This is a medicine; Consult your doctor or pharmacist if you have an underlying medical condition, are taking any other medication or complementary therapy, or if symptoms persist. A mixed respiratory alkalosis and metabolic acidosis with normal or high arterial pH (normal or reduced hydrogen ion concentration) is usual in adults and children over the age of four years. In children aged four years or less, a dominant metabolic acidosis with low arterial pH (raised hydrogen ion concentration) is common. Acidosis may increase salicylate transfer across the blood brain barrier. There is a possible association between aspirin and Reye's syndrome when given to children. Reye's syndrome is a very rare disease, which affects the brain and liver, and can be fatal. For this reason aspirin should not be given to children aged under 16 years unless specifically indicated (e.g. Kawasaki's disease).

Part II CLAUSE 10 B of the Drug Tariff ‘Drugs and Chemical Reagents in Special Containers’ states the following:There is a possible association between aspirin and Reyes syndrome when given to children. Reyessyndrome is a very rare disease, which can be fatal.For this reason aspirin should not be given tochildren under 16 years, unless on the advice of adoctor. Alka-Seltzer XS contains paracetamol and so other paracetamol-containing preparations should be avoided. The maximum dose of paracetamol for adults is 4g daily. Do not exceed the recommended dose. If symptoms persist consult your doctor. Keep out of the reach of children. Do not take Alka-Seltzer XS for more than 3 days in a row. If symptoms persist, speak to your doctor orpharmacist. Due to its inhibitory effect on platelet aggregation aspirin may cause increased bleeding during and after surgery.

The Alka-Seltzer Plus products subject to the recall are intended to temporarily relieve symptoms associated with cold and flu, such as cough, congestion, fever and/or mucus. Colestipol (Colestid®) orange and plain 5g granule sachets – both preparations have been discontinued. Other bile-acid sequestrants remain available and can support the uplift in demand. Acetylsalicylic acid has the ability to alter platelet function and, therefore, there may be a risk of haemorrhage in infants whose mothers have consumed acetylsalicylic acid during pregnancy. The onset of labour may be delayed and the duration increased, with an increase in maternal blood loss. Therefore, analgesic doses should be avoided during the last trimester of pregnancy. If you experience any of the following side effects, stop taking Alka-Seltzer XS and go to your nearest Accident and Emergency Department or doctor immediately: If you experience any of the following side effects, stop taking Alka-Seltzer XS and go to your nearestAccident and Emergency Department or doctorimmediately:

Symptoms of paracetamol overdosage in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, hepatic failure may progress to encephalopathy, coma and death. Acute renal failure with acute tubular necrosis may develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have been reported. Common features include vomiting, dehydration, tinnitus, vertigo, deafness, sweating, warm extremities with bounding pulses, increased respiratory rate and hyperventilation. Some degree of acid-base disturbance is present in most cases. Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.