Ambroxol - instructions for use, dose, side effects, contraindications

Pharmacodynamics:Stimulates the formation of a tracheobronchial secretion of reduced viscosity due to a change in the structure of mucopolysaccharides of sputum and increases the secretion of glycoproteins (mukokinetic effect). Stimulates motor activity of cilia of ciliated epithelium and improves mucociliary transport; increases synthesis, secretion of surfactant and blocks its disintegration.

Pharmacokinetics:

Absorption is high. Penetrates through blood-brain barrier. Bioavailability is 70-80%.The connection with plasma proteins is 80%. Biotransformation in the liver. Half-life - 1.3 hours, for prolonged forms - 10-12 hours; Increase in severe chronic renal failure. Elimination of the kidneys in the form of metabolites - 90% and unchanged - 5%.

Indications:

Diseases of the respiratory tract with the formation of viscous sputum: acute and chronic bronchitis, pneumonia, chronic obstructive pulmonary disease, bronchial asthma with difficulty in sputum discharge, bronchiectatic disease.

Respiratory distress syndrome in premature infants and newborns.

ICD-10

X.J20-J22.J20 Acute bronchitis

X.J40-J47.J42 Chronic bronchitis, unspecified

X.J40-J47.J40 Bronchitis, not specified as acute or chronic

X.J10-J18.J18 Pneumonia without clarification of the pathogen

X.J40-J47.J45 Asthma

X.J40-J47.J47 Bronchoectasia

X.J40-J47.J44.9 Chronic obstructive pulmonary disease, unspecified

XVI.P20-P29.P22 Breathing disorder in a newborn [distress]

XVIII.R00-R09.R09.3 Sputum

Contraindications:

Hypersensitivity, pregnancy (I trimester), phenylketonuria (for dosage forms containing aspartame), convulsive syndrome.

Carefully:Hepatic, renal failure, peptic ulcer of stomach and duodenum, pregnancy (II-III trimester), breast-feeding.

Pregnancy and lactation:

The category of FDA recommendations is not defined. Adequate and well-controlled studies on humans have not been conducted. Do not apply in the I trimester. With caution in II-III trimesters.

Penetrates into breast milk. For the duration of treatment, breastfeeding should be discontinued.

Dosing and Administration:

Tablets of 30 mg take 3 times a day for the first 2-3 days, then 30 mg 2 times or 15 mg 3 times a day, or 1 capsule retard (75 mg) in the morning. In severe conditions diseases dose do not decrease throughout the course of treatment.

Solution for oral administration (7.5 mg / ml) - during the first 2-3 days of 4 ml, and then - 2 ml 3 times a day or 4 ml 2 times a day.

Syrup (3 mg / ml) is taken in the first 2-3 days of 10 ml, and then 5 ml 3 times a day or 10 ml 2 times a day. In severe cases, the dose can not be reduced throughout the course of treatment.

A solution for inhalation of 15-22.5 mg 1-2 times a day.

Subcutaneously, intramuscularly, intravenously (slowly or driply) 15 mg, in severe cases - at a dose of 30 mg 2-3 times a day (1 g in 500 ml of 0.9% sodium chloride solution daily for 5-6 days) . Repeated treatment - after 14 days (if the indications remain).

Rectally 30 mg 3 times a day for 2-3 days, then 60 mg twice a day, the maximum daily dose of 0.12 g.

Side effects:

From the side of the digestive system: diarrhea / constipation; with prolonged use in high doses - heartburn, gastralgia, nausea, vomiting.

Allergic reactions: skin rash, hives, angioedema; in some cases - allergic contact dermatitis, anaphylactic shock.

Other: Weakness, headache, dryness of the mucous membrane of the oral cavity and respiratory tract, exanthema, rhinorrhea, dysuria; with rapid intravenous injection - a sensation of numbness, intense headache, adynamia, lowering of blood pressure, shortness of breath, hyperthermia, chills.

Overdose:

Nausea, vomiting, diarrhea, dyspepsia, lowering of blood pressure.

Treatment: gastric lavage in the first 1-2 hours after ingestion, intake of fat-containing products; it is necessary to monitor the parameters of hemodynamics and to carry out symptomatic therapy if necessary.

Interaction:

Antitussives: it is difficult to leave the sputum on the background of a reduction in cough.

Means that inhibit labor: compatible.

Alkaline solutions (pH> 6.3): pharmaceutical incompatibility.

Amoxicillin: increased concentration of amoxicillin in sputum and bronchial secretion.

Glaucine + Ephedrine + [Basil of common oil]: it is not recommended to use due to the difficulty of coughing up phlegm.

Doxycycline: increased concentration of doxycycline in sputum and bronchial secretion.

Cromoglycic acid: do not mix solutions in one syringe.

Cefuroxime: an increase in the concentration of cefuroxime in sputum and bronchial secretion.

Erythromycin: increased erythromycin concentration in sputum and bronchial secretion.

Special instructions:Doses in terms of 1 mg are the same for all drugs taken orally. Do not use without medical appointment for more than 4-5 days. When prescribing ambroxol to diabetic patients, remember that 5 ml of syrup contains sorbitol and saccharin in an amount corresponding to 0.18 XE. Patients suffering from bronchial asthma can use bronchodilators to avoid nonspecific irritation of the airways and their spasm before inhaling ambroxol.

Instructions

Ambroxol (Ambroxolum)