Metafex 325 mg/200 mg tablets – paracetamol and ibuprofen for mild to moderate pain and fever

Metafex tablets contain two active substances: 325 mg paracetamol and 200 mg ibuprofen. Ibuprofen belongs to the non-steroidal anti-inflammatory drugs (NSAIDs) and relieves pain, reduces swelling and lowers fever, while paracetamol relieves pain and lowers fever by a different mechanism (ATC N02BE51).

The medicine is intended for adults for the temporary relief of mild to moderate pain – headache, toothache, pain after injury or surgery, period pain and back pain – as well as symptoms of colds, flu and fever. It is used for the shortest possible time, no longer than 3 days without medical advice.

What is Metafex used for and how should it be taken?

Key facts about the medicine

What is Metafex used for?

In adults, Metafex is used for the temporary relief of mild to moderate pain in:

• headache,
• toothache,
• pain after injury (post-traumatic pain),
• pain after surgery,
• period pain,
• back pain,
• symptoms of colds, flu and fever.

The combination of two substances with different mechanisms of action is intended for short-term use.

How is Metafex taken and dosed?

The medicine is for oral and short-term use only, at the lowest effective dose and for the shortest possible time.

• Adults: one tablet three times a day with enough water, preferably with food.
• There must be at least 6 hours between two doses.
• If one tablet does not relieve the symptoms, a maximum of two tablets three times a day may be taken.
• Do not take more than 6 tablets in 24 hours (3000 mg paracetamol, 1200 mg ibuprofen).
• Do not take the medicine for more than 3 days; if symptoms worsen or persist, see a doctor.

Taking it with food reduces the likelihood of side effects.

Special patient groups

• Children and adolescents under 18 years: the medicine is not intended for use.
• Older people: talk to a doctor or pharmacist before use.
• Kidney, liver or heart impairment: medical advice is needed; in severe heart, kidney or liver failure the medicine must not be taken.

Contraindications – when the medicine must not be used

• allergy to ibuprofen, paracetamol or any of the excipients;
• taking any other medicine containing paracetamol at the same time;
• taking other painkillers at the same time, including ibuprofen, acetylsalicylic acid at doses above 75 mg daily or other NSAIDs, including selective COX-2 inhibitors;
• allergy to acetylsalicylic acid or other NSAIDs;
• ulcer or bleeding in the stomach or duodenum, now or in the past (especially if caused by NSAIDs);
• a blood clotting disorder;
• severe heart, kidney or liver failure;
• the last trimester of pregnancy.

Warnings and precautions

• Talk to a doctor or pharmacist if you are elderly, have or have had asthma, impaired heart, liver or kidney function or bowel problems, systemic lupus erythematosus or mixed connective tissue disease, previous digestive tract disease or chronic bowel inflammation (ulcerative colitis, Crohn’s disease), if you are in the first 6 months of pregnancy, breastfeeding or planning a pregnancy.
• Ibuprofen may be associated with a slightly increased risk of heart attack or stroke, especially at high doses – do not exceed the dose or duration of treatment; tell your doctor in particular if you have heart disease, a previous heart attack or stroke (including TIA), peripheral arterial disease, high blood pressure, diabetes, high cholesterol, a family history of heart disease, or if you smoke.
• Serious skin reactions associated with NSAIDs have been reported – if you develop a rash, mucosal lesions, blisters or other signs of allergy, stop the medicine and seek help immediately.
• The medicine may mask symptoms of infection (fever, pain) and delay appropriate treatment – this has been seen with bacterial pneumonia and bacterial skin infections related to chickenpox; if symptoms of infection persist or worsen, see a doctor immediately.

Interactions with other medicines, food and drink

You must not take Metafex with other medicines containing paracetamol or with other NSAIDs (e.g. acetylsalicylic acid, ibuprofen).

Special caution is needed with:

• corticosteroids;
• antibiotics (e.g. chloramphenicol, quinolones);
• anti-nausea medicines (e.g. metoclopramide, domperidone);
• cardiac glycosides;
• colestyramine;
• diuretics;
• methotrexate, ciclosporin, tacrolimus;
• lithium and SSRI antidepressants;
• mifepristone;
• zidovudine;
• anticoagulants and antiplatelet medicines (e.g. acetylsalicylic acid, warfarin, ticlopidine);
• blood pressure medicines (ACE inhibitors such as captopril, beta-blockers such as atenolol, angiotensin II antagonists such as losartan).

Talk to a doctor or pharmacist before combining it with any other medicine.

Pregnancy and breast-feeding

• Last three months of pregnancy: the medicine must not be taken.
• First six months of pregnancy: special caution is needed – consult your doctor before use.
• Breastfeeding: ask your doctor for advice before use.
• Fertility: ibuprofen may make it more difficult to conceive; the effect is reversible after stopping. Tell your doctor if you are planning a pregnancy or having difficulty conceiving.

Driving and using machines

• Dizziness, drowsiness, fatigue or visual disturbances may occur with NSAIDs. If you notice them, do not drive or use machines.

Possible side effects

Stop taking the medicine and see a doctor in case of: heartburn and digestive problems; signs of intestinal bleeding (severe abdominal pain, vomiting blood or coffee-ground fluid, blood in the stool, black stool); signs of meningitis (stiff neck, headache, nausea, fever, disorientation); signs of a severe allergic reaction (swelling of the face, tongue or throat, difficulty breathing, worsening asthma); DRESS syndrome (rash, fever, swollen lymph nodes, raised eosinophils).

Common (up to 1 in 10): abdominal pain or discomfort, indigestion, nausea, vomiting, diarrhoea; changes in liver enzymes; increased creatinine and urea; fluid retention; excessive sweating.

Uncommon (up to 1 in 100): headache, dizziness, bloating, constipation, rash, facial swelling; reduced red blood cells, increased platelets; hives and itching; worsening of ulcerative colitis and Crohn’s disease; gastritis; pancreatitis.

Rare: tingling in the hands and feet.

Very rare (up to 1 in 10,000): reduced blood cell counts (sore throat, mouth ulcers, flu-like symptoms, exhaustion, bruising, bleeding); visual disturbance, ringing in the ears, dizziness; confusion, depression, hallucinations; fatigue and weakness; severe blistering skin reactions; high blood pressure; optic nerve inflammation and drowsiness; liver damage (jaundice); kidney damage; heart failure.

Not known: acute generalised exanthematous pustulosis – a red, scaly rash with blisters and fever at the start of treatment; stop the medicine and seek help immediately.

Overdose, missed dose and stopping treatment

• Overdose: if you have taken more than you should, or a child has accidentally taken the medicine, contact a doctor or the nearest healthcare facility immediately, even if you feel well – large doses of paracetamol can cause delayed, serious liver damage. Possible symptoms are nausea, upper abdominal pain, vomiting (including blood), headache, ringing in the ears, confusion and uncontrolled eye movements; at high doses drowsiness, chest pain, palpitations, loss of consciousness, convulsions, blood in the urine and breathing problems.
• Missed dose: take it as soon as possible and the next dose at least 6 hours later; do not take a double dose.
• Stopping use: the medicine is intended for short-term use only; if symptoms last longer than 3 days, see a doctor.

Related information

For additional care and support with headaches, see also the category Headaches, migraines and vertigo – products in this category do not replace the medicine you have been prescribed.

Composition, pack and manufacturer

• Active substances: paracetamol 325 mg and ibuprofen 200 mg per tablet.
• Excipients: pregelatinised starch; microcrystalline cellulose; povidone K29/32; povidone K90; magnesium stearate.
• Appearance: oval, biconvex, white to almost white tablets.
• Pack: PVC/Al blister with 10 tablets; box with 1 blister (10 tablets) or 2 blisters (20 tablets).
• Marketing authorisation holder: Goodwill Pharma d.o.o. Subotica, Matije Gubca 14, Subotica. Manufacturers: Zaklady Farmaceutyczne Polpharma S.A., Starogard Gdanski, Poland; Goodwill Pharma d.o.o. Subotica, Segedinski put 80, Subotica.
• Marketing authorisation numbers: 515-01-00252-21-003 (10 tablets) and 515-01-00253-21-003 (20 tablets), renewal of 09.11.2021.

Storage

• Store below 25 °C in the original package to protect from moisture and light.
• Keep out of the sight and reach of children.
• Shelf life: 3 years; do not use after the expiry date stated on the pack.
• Return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

How many Metafex tablets may I take per day?

Usually one tablet three times a day. If one tablet does not help, a maximum of two tablets three times a day, at least 6 hours apart – in total no more than 6 tablets in 24 hours.

Can I take a flu sachet together with Metafex?

Only if it does not contain paracetamol, ibuprofen or another NSAID. Many cold and flu products contain paracetamol, so using them at the same time could lead to an overdose.

For how many days may I use Metafex?

A maximum of 3 days. If symptoms worsen or do not go away, see a doctor.

Can Metafex be given to children or teenagers?

No. Metafex is not intended for use in children and adolescents under 18 years.

Sources

• ALIMS – Patient information leaflet Metafex 325 mg/200 mg tablets (PIL)
• ALIMS – Summary of product characteristics Metafex 325 mg/200 mg (SmPC)

Date sources were checked: 25.10.2026.