Wednesday, March 27, 2019

Ambroxol

Description overdue on 11/11/2014

  • Latin name: Ambroxol
  • ATC code: R05CB06
  • Active substance: Ambroxol (Ambroxol)
  • Manufacturer: Borschagovsky CPP, FC "Health" FF "Darnitsa", LLC "Stirolbiopharm", JSC "ALSI Pharma" UAB Kanonfarma production, EKOlab, Ltd. "Rozfarm", Russia
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  • Composition
  • Product form
  • Pharmacological action
  • Pharmacodynamics and pharmacokinetics
  • Indications for use: what pills and what Ambroxol Ambroxol in the form of a syrup
  • Contraindications
  • Side effects
  • Instructions for use Ambroxol
  • Overdose
  • Cooperation
  • Terms of sale
  • Storage conditions
  • Shelf life
  • Cautions
  • Analogs
  • Ambroxol for children
  • During pregnancy (and lactation)
  • Reviews
  • Price, where to buy

 Ambroxol

Composition

AT tablets Ambroxol   contains 30 mg ambroxol hydrochloride   (Ambroxol hydrochloride) as active ingredient and excipient substances: lactose monohydrate   (Lactose monohydrate), corn starch   (Amylum maidis), microcrystalline cellulose   (Cellulose microcristallic), magnesium stearate   (Magnesium stearate), silica   (Silicii dioxydum).

The structure 5 ml Ambroxol syrup   includes 15 mg ambroxol hydrochloride   (Ambroxol hydrochloride) and a number of other ingredients: sodium benzoate (E211, Sodium benzoate), Propylene Glycol (Propylene glycol), glycerin (Glycerinum), saccharin sodium (Saccharin sodium), sorbitol (E420; Sorbitol), hydroxyethyl cellulose (Hydroxyethylcellulose), citric acid monohydrate (Citric acid monohydrate), flavors (apricot, raspberry, orange), menthol (Mentholum), purified water (Aquae purificati).

Product form

Ambroxol is available in the form of:

  • tablets (effervescent and for sucking), lozenges, syrup, inhalant solution;
  • solutions for injection, infusion or oral application;
  • hard capsules, retard, concentrate for solution for infusion.

Pharmacological action

The drug belongs to the group mucolytic drugs   and used as expectorant   diseases affecting respiratory tract .

It stimulates respiratory tract motor function   and has expressed secretolytic   and expectorant action .


It stimulates the production Sputum   ( tracheobronchial secretions ) Reduced viscosity due to changes in the structure mucopolysaccharides sputum   and increases the production of glycoproteins   (thus rendering mukokineticheskoe action ).

While taking Ambroxol increases motor activity cilia of ciliated epithelial tissue   and improved transport pathogenic agents mucociliary system .

An important property of the drug - is its ability to increase the number of pulmonary surfactant   ( antiatelekticheskogo factor ), Supported by which the surface tension uniformity configuration, volume and performance in lung.

In addition, due to the collapse of ambroxol is blocked Surfactant   amplified and its synthesis and secretion in large alveolar cells   ( type II alveolar pneumocytes ) Which are involved in the transport of liquids through the alveolar-capillary system .

A feature of the means is that by reducing the viscosity of sputum, it practically does not cause the increase of its volume, and thus does not cause the adverse effects that develop in patients receiving drugs expectorants.
The deflocculating effect on phlegm   provided by destroying the integrity of the disulfide bonds of acid mucopolysaccharides sputum and gel.

According to the JECFA (the National Classification of products) Ambroxol code - 24.42.13.723.

Pharmacodynamics and pharmacokinetics

Ambroxol promotes normalization functions located in bronchial mucosa serous and mucosal glands , Reduces the amount of cystic cavities in the mucosa   and stimulates serous component Without provoking it bronchial obstruction .

Studies show that after treatment in patients with bronchial obstruction   significantly improved lung ventilation function and reduced symptoms of hypoxemia.

There are also data to suggest a drug's ability to provide immunomodulatory effects He strengthens local immunity   due to the activation of tissue mononuclear phagocytes   and increase the production secretory immunoglobulin IgA class .

Ambroxol suppresses production mononuclear phagocytes TNF and interleukin 1 Which are mediators of inflammation and enhances the natural defenses of light by increasing the activity macrophages .

And proved that Ambroxol is capable of providing decongestant   and anti-inflammatory Effectively relieves symptoms exacerbated chronic bronchitis   and prevents the development of Idiopathic pulmonary fibrosis .

Some authors have reported that in in vitro models Ambroxol is capable to suppress neutrophil chemotaxis .

Ambroxol is quickly and fully absorbed by any of the introduction, a well penetrating the lung tissue. Outside the plasma concentration of the compound reaches a maximum within two hours of ingestion per os.

The process takes place in the biotransformation liver . Products metabolism   are glucuronide   and dibromantranilovaya acid .

About 90% is excreted in the urine in the form water-soluble metabolites ; excreted unchanged in the order of 5%.

T1 / 2 - from 10 to 12 hours. It is increased in patients with severe renal failure But remains unchanged in patients with impaired liver function .

Indications for use: what pills and what Ambroxol Ambroxol in the form of a syrup

Diseases:
  •  Ambroxol  Rhinitis
  •  Ambroxol  Pharyngitis
  •  Ambroxol  Laryngitis
  •  Ambroxol  Pneumonia
  •  Ambroxol  Bronchial asthma

It is known that the performance of viscosity and elasticity of sputum adhesiveness determine how easy it is separated and expectorated.

Therefore mucolytic drugs   particularly useful in diseases Respiratory system , States that are accompanied by the formation and accumulation in bronchi and lungs   viscous, poorly separated mucous or mucous-purulent sputum .

Indications for use of ambroxol are:

  • obstructive bronchitis   (acute and chronic forms);
  • pneumonia ;
  • tracheitis ;
  • constrictive bronchiolitis ;
  • laryngitis ;
  • rhinitis ;
  • cystic fibrosis ;
  • bronchial asthma ;
  • pharyngitis ;
  • atelectasis Which developed as a result mucoid bronchial obstruction In patients with established   tracheostomy tube   and etc.;
  • respiratory distress syndrome   (shock lung) in adults;
  • respiratory distress syndrome   (SDR) in newborn babies (including children born prematurely) and other related diseases violation of bronchial secretions   and accompanied by increased production of viscous mucus.

Contraindications

The drug is not used to treat patients with hypersensitive   to one or more of its member components, as well as women in the first 13 weeks of pregnancy.

Ambroxol tablets are contraindicated in patients who have diagnosed stomach ulcer and 12 tiperstnoj intestines   (preparation can influence the clinical picture of these diseases) and in the case of epilepsy syndrome   different nature.

An additional contraindication for syrup is hereditary fructose intolerance.

Ambroxol is contraindicated in dry cough Which is usually accompanied by influenza and other acute respiratory viral infections .

Side effects

Adverse reactions associated with taking Ambroxol, are rare. The drug is non-toxic and well tolerated by patients.

In some cases, the body may respond to treatment dyspeptic symptoms . skin rash . angioedema . allergic reactions , General weakness, headache .

Reported as isolated cases of severe skin lesions ( Lyell's disease   or disease, Stevens-Johnson ). Most likely, they are explained by severe illness or reaction to a specific organism for simultaneous reception of multiple drugs.

Instructions for use Ambroxol

Tablets Ambroksol: instructions for use

Ambroxol hydrochloride tablets intended for oral administration. To wash down should be a small amount of liquid.

The recommended dose for adults and children over the age of twelve - 30 mg (one tablet). Multiplicity of reception - 2 (if necessary, be allowed to take the drug three times a day).

In the case of aggravation of chronic disease dose Ambroxol tablets increased by half (60 mg). Multiplicity of reception - 2 times a day.

Cough tablets used for the treatment of children over the age of six. The therapeutic dose for children from six to twelve years - 1, 2 to 1, 6 mg / kg / day in 3 divided doses.

Duration of treatment is determined individually depending on the severity of the disease and the response of the patient to therapy. Usually, it is 10 to 14 days.

Syrup Ambroxol: instructions for use

All categories of patients over the age of twelve during the first 2-3 days of the disease the recommended dose is 10 ml (the equivalent of two teaspoons). Further treatment should be continued, taking the syrup 3 times / day. 5 ml (the volume equivalent to one teaspoon).

Syrup for children dosed depending on the age of the child. For children aged five to twelve years is recommended to take 2 times a day for 5 ml of the syrup (30 mg of active ingredient per day). If needed dosing frequency is increased to three (the daily dose of ambroxol is in this case 45 mg).

Children aged two to six years to designate take 2.5 ml syrup 3 times / day; children under two years of age - 2.5 ml of syrup 2 times / day. This is equivalent to, respectively, 22, 5 and 15 mg of active ingredient per day.

If the patient shows the long-term treatment, the dose permitted halved.

Instructions on Ambroksol: Abroksola dosing regimen for inhalation, as well as a solution for injection and infusion

Adult patients prescribed holding one or two inhalations per day with 3 ml of solution for inhalation; children over 5 years of age is recommended to do one inhalation per day with 2 ml solution (equivalent to 15 mg of active substance).

If the drug is administered in the form of a solution for injection, the optimal dose for an adult patient is 30 to 60 mg / day .. divide it into three doses. The maximum single dose - 30 mg.

Typically, the solution was injected into the vein or muscle, although acceptable, and subcutaneous administration. At shock lung syndrome   ambroxol dose - 10 mg / kg / day .. entering drug should be 3 or 4 times a day. Where appropriate, the daily dose increased to 30 mg / kg. Enter it for 3-4 hours.

Overdose

Symptoms of overdose of ambroxol is usually manifested in the form of attacks nausea . vomiting . stomach upset . dyspepsia .

To eliminate them in the first hour or two after taking the drug need to artificially induce the patient vomiting   and make it gastric lavage . In the future, it is recommended to enter into the diet of meals containing fat.

Cooperation

Use of Ambroxol in combination with antibiotics   contributes to the concentration of the active substance in the last bronchial mucosa and lung alveoli , Which in turn improves the clinical situation in bacterial infections of the lungs .

The combination of the drug with antibiotics   It has an advantage over using only antibiotic Even in cases where it is proven effective antibacterial medicament .

Ambroxol enhances the action Ampicillin   (Ampicillinum), Amoxicillin   (Amoxicillin), as well Theophylline   (Theophyllinum) and contributes to their better penetration in bronchial secretion .

Not identified antagonistic drug interactions with dirueticheskimi means   and cardiac glycosides .

Use of ambroxol with drugs that suppress cough reflex Significantly complicates the discharge of Sputum   against the backdrop of decreasing intensity Cough .

The product is compatible with the tools that are used to slow labor.

Terms of sale

To purchase a prescription drug in Latin is required.

Storage conditions

The optimal temperature for storage of the drug - not above + 25 ° C. Keep away from children.

Shelf life

36 months.

Cautions

At reception mucolytics it is desirable to more often than usual, and drink more warm liquid: weak tea, juice or compote.

Patients diagnosed with bronchial asthma Avoid unspecific irritation respiratory tract   and his spasm   procedure before inhalation using Ambroxol encouraged to bronchodilator .

Analogs

Match code ATC 4th level:
  •  Ambroxol  Fluifort
  •  Ambroxol  Flavamed
  •  Ambroxol  Ambrogeksal
  •  Ambroxol  Fluimucil
  •  Ambroxol  ACC
  •  Ambroxol  Atsistein
  •  Ambroxol  Mucosolvan
  •  Ambroxol  Bromhexine

Analogs Ambroxol - a drug Ambrobene . Ambrogeksal . Ambroxol-Vial . Ambroxol-Health . Ambroxol-Vishfa . Ambroxol-Darnitsa . Mucosolvan . Flavamed . Bronhoksol . Neo-bronchodilator . Haliksol . Maddox   and etc..

Is it better or Ambroxol Bromhexine? From what these pills?

The active ingredient Ambroxol - it the active metabolite of bromhexine hydrochloride   (substance is a synthetic analogue alkaloid vasicine ). At the same therapeutic efficacy Ambroxol is much higher than that of its predecessor.

In addition, the Ambroksol better tolerated by patients, has virtually no contraindications (assuming it is possible even to infants and pregnant women), and the side effects on the background of its application is extremely rare.

Ambroxol for children

The most common childhood diseases - is bronchus and lung diseases Which is usually accompanied by stagnation of phlegm in the bronchi . Timely excretion of mucus   It is a prerequisite for proper operation respiratory system As well as the key to their recovery from illness.

Ambroxol syrup for children is one of the newest developments in the field of pharmacy. Like other dosage forms Ambroxol, the drug has established itself as an effective means for the discharge of Sputum So pediatricians recommend it to treat even very young patients.

The dose and dosage form of the drug to children is selected depending on the age (the dose ranges from 15 mg to 45 mg per day).

Ambroxol during pregnancy

At pregnancy   The drug is not only in the I trimester. In the second and third trimesters allowed him to appoint, taking into account the benefits for the expectant mother and the potential risk to the developing fetus.

On the forums, many are wondering why doctors recommend just that the drug during pregnancy. There is evidence that in cases where a woman takes the tablet or syrup during pregnancy , The fetus is stimulated the synthesis of pulmonary surfactant .

Interesting results have been observed when using the drug in the treatment of disorders Respiratory system   from unborn children. Ability of the well to pass through the placental barrier can be used in cases where the child, for whatever reason, begins to accumulate mucus in the bronchi or lungs .

If necessary during treatment with breast-feeding   should decide on the termination of the latter, as the active ingredient Ambroxol is excreted in the milk.

Reviews ambroksol

Preparation Ambroxol - this is a very popular tool that allows you to effectively treat respiratory diseases . It normalizes the cilia of the bronchi , Dilutes slime and activates its removal.

Application solution for inhalation, injection, syrup or tablets Ambroxol - the reviews are proof of that - enhances the formation of an agent which clears mucus from the bronchi and lungs, as well as extend its validity.

Reviews of Ambroxol syrup indicate that the drug almost no flaws. It effectively eliminates the unpleasant symptoms of the disease, reduces inflammation and stimulates synthesis immunoglobulin That in turn contributes to the strengthening of local immunity.

Another advantage of the drug is its price - and pills and syrup for children are categorized as low-cost medicines.

Price Ambroxol

The average price in the form of tablets Ambroxol in Ukraine is 3, 8 USD. Price Ambroxol syrup - from 11 to 75 UAH (depending on the manufacturer). Cost solution for inhalation, and oral administration also varies depending on whether it produces pharmaceutical company.

The average price of tablets Ambroxol in Russia - 20 rubles, syrup for children can be purchased at an average of 30-50 rubles per bottle.

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