Actimol Menstrual Tablet

Actimol Menstrual Tablet is an over-the-counter oral tablet from Pharmaniaga, one of Malaysia’s established pharmaceutical manufacturers. Each tablet is a fixed-dose combination of two active ingredients: paracetamol 500 mg and pamabrom 25 mg. Paracetamol belongs to the analgesic and antipyretic class of medicines, while pamabrom is a mild diuretic compound. The tablets are taken by mouth and are supplied in blister strips so that each dose stays sealed until it is needed.

Because this is a combination product, the label carries the standard paracetamol warning: it must not be taken together with any other paracetamol-containing medicine. Many multi-symptom cold, flu and general analgesic products also contain paracetamol, so reading the active-ingredient list on every product in your medicine cabinet is the simplest way to avoid accidental double dosing. Every tablet delivers both ingredients at once, which is why the number of tablets should always follow the pack directions rather than being adjusted by guesswork.

Actimol Menstrual Tablet sits within Pharmaniaga’s Actimol range, which also includes single-ingredient paracetamol tablets, and DoctorOnCall lists it as a 20-tablet pack (please check the product page for the pack sizes currently supplied). It is intended for adults and adolescents aged 12 years and above. As with all OTC medicines, please read the pack label, keep the tablets out of reach of children, and speak to a pharmacist or doctor if you take other medicines, have liver or kidney problems, or are pregnant or breastfeeding.

Swallow the tablets whole with a glass of water. They may be taken with or without food, and food does not change the way the tablets should be used.

• Adults and adolescents aged 12 years and above: take 1 to 2 tablets every 4 to 6 hours as required.
• Leave at least 4 hours between doses, and never take more than 8 tablets in any 24-hour period.
• Use the smallest number of tablets that is needed and for the shortest possible time.
• Do not take any other paracetamol-containing medicine at the same time, and check the labels of cough, cold and flu products first.
• Do not give this product to children under 12 years unless a doctor has specifically advised it.

The recommended dose for adults and adolescents aged 12 years and above is 1 to 2 tablets (paracetamol 500 mg to 1,000 mg with pamabrom 25 mg to 50 mg) every 4 to 6 hours as required.

• Maximum: 8 tablets in 24 hours, which equals paracetamol 4,000 mg and pamabrom 200 mg.
• Missed dose: this is an as-required product, so there is no schedule to catch up on. Simply take the next dose only when it is needed and the minimum 4-hour interval has passed. Never double up.
• Duration: do not keep taking the tablets for more than a few days in a row without medical advice. If symptoms continue or get worse, stop and speak to a doctor or pharmacist.
• Overdose: if too many tablets have been taken, seek emergency medical care immediately even if you feel well, because liver damage from paracetamol may take 1 to 3 days to show.

Store below 30°C in a dry place, protected from moisture and direct sunlight. Keep the tablets in their original blister strip and carton until needed, and keep all medicines out of the sight and reach of children.

• Common: Paracetamol is generally well tolerated at the recommended dose, and side effects are uncommon. Mild stomach discomfort or nausea may occasionally occur.
• Common: Pamabrom is a diuretic, so slightly increased urination may be noticed, and occasional mild dizziness or restlessness can occur in sensitive individuals.
• Uncommon: Skin rash, itching or hives can occur as a sign of sensitivity to the medicine. Stop taking the product and speak to a doctor or pharmacist if a rash develops.
• Serious: Swelling of the face, lips, tongue or throat, wheezing or difficulty breathing may indicate a severe allergic reaction, and needs emergency medical care straight away.
• Serious: Blistering, peeling or widespread red skin rashes, sores in the mouth or around the eyes, or fever with skin symptoms are rare but potentially life-threatening skin reactions that require urgent medical attention.
• Serious: Taking more than the recommended amount can cause liver damage. Warning signs include yellowing of the skin or eyes, dark urine, pale stools, persistent nausea or vomiting and pain in the upper right abdomen, and may not appear for 1 to 3 days after an overdose, so urgent medical help should be sought even if you feel well.
• Serious: Unusual bruising, bleeding, frequent infections or persistent sore throat are very rare signs of blood disorders and should be checked by a doctor promptly.

• Known hypersensitivity (allergy) to paracetamol, pamabrom or any other ingredient in the tablet.
• Anuria (the kidneys not producing urine), because pamabrom has a diuretic action.
• Severe active liver impairment or acute liver disease.
• Children under 12 years of age, unless specifically advised by a doctor.

• Duplicate paracetamol: Do not take this product together with any other medicine that contains paracetamol (also labelled acetaminophen), including many multi-symptom cough, cold and flu products, as combined intake can exceed the safe daily limit and harm the liver.
• Warfarin and other coumarin anticoagulants: Regular, repeated use of paracetamol over several days can enhance the blood-thinning effect and raise the risk of bleeding, so tell your doctor or pharmacist if you are on these medicines.
• Enzyme-inducing medicines: Medicines such as carbamazepine, phenytoin, phenobarbital, primidone and rifampicin can increase the formation of paracetamol’s liver-toxic by-products, so caution and professional advice are needed.
• Absorption-altering medicines: Metoclopramide and domperidone may speed up absorption of paracetamol, while colestyramine may reduce it if taken within about an hour of paracetamol.
• Flucloxacillin: Taking paracetamol together with flucloxacillin, particularly in people with risk factors such as kidney impairment, sepsis or malnutrition, has been linked to a serious blood and body chemistry disturbance called metabolic acidosis, so inform your doctor if you are prescribed this antibiotic.
• Alcohol: Regular or heavy alcohol intake increases the risk of liver injury with paracetamol; avoid drinking alcohol while using this product.
• Food: No significant food interaction is known, and the tablets can be taken with or without food.
• Other diuretics: Pamabrom may add to the effect of other diuretic (water) tablets, which can increase fluid and salt loss, so ask a pharmacist before combining them.
• Lithium: Diuretic ingredients can alter lithium levels in the body, so speak to your doctor before using this product if you take lithium.
• Caffeine and other xanthines: Pamabrom is a xanthine derivative, so very large amounts of coffee, tea or energy drinks may add to restlessness or a fast heartbeat; moderate intake is sensible.

• Check every other medicine you are taking for paracetamol or acetaminophen before swallowing a tablet.
• Note down the time of each dose on your phone so that you can keep to the 4-hour minimum interval and the 8-tablet daily limit.
• Drink a full glass of water with the tablets, and keep up your normal fluid intake because pamabrom is a mild diuretic.
• Keep the tablets in their blister strip until the moment you need them, as loose tablets are easily mixed up or damaged.
• Store the pack somewhere cool, dry and high up, away from children, and not in a hot bathroom or car glove box.
• Bring the carton or take a photo of the label when speaking to a pharmacist or doctor so the exact ingredients and strengths can be checked.

Precautions: Speak to a doctor or pharmacist before use if you have liver disease, kidney disease, a history of regular alcohol use, low body weight, malnutrition or dehydration, because these situations raise the risk of paracetamol-related harm. Pamabrom is a diuretic, so people on fluid or salt restrictions or taking diuretics should seek advice first. Safety data for the combination during pregnancy and breastfeeding is limited, so ask a doctor or pharmacist before taking it in these situations. Older adults may be more sensitive to the diuretic effect and should use the lowest effective number of tablets.

When to See a Doctor or Pharmacist: Stop the tablets and get medical advice if your symptoms last more than a few days, get worse, or return soon after stopping. Seek urgent care for any rash, facial swelling, wheezing, yellowing of the skin or eyes, dark urine or unusual bruising. If more than the recommended amount has been taken, go to the nearest clinic or hospital emergency department immediately, bringing the pack with you, even if you feel completely well.