Tos-Mai

General characteristics. Structure:

Active ingredients: 1 tablet contains dextromethorphan of hydrobromide 2 mg, benzocaine of 0,2 mg, a guayakolsulfonat of potassium of 35 mg, sodium benzoate of 15 mg; excipients: mannitol (E421), povidone, talc, magnesium stearate, essence anisic, menthol, sodium saccharin.

Pharmacological properties:

The combined drug rendering antibechic, mucolytic, expectorant, mestnoanesteziruyushchy action thanks to what reduces painful feelings and feeling of irritation in a throat. Effect of drug is caused by pharmacological properties of the components which are its part.

Dextromethorphan — the antibechic which is levorphanol D-stereoizomerom. On the action mechanism dextromethorphan — the antagonist of NMDA receptors of a myelencephalon, influences the central link of a tussive reflex, the dry unproductive cough connected with irritation of a mucous membrane of respiratory tracts at catarrhal diseases as a result decreases. Also impact of a dektrometorfan on a peripheral link of a tussive reflex by suppression of the impulses arriving from a mucous membrane of upper respiratory tracts is noted. On expressiveness of antibechic action dextromethorphan is close to codeine, however, unlike it, does not cause dependence, the respiratory center and activity of a ciliate epithelium of respiratory tracts does not oppress, has no analgetic action.

Benzocaine — the highly active superficial mestnoanestiziruyushchy means derivative of paraaminobenzoic acid. Has no resorptive effect. The mechanism of action is connected with reduction of ion permeability of nerve terminations. As a part of the combined drugs reduces painful feelings and feeling of irritation in a throat.

Guayakolsulfonat of potassium treats expectorants. Promotes reduction of viscosity of bronchial slime, depolimerizirut mucopolysaccharides and increases activity of cilia of a ciliary epithelium of respiratory tracts. Reduces surface intention and adhesive properties of a phlegm, reduces its viscosity and facilitates evacuation from respiratory tracts, transforming unproductive cough to productive. Has weak antiseptic and anesthetic effect.

Sodium benzoate belongs to expectorants of direct action. At intake increases secretion of bronchial glands, liquefies a phlegm and facilitates its evacuation from respiratory tracts. Has slight antibacterial and antifungal properties.

After use inside dextromethorphan is quickly soaked up in digestive tract, has high bioavailability. Antibechic the effect develops in 15-30 minutes after its intake and 5-6 hours last. The maximum concentration in blood is reached in 2 hours. It is actively metabolized in a liver by N-and O-demethylation. The elimination half-life makes 6,5 hours. It is excreted preferential by kidneys in the form of metabolites, and only a small amount is removed in not changed look. Guayakolsulfonat of potassium is quickly absorbed from digestive tract. After oral administration the maximum concentration is reached in 1-2 hours. Therapeutic concentration remains about 6 hours. The elimination half-life makes 1-2 hours. It is excreted with a phlegm and removed by kidneys in the form of metabolites and in not changed look.

Indications to use:

Symptomatic treatment of dry irritable cough at acute respiratory viral infections and infectious and inflammatory diseases of upper and lower respiratory tracts. When training patients for carrying out a bronkhoskopiya.

Route of administration and doses:

To children 12 years are more senior and the adult usually apply 1-2 tablets of 4-6 times a day (at most 16 tablets a day), to children aged from 6 up to 12 years — on 1 tablet 4 times a day (at most 8 tablets a day).

For the purpose of achievement of more bystry effect of drug of a tablet it is necessary to rassasyvat slowly in an oral cavity.

Features of use:

It is not necessary to exceed the recommended drug doses, to combine use of drug with reception of alcoholic beverages, and also to use drug at the chronic cough connected with bronchial asthma and emphysema of lungs. With care appoint drug to persons with liver diseases.

Use during pregnancy or feeding by a breast. Teratogenic and embriotoksichesky influence of drug it is not registered, however, considering lack of adequate clinical tests, it is possible to apply Toe-Mai during pregnancy only on doctor's orders in case the expected advantage for mother exceeds potential risk for a fruit.

Ability to influence speed of response at control of motor transport or work with other mechanisms. Some patients after use of drug can have a drowsiness, decrease in reaction that should be meant at control of vehicles.

Children. Toe-Mai appoint to children aged from 6 years.

Side effects:

In rare instances, as a rule, at disturbance of the recommended mode of use of drug and exceeding of an admissible dose there can be a drowsiness, nausea, an abdominal pain, diarrhea which disappear after drug withdrawal. At persons with hypersensitivity allergic reactions are possible.

Interaction with other medicines:

It is necessary to avoid simultaneous use of drug with antidepressants — monoamine oxidase inhibitors (MAO), furasolidone, Procarbazinum owing to increase in risk of excitement of TsNS, development of arterial hypertension and a hyperthermia. Means, the oppressing TsNS, alcohol at combined use strengthen drug sedation. Quinidine slows down metabolism of dextromethorphan in a liver, increasing its concentration in blood.

Contraindications:

Hypersensitivity to dextromethorphan and other components of drug. Respiratory insufficiency, bronchial asthma, emphysema of lungs. Children's age up to 6 years.

Overdose:

At considerable overdose the symptoms caused can be noted: dextromethorphan — drowsiness, dizziness, an ataxy, irritability, a hyperactivity, confusion of consciousness, a sight illegibility, a nystagmus, respiratory depression, nausea, vomiting; guayakolsulfonaty potassium — drowsiness, nausea, vomiting; benzocaine — seldom or never a methemoglobinemia. There is no specific antidote, a symptomatic treatment.

Storage conditions:

Period of validity. 2 years. It is not necessary to use drug after the termination of the period of validity specified on packaging. To store at a temperature not above +25 °C. To store in the place, unavailable to children.

Issue conditions:

Without recipe

Packaging:

On 8 tablets in the blister from aluminum foil, on 2 blisters in a cardboard pack.