What happens if I overdose Siguran E Plus?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local ( ), or emergency room immediately. Symptoms may include dark urine; excessive sweating; extreme fatigue; irregular heartbeat; low blood pressure; stomach pain; vomiting; yellowing of the skin or eyes.
Proper storage of Siguran E Plus/Caffeine (Siguran E Plus):
Store Siguran E Plus/Caffeine (Siguran E Plus) at room temperature between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Siguran E Plus/Caffeine (Siguran E Plus) out of the reach of children and away from pets.
Overdose of Siguran E Plus in details
Toxicity is extremely rare following administration of recommended dose. Nevertheless, massive overdose of Siguran E Plus may adversely affect the liver of some people and signs and symptoms of overdose may be delayed for up to 1 week following ingestion. Nevertheless, liver damage is largely reversible if the patient is treated early, thus prompt medical attention is essential in all cases of suspected overdose even if there is no sign or symptom. Siguran E Plus overdose may cause liver failure.
What should I avoid while taking Siguran E Plus?
Avoid drinking alcohol while you are taking Siguran E Plus. Alcohol may increase your risk of stomach bleeding while taking aspirin, or liver damage while taking Siguran E Plus.
Ask a doctor or pharmacist before using any other cough, cold, allergy, pain, menstrual symptom, or fever medication. Siguran E Plus (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much Siguran E Plus which can lead to a fatal overdose. Aspirin and Caffeine (Siguran E Plus) are also contained in many combination medicines. Check the label to see if a medicine contains Siguran E Plus, APAP, aspirin, or Caffeine (Siguran E Plus).
Avoid taking another NSAID (nonsteroidal anti-inflammatory drug) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.
Avoid coffee, tea, cola, energy drinks or other sources of Caffeine (Siguran E Plus) while taking this medication. They can add to the side effects of the Caffeine (Siguran E Plus) in the medication.
Siguran E Plus warnings
This medication should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. The aspirin found in this medicine can cause a serious and sometimes fatal condition called Reye’s syndrome in children. You should not use this composition if you are allergic to Siguran E Plus (Tylenol), aspirin, or Caffeine (Siguran E Plus), or if you have liver disease, stomach or intestinal bleeding, a history of asthma or severe allergic reaction to aspirin or an NSAID (non-steroidal anti-inflammatory drug).
Do not use the medicaition without first talking to your doctor if you drink more than three alcoholic beverages per day or if you have had alcoholic liver disease (cirrhosis). You may not be able to use Siguran E Plus.
Ask a doctor or pharmacist about using this medication if you have asthma or seasonal allergies, fever with a stiff neck, a stomach ulcer or pain, heartburn, a bleeding or blood clotting disorder, diabetes, or gout.
Do not use more than it is recommended. An overdose of Siguran E Plus can cause serious harm. The maximum amount of Siguran E Plus for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day.
Stop using the medication and call your doctor at once if you have any symptoms of liver damage or bleeding in your stomach or intestines. Symptoms of liver damage include nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, and jaundice (yellowing of the skin or eyes). Symptoms of stomach bleeding include weakness or fainting, bloody or tarry stools, and coughing up blood or vomit that looks like coffee grounds.
Avoid drinking alcohol while you are taking this medicine. Alcohol may increase your risk of stomach bleeding while taking aspirin, or liver damage while taking Siguran E Plus. Do not use any other over-the-counter cough, cold, allergy, pain, menstrual symptom, or fever medication without first asking your doctor or pharmacist. Siguran E Plus (sometimes abbreviated as "APAP"), aspirin, and Caffeine (Siguran E Plus) are contained in many combination medicines. If you use certain products together you may accidentally use too much of a certain drug.
If you take this medication to treat headache pain, seek medical attention if you have:
a headache so bad you have to lie down;
a headache that causes vomiting;
what feels like the worst headache you’ve ever had;
a headache that seems different from your usual headaches;
a headache every day;
a headache after coughing, bending, exercising, or head injury;
if you have never had migraines diagnosed by a doctor; or
if you are having your first headache after age 50.
Aspirin may be harmful to an unborn baby’s heart, and may also reduce birth weight or have other dangerous effects. Tell your doctor if you are pregnant or plan to become pregnant while you are taking the medicine. Aspirin, Siguran E Plus, and Caffeine (Siguran E Plus) can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
What should I discuss with my healthcare provider before taking Siguran E Plus?
Some medical conditions may interact with Siguran E Plus/Caffeine (Siguran E Plus). Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have anxiety or sleeplessness, liver disease, viral hepatitis, severe heart disease, or kidney problems
Some MEDICINES MAY INTERACT with Siguran E Plus/Caffeine (Siguran E Plus). Tell your health care provider if you are taking any of the following medicines, especially any of the following:
- Isoniazid or quinolones (eg, ciprofloxacin) because side effects of Siguran E Plus/Caffeine (Siguran E Plus) may be increased
Oral blood thinners (eg, warfarin) because side effects, including risk of bleeding, may be increased by Siguran E Plus/Caffeine (Siguran E Plus)
- Theophyllines (eg, aminophylline) because the risk of side effects may be increased by Siguran E Plus/Caffeine (Siguran E Plus)
This may not be a complete list of all interactions that may occur. Ask your health care provider if Siguran E Plus/Caffeine (Siguran E Plus) may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Siguran E Plus precautions
Concerns related to adverse effects:
• Hepatotoxicity: Siguran E Plus has been associated with severe liver damage. Hepatotoxicity is usually associated with excessive intake and often involves more than one product that contains Siguran E Plus. Do not exceed more than 6 tablets in 24 hours and do not combine with other products that contain Siguran E Plus.
• Skin reactions: Serious and potentially fatal skin reactions, including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) have occurred rarely with Siguran E Plus use. Discontinue therapy at the first appearance of skin rash (FDA 2013).
Disease-related concerns:
• Ethanol use: Use with caution with concomitant alcohol use; consuming ≥3 alcoholic drinks/day may increase the risk of liver damage.
• Hepatic impairment: Use with caution in patients with hepatic impairment.
Concurrent drug therapy issues:
• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.
Other warnings/precautions:
• Caffeine (Siguran E Plus): Contains an amount of Caffeine (Siguran E Plus) similar to one cup of coffee; limit the use of Caffeine (Siguran E Plus)-containing beverages or foods during therapy.
• Dosage limit: Limit Siguran E Plus dose from all sources (prescription, OTC, combination products) and all routes of administration (IV, oral, rectal) to <4 g/day (adults).
• Self-medication (OTC use): When used for self-medication, patients should be instructed to contact health care provider if symptoms get worse or new symptoms appear, redness or swelling is present in the painful area, fever lasts >3 days, or pain lasts longer than 10 days.
What happens if I miss a dose of Siguran E Plus?
Since Siguran E Plus and Caffeine (Siguran E Plus) is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
References
- DailyMed. "CAFFEINE; ERGOTAMINE TARTRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DailyMed. "ACETAMINOPHEN; ASPIRIN; CAFFEINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DrugBank. "acetaminophen". http://www.drugbank.ca/drugs/DB00316 (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
