The article will present instructions for use with Ambroxol tablets.
They are a mucolytic drug with an expectorant effect. Thanks to him, sputum transportation is enhanced. To a small extent, cough suppresses. Available in the form of tablets, in one blister pack of ten tablets, in a cardboard box - two packs.
Pharmacological effect
"Ambroxol" is an expectorant and mucolytic agent, which is an active N-demethylated bromhexine metabolism. It has not only expectorant, but also secretolitic and secretomotor influence. It stimulates the serous cells of the glands of the bronchial mucous membrane, increasing the amount of mucous secretion and thus changing the disturbed proportion of the mucous and serous components of sputum. At the same time, hydrolyzing enzymes are activated, as well as an increase in the release of lysosomes from Clara cells, and this leads to a decrease in the viscosity of sputum. The drug "Ambroxol" contributes to an increase in lung content of endogenous surfactant associated with increased secretion and synthesis in alveolar pneumocytes and defects in its decay. Surfactant is a surface-active component that provides glide secretion of the bronchi in the lumen of the respiratory system.
Thanks to Ambroxol, the content of the serous component in the secretion of the bronchi increases, its structure improves and the viscosity of sputum decreases, it liquefies; as a result, mucociliary transport is improved, sputum is more easily excreted from the bronchial tree. After using Ambroxol, the effect on average occurs after half an hour and lasts from six to twelve hours, which is determined by a single dosage.
Pharmacokinetics
In accordance with the instructions for use with tablets, Ambroxol, when ingested, is absorbed rapidly and almost completely. The maximum time is from one to three hours. It binds to plasma proteins by approximately 85%. It passes through the placental barrier and is excreted along with breast milk. The drug is metabolized in the liver, metabolites are formed (glucuronic conjugates, dibromanthranilic acid), excreted mainly by the kidneys (90% in the form of metabolites), unchanged - less than ten percent.
Due to the high binding to proteins, as well as the large value of V d and the reverse slow penetration into the blood from tissues, during forced diuresis or dialysis, there is no significant excretion of ambroxol. The clearance of the latter in patients with severe liver failure is reduced by 20-40%. The metabolite time increases with severe renal failure.
In what cases do adults use Ambroxol tablets according to the instructions for use?
When applied
Ambroxol tablets are used for respiratory diseases when viscous sputum is released:
- chronic and acute form of bronchitis;
- chronic obstructive pulmonary disease;
- bronchiectatic disease;
- bronchial asthma, in which sputum discharge is difficult.
Contraindications
According to the instructions for use, Ambroxol tablets are contraindicated in:
- excessive sensitivity of the patient to any of the substances of the drug;
- first trimester of pregnancy;
- liver and / or kidney failure;
- rare genetic diseases caused by intolerance to any of the auxiliary components that make up the drug.
With caution, it can be used by patients during pregnancy (second and third trimester) and breastfeeding, as well as those people who suffer from peptic ulcer of the duodenum and stomach. This is confirmed by the instructions for use with Ambroxol 30 mg tablets.
Pregnancy and lactation
Seriously controlled and adequate studies regarding the safety of the drug during pregnancy and breastfeeding have not been conducted. The drug overcomes the placental barrier. When animal studies were performed, there was no direct or indirect negative effect on pregnancy, fetal or postnatal development of the fetus. Extensive clinical experience has confirmed the absence of any symptoms of adverse effects after the 28th week of gestation. However, the simple precautions common to any medication during pregnancy must be followed.
Means "Ambroxol" is undesirable to take in the first trimester of bearing a child. It also passes into breast milk, and although an adverse effect of the drug on the baby is not expected, it is not recommended for women during breastfeeding.
Instructions for use with Ambroxol tablets allow children to give them.
The use of the drug and dosage features
"Ambroxol" is taken after a meal and washed down with liquid. Children from twelve years of age and adults: one tablet three times a day (30 mg). This dosage can be reduced after 8-10 days - twice a day with one Ambroxol tablet.
According to the instructions for use for children 3 years of age, the drug is given in the form of a syrup, 7.5 mg of the active substance. This corresponds to 1 ml of oral solution, half a measuring spoon of syrup containing 15 mg / 5 ml of Ambroxol, or 1/4 measuring spoon of syrup with a higher concentration (30 mg / 5 ml).
Children from six to twelve years: half a tablet 2-3 times a day (15 mg). The duration of treatment is individually determined by the doctor, it depends on the severity of the disease. If one or two doses of the drug are missed, then it is not allowed to take a larger dose next time. The missed dose should be taken the next day. If the dosage regimen is not respected, then a decrease in the effectiveness of therapy may be observed.
Side effect
According to the instructions for use and reviews of Ambroxol tablets, side effects can be observed from the gastrointestinal tract: in rare cases, dry mouth, diarrhea, constipation; if the drug is used for a long time and in large doses, vomiting, nausea, gastralgia and heartburn occur.
Allergic reactions: rash on the skin, angioedema, urticaria, itching; individual cases - contact allergic dermatitis, isolated manifestations of anaphylactic reactions of the patient.
Other side effects: rarely - headache and weakness. If these negative reactions appear, as well as adverse symptoms that are not described in the instructions, you should contact your doctor.
Overdose
According to the instructions for use with Ambroxol tablets, overdose symptoms include the following: dyspepsia, vomiting, nausea and diarrhea. Therapy is carried out by washing the stomach for one to two hours after taking the medicine, inducing vomiting artificially, using products containing fat, as well as symptomatic treatment.
Features of interaction with other drugs
Concomitant use with antitussive drugs causes difficulty in sputum discharge while reducing manifestations of cough. Helps increase the penetration into the secret of the bronchi of doxycycline, erythromycin, cefuroxime and amoxicillin.
What else does the instructions for use for Ambroxol cough tablets tell us?
Precautionary measures
It is not recommended to simultaneously use it with antitussive drugs, which make it difficult to discharge sputum. Several cases of serious skin damage have been documented, including Stevens-Johnson syndrome and epidermal toxic necrolysis associated with the use of the expectorant Ambroxol. These cases can be explained most often by the severity of concomitant pathologies or by the simultaneous use of other drugs.
In addition, in the early stages of epidermal toxic necrolysis and Stevens-Johnson syndrome, people may show symptoms of a non-specific disease that resembles the flu: body pain, fever, cough, rhinitis and sore throat. If these signs appear, then this may cause unnecessary treatment with cold remedies. That is why, in the event of various injuries of the mucous membrane or skin, it is necessary to consult a specialist, and therapy should be stopped for caution. This is confirmed by the instructions for use with Ambroxol Hydrochloride tablets.
If the functioning of the kidneys is impaired, then the medication should be taken only after a conversation with the doctor.
The drug contains lactose, and therefore it should not be consumed by those patients who have rare galactose intolerance from birth, Lapp lactase deficiency or poor digestibility of glucose-galactose.
Ambroxol: analogues
The drug "Ambroxol" has the following analogues in the main active ingredient: "AmbroHEXAL", "Halixol", "Ambrobene", "Flavamed", "Ambroxol Vramed", "Fervex", "Ambroxol retard", "Suprim-coffee", "Ambroxol -Werte ”,“ Remebrox ”,“ Ambroxol-Vial ”,“ Neo-Bronchol ”,“ Ambroxol-Richter ”,“ Mukobron ”,“ Ambroxol-Teva ”,“ Medox ”,“ Bronchorus ”,“ Ambroxol-Hemofarm ”, “Lazolvan”, “Ambrolan”, “Lazolangin”, “Bronchoxol”, “Ambrosan”, “Bronchovern” (drops), “Ambrosol”, “Deflegmin”.
Reviews about the drug
Reviews on the use of Ambroxol are mostly positive. Among its advantages are noted affordability, excellent elimination of sputum, good quality, effectiveness. It is an analogue of expensive imported drugs. Many patients consider Ambroxol to be the best drug to prevent expectorant cough. Tablets do not cause allergic reactions, not harmful, there are no significant contraindications. It removes sputum well and quickly, helps to soften cough, both wet and dry. The effect is observed after 3-4 days.
Among the shortcomings, there is a frequent lack of the drug in a prominent place in pharmacies. In some cases, it still turns out to be ineffective, however, there are much fewer negative reviews than positive ones.
We examined 30 mg tablets for Ambroxol tablets.