phenylephrine.

Beta-blockers, contraindicated

Do not combine with beta-blockers. Firstly, the combination with phenylephrine can cause paradoxical high blood pressure.

Other sympathomimetic decongestants, contraindicated

Do not combine with any other decongestant containing pseudoephedrine, phenylephrine, ephedrine, oxymetazoline, or xylometazoline.

Also, this includes both systemic products (Sudafed, Actifed, Sinutab, Nurofen Cold and Flu) and topical nasal sprays.

Other paracetamol products

Above all, do not combine with other paracetamol-containing products. Firstly, this includes plain paracetamol, Panadol, Anadin Extra, Beechams All in One, Day Nurse, Night Nurse, Sinutab Non-Drowsy, Nurofen Plus, co-codamol, and co-dydramol.

Also, paracetamol overdose from combined products is a common cause of accidental liver damage. Always check ingredient labels.

Other caffeine sources (Day capsules)

The Day capsules contain caffeine 25mg per capsule. Firstly, avoid excessive additional caffeine (energy drinks, large coffees, other caffeine-containing medicines) alongside Day doses.

However, moderate caffeine intake is usually not a problem for most adults.

Flucloxacillin, HAGMA risk

Concurrent use with flucloxacillin has been linked to high anion gap metabolic acidosis (HAGMA) due to pyroglutamic acidosis.

However, this is particularly risky in patients with severe illness, severe renal impairment, sepsis, or malnutrition.

Warfarin, long-term paracetamol interaction

Regular paracetamol use can enhance the anticoagulant effect of warfarin. Firstly, this raises INR and bleeding risk.

However, occasional use is usually acceptable. Discuss with your anticoagulation clinic if you take warfarin regularly.

Metoclopramide, domperidone, and colestyramine

Metoclopramide and domperidone speed up paracetamol absorption. Colestyramine slows it down.

However, these interactions are usually clinically minor.

Digoxin

Use with caution with digoxin. Firstly, phenylephrine can potentially interact and raise the risk of cardiac arrhythmias.

Alcohol

Avoid alcohol while taking these capsules. Firstly, alcohol raises the risk of paracetamol-related liver injury.

Also, alcohol has its own cardiovascular effects that can add to phenylephrine's blood-pressure-raising effect.

Frequently asked questions about Lemsip Max Day and Night Cold and Flu Relief Capsules

What's the difference between Day and Night capsules?

Day capsules contain paracetamol 500mg, caffeine 25mg, and phenylephrine 6.1mg. Night capsules contain paracetamol 500mg and phenylephrine 6.1mg only (no caffeine).

However, Night capsules do NOT contain a sedating antihistamine. Firstly, they will not actively help you sleep, they only avoid keeping you awake.

Will the Night capsules help me sleep?

Not actively. Firstly, the Night capsules simply remove the caffeine so they don't disturb sleep. They contain no sedating antihistamine.

However, if you want an actively sedating cold and flu product for night use, Night Nurse (which contains promethazine) is the standard option.

Can I take Day capsules at night if I've run out of Night capsules?

Not ideally. Firstly, the caffeine in Day capsules can disturb sleep if taken close to bedtime.

However, if you need a night-time dose and have only Day capsules left, plain paracetamol at bedtime is a better option. Ask a pharmacist for guidance.

How quickly do the capsules work?

Paracetamol usually starts to reduce pain and fever within 30 to 60 minutes. Phenylephrine relieves congestion within about 30 minutes.

Also, peak effect for pain and fever relief is reached at about 1 to 2 hours. The effect usually lasts around 4-6 hours per dose.

Can I take these with paracetamol?

No. Firstly, each capsule already contains paracetamol 500mg (1000mg per adult dose).

Also, adding more paracetamol from another product can lead to overdose and serious liver damage.

Can I take these with ibuprofen?

Yes, generally. Firstly, ibuprofen and paracetamol work through different mechanisms and can be combined for extra pain relief.

However, always follow ibuprofen's own dose directions. Do not take another product that also contains ibuprofen.

Can I take these with other cold and flu products?

No. Firstly, do not combine with other cold and flu remedies without pharmacist advice. Most contain paracetamol or a decongestant. Combining overloads the doses.

Can I drink coffee while taking Day capsules?

Moderate coffee (a cup or two) is usually fine. However, avoid excessive caffeine (large coffees, energy drinks) alongside Day capsules.

Also, avoid caffeine after your last Day dose to prevent sleep disturbance.

Can I take these if I take antidepressants?

Discuss with the pharmacist first. Firstly, if you take an MAOI antidepressant OR a tricyclic antidepressant, these capsules are contraindicated.

Also, some SSRIs may add to CNS effects. Ask the pharmacist for guidance based on your specific medicine.

Can children take these capsules?

No. Firstly, Lemsip Max Day and Night Capsules are licensed for adults and children 16 and over only.

However, for children under 16 with cold and flu, paediatric options (Calpol, ibuprofen, saline nasal drops) are the standard approach.

Can I take these during pregnancy or breastfeeding?

Not without medical advice. Firstly, these capsules are not recommended in pregnancy or breastfeeding.

However, paracetamol alone at the lowest effective dose is generally preferred for pain and fever in pregnancy. Ask your midwife, GP, or pharmacist.

How long can I take these capsules for?

Do not take these capsules for more than 5 days without medical advice. Firstly, ongoing symptoms need medical assessment.

Are these capsules addictive?

No. Firstly, none of the active ingredients cause chemical dependence at therapeutic doses.

However, prolonged use of any analgesic can lead to medication-overuse headache. Stick to short-term use.

What if I've taken too many?

Contact NHS 111 or A&E immediately. Firstly, paracetamol overdose can cause serious liver damage even at doses just above the maximum.

Also, phenylephrine overdose can cause severe hypertension, confusion, and (rarely) seizures or cardiac arrhythmias.

However, take the pack with you so medical staff can see exactly what and how much you have taken.

Are these good for a chesty cough?

No. Firstly, Lemsip Max Day and Night Capsules do not contain an expectorant like guaifenesin. They are not designed for chesty productive cough.

However, Beechams All in One Tablets contain guaifenesin and are a better choice for chesty productive cough.

Why is phenylephrine used instead of pseudoephedrine?

Both are sympathomimetic decongestants. Firstly, phenylephrine is not controlled under the Misuse of Drugs Regulations, so there are no pack size limits.

However, pseudoephedrine is generally stronger as an oral decongestant. Sudafed Decongestant Tablets (pseudoephedrine) may work better if congestion is the dominant symptom.

Do I need a prescription from Courier Pharmacy?

No. Firstly, smaller packs are General Sale List (GSL). Larger packs are Pharmacy medicines (P), sold with pharmacist involvement but without prescription.

Disclaimer

Disclaimer: This information is for education only and isn't a substitute for personal medical advice. Always follow the packaging directions, and ask your pharmacist or GP if you're unsure whether Lemsip Max Day and Night Capsules are suitable for you.

References

Electronic Medicines Compendium (2024) Lemsip Max Day & Night Cold and Flu Relief Capsules (GSL): Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/5642/smpc
Electronic Medicines Compendium (2026) Lemsip Max Day & Night Cold & Flu Relief Capsules (P): Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/5634/smpc
Electronic Medicines Compendium (2024) Lemsip Max Day & Night Cold & Flu Relief Capsules (P): Patient Information Leaflet. Available at: https://www.medicines.org.uk/emc/product/5634/pil
General Pharmaceutical Council (2024) Standards for pharmacy professionals. Available at: https://www.pharmacyregulation.org/standards
Medicines and Healthcare products Regulatory Agency (2024) Yellow Card reporting. Available at: https://yellowcard.mhra.gov.uk/
Medicines and Healthcare products Regulatory Agency (2024) Pseudoephedrine: very rare risk of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS). Drug Safety Update. Available at: https://www.gov.uk/drug-safety-update/pseudoephedrine-very-rare-risk-of-posterior-reversible-encephalopathy-syndrome-pres-and-reversible-cerebral-vasoconstriction-syndrome-rcvs
National Institute for Health and Care Excellence (2023) Common cold. Clinical Knowledge Summary. Available at: https://cks.nice.org.uk/topics/common-cold/
NHS (2024) Common cold. Available at: https://www.nhs.uk/conditions/common-cold/
NHS (2024) Flu. Available at: https://www.nhs.uk/conditions/flu/
NHS (2024) Paracetamol for adults. Available at: https://www.nhs.uk/medicines/paracetamol-for-adults/

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