Milistan for cough

General characteristics. Structure:

Active ingredients: 15 mg of Ambroxol of a hydrochloride, 100 mg of a karbotsistein in 5 ml of syrup.

Excipients: sodium methylhydroxybenzoate (Е 219), sodium пропилгидроксибензоат (E217), solution of glucose of 70%, sorbite (E 420), glyceryl (glycerin), aspartame (Е 951), propylene glycol, dinatrium эдедат, citric acid monohydrate, Natrium benzoicum, sodium hydroxide, dye: Ponceau 4R of Ponso 4R (crimson 4R) (Е 124), the strawberry essence, water purified.

The combined mucolytic means.

Pharmacological properties:

Pharmacodynamics. Ambroxol is an active metabolite of Bromhexine, but more effective. Normalizes patholologically the changed secretion of cells of glands of a mucous membrane of bronchial tubes, promotes fluidifying of a viscous bronchial secret and facilitates its otkhozhdeniye due to increase in mukotsiliarny clearance, changes a ratio of serous and mucous components of a phlegm. Stimulates Clark's cells and activates the hydrolyzing enzymes that also leads to decrease in viscosity of a phlegm. Ambroxol has sekretomotorny properties – stimulates work of a ciliary epithelium of bronchial tubes, recovers drainage function of small bronchial tubes and bronchioles. Drug stimulates formation of endogenous surfactant, does not cause excessive formation of a secret, reduces spastic hyperreactivity of bronchial tubes. Cough and volume of a phlegm considerably decrease.

Karbotsistein has mucolytic and expectorant effect due to activation of sialine transferase – enzyme of scyphoid cells of a mucous membrane of bronchial tubes. Normalizes a quantitative ratio of acid and neutral sialomutsin that promotes reduction of viscosity of a bronchial secret. Facilitates otkhozhdeny phlegms due to increase in mukotsiliarny clearance, has antioxidant and pneumotyre-tread properties that is caused by ability of sulphhydryl groups to connect free radicals.

Pharmacokinetics. After reception Ambroxol is almost completely absorbed in a digestive tract, well gets into tissues of lungs. Absolute bioavailability at oral administration makes 70-80%. The maximum kontsetration in a blood plasma is reached approximately in 2 hours after intake. The elimination half-life makes 7-12 hours. It is removed mainly with urine (to 90%). Gets through a blood-brain barrier into breast milk, does not accumulate.

The maximum concentration of a karbotsistein in a blood plasma and a mucous membrane of respiratory tracts is reached in 1-3 hours and remains in a mucous membrane within 8 hours. It is excreted almost completely in the form of inactive metabolites (inorganic sulfates, a diatsetiltsistin) with urine. Only a small amount is allocated in not changed view with a stake. Can get through a placental barrier and collect in amniotic liquid.

Indications to use:

The acute and chronic respiratory diseases which are followed by formation of the secret which is difficult allocated chronic bronchitis with an obstructive syndrome, pneumonia, bronchial asthma with a heavy otkhozhdeniye of a phlegm, a bronchoectatic disease, a respiratory distress syndrome, treatment of complications after operative measures on lungs at care of a tracheostoma, before and after a bronkhoskopiya. Inflammatory diseases of a middle ear and adnexal bosoms of a nose.

Route of administration and doses:

Children of 7 - 12 years: 5 ml (1 measured spoon) 2-3 times a day; 2-6 years: 2,5 ml (1/2 measured spoons) 2-3 times a day; 1 month - 2 years: 2,5 ml (1/2 measured spoons) 2 times a day.

Features of use:

Use during pregnancy or feeding by a breast. Not to use drug in the I trimester of pregnancy. Use in the II-III trimester of pregnancy is possible only when the estimated advantage for mother exceeds potential risk for a fruit. It is desirable to refrain from use of drug during feeding by a breast, or it is necessary to resolve an issue of the feeding termination by a breast (drug is capable to get into breast milk).

Ability to influence speed of response at control of motor transport or other mechanisms. Drug does not show ability to influence speed of response at control of motor transport or other mechanisms.

Children. Children can use drug, since first month of life.

Side effects:

The general weakness, allergic reactions (an enanthesis, contact dermatitis, it is very rare – a Quincke's disease, an acute anaphylaxis, Stephens-Johnson's syndrome, Layella) can seldom be observed, in rare instances there can be gastrointestinal bleeding. At prolonged use are possible: stomach ache, nausea, vomiting, diarrhea and heartburn, heart consciousness, dizziness, headache.

Interaction with other medicines:

Increases efficiency of glucocorticoid and antibacterial therapy at treatment of inflammatory diseases of upper and lower respiratory tracts. But it is not recommended to apply along with antibiotics of a tetracycline row (except for doxycycline), the interval between their reception has to make not less than 2 hours. Simultaneous use of Ambroxol and a karbotsistein with antibechic medicines, for example, with codeine, is not recommended in connection with difficulty of an otkhozhdeniye of a phlegm at oppression of a tussive reflex and accumulation of a secret in respiratory tracts.

Contraindications:

Hypersensitivity to any component of drug, a round ulcer of a stomach and duodenum, the first trimester of pregnancy, a spasm, a chronic glomerulonephritis in the period of an aggravation. Pregnancy I-trimester.

Appropriate security measures at use. Before use it is necessary to consult with the doctor.

Overdose:

In case of exceeding of a dose nausea and vomiting can be noted. A symptomatic treatment and supporting.

Storage conditions:

To store at a temperature not above 25 °C in original packaging in the place, unavailable to children. Period of validity 2 years.

Issue conditions:

Without recipe

Packaging:

On 100 ml in a plastic bottle together with a measured spoon in a cardboard box.