Ambroxol

General characteristics. Structure:

Active ingredient: 0,03 g of Ambroxol of a hydrochloride.

Excipients: Sugar milk (lactose), starch corn, polyvinylpirrolidone (povidone), calcium stearate.

The medicine reducing viscosity of a phlegm and possessing expectorant and mucolytic action.

Pharmacological properties:

Pharmacodynamics. Drug possesses expectorant, mucolytic action. Decrease in viscosity of a phlegm results from a depolymerization of mucopolysaccharides which are in a phlegm. A depolymerization of mucopolysaccharides of a svzan first of all with a rupture of disulfide bridges in their molecules. Ambroxol increases physical activity of a metsatelny epithelium, increases mukotsiliarny transport, normalizes a ratio of serous and mucous components of a phlegm.

Activating the hydrolyzing enzymes and strengthening release of lysosomes from Clark's cells, reduces a phlegm avyazkost. Facilitates removal of a phlegm from respiratory tracts. Ambroxol stimulates prenatal development of lungs by increase in synthesis and secretion of surfactant in alveoluses. Synthesis of surfactant decreases as a result of chronic diseases of respiratory system, besides, properties of an urfaktant because of formation of bonds between surface-active phospholipids and inflammatory proteins change.
 
Pharmacokinetics. After use inside absorption of drug from digestive tract high. Effect of drug is shown within 30 minutes and 6-12 hours keep. Time of achievement of the maximum concentration in blood (Tcmax) — about 2 hours. Linkng with proteins of plasma — 80-90%.

Drug is metabolized in a liver to inactive metabolites (dibromantranilovy acid and glucuronic conjugates). An elimination half-life (T1/2) — 9-10 hours. Gets through gistogematichesky barriers, it is excreted in breast milk. It is removed by kidneys: 90% in the form of metabolites, 10% in an invariable look.

Indications to use:

- The infectious and inflammatory diseases of bronchopulmonary system which are followed by formation of the hardly separated phlegm: acute and chronic bronchitis, tracheitis, chronic obstructive pulmonary disease, pneumonia, bronchial astvma, bronchoectatic disease, mucoviscidosis.
- Treatment and prevention of a respiratory distresssindrom.

Route of administration and doses:

Drug is used inside after food with enough liquid.

Adults and children are more senior than 12 years: 1 tablet of 30 mg 3 times a day during the first 2-3 days, then a dose of drug it is necessary to reduce to 1 tablet 2 times a day.

Children aged from 6 up to 12 years: ½ (15 mg) tablets 2-3 times a day.

It is not recommended to apply without medical appointment more than within 4-5 days.

Features of use:

Ambroxol should be applied with care at patients with the weakened tussive reflex or the broken mukotsiliarny transport because of a possibility of accumulation of a phlegm.

The patients accepting Ambroxol should not recommend performance of respiratory gymnastics; at seriously ill patients it is necessary to carry out aspiration of the liquefied phlegm.

At patients with bronchial asthma Ambroxol can strengthen cough.

It is not necessary to accept Ambroxol just before a dream.

Ambroxol should not be accepted along with antibechic drugs which can brake a tussive reflex, for example, with codeine since it can complicate removal of the liquefied phlegm from a bronchial tree.

Influence on ability to drive the car or other mechanisms. Use of drug does not influence the speed of psychomotor reactions.

Use during pregnancy and a lactation. Drug is not recommended to be used during the I trimester of pregnancy. In need of use of Ambroxol in the II-III trimesters of pregnancy it is necessary to estimate potential advantage for mother with possible risk for a fruit. During breastfeeding to use drug with care as it is excreted in breast milk.

Side effects:

From the alimentary system: nausea, vomiting, a gastralgia, diarrhea, locks, dryness in a mouth.

Allergic reactions: skin rash, a small tortoiseshell, a Quincke's disease, vredky cases — an acute anaphylaxis.

Seldom: weakness, headache, rhinorrhea.

Interaction with other medicines:

At use with antibechic drugs difficulty of an otkhozhdeniye of a phlegm as a result of suppression of a tussive reflex is possible.

At simultaneous use with amoxicillin, tsefuroksimy, erythromycin, doxycycline Ambroxol increases their concentration in a bronchial secret.

Contraindications:

- Hypersensitivity to any component of drug.
- Pregnancy (I trimester).
- Children's age up to 6 years.  

With care. Drug should be used with care at patients with a peptic ulcer of a stomach and duodenum as there can come the aggravation of a peptic ulcer, and also at patients with a renal and liver failure.

Overdose:

Symptoms: nausea, vomiting, gastralgia.

Treatment: artificial vomiting, a gastric lavage in the first 1-2 h after administration of drug, reception of fat-containing products.

Storage conditions:

In the dry, protected from light place at  a temperature not over 25 ºС. To store in the place, unavailable to children! Period of validity 2 years. Not to use drug after a period of validity.

Issue conditions:

Without recipe

Packaging:

Tablets on 30 mg. On 10 tablets in a blister strip packaging. On 20 tablets in banks polymeric. Two blister strip packagings or each can together with the application instruction are placed in a pack from a cardboard.