Included in the formulation
АТХ:R.05.C.B.03 Carbocysteine
Pharmacodynamics:Pharmacological action - mucolytic, expectorant. Activity is due to the stimulation of the synthesis of sialic transferase - the enzyme of goblet cells of bronchial mucosa. Normalizes the proportion of acidic and neutral components of bronchial secretion, restores elasticity and viscosity of mucus. Promotes regeneration of the mucous membrane, normalizes its structure, activates the activity of the ciliary epithelium. Restores the secretion of immunologically active immunoglobulin A (specific protection), improves mucociliary clearance.
Pharmacokinetics:Bioavailability is low, less than 10% (bioavailability of tablets, capsules and syrup is the same). Accumulation in the bronchial secretion (17.5% of the assimilated dose). Biotransformation in the liver, the effect of the first passage. Half-life 2-3.15 hours. Elimination of the kidneys in unchanged form (60-90%) and in the form of metabolites.
Indications:Diseases accompanied by the separation of abundant and viscous sputum: tracheitis, bronchitis, tracheobronchitis, bronchial asthma, whooping cough, bronchiectatic disease. Rhinitis, adenoiditis, otitis media, sinusitis.
Preparation for bronchoscopy and / or bronchography.
IV.E70-E90.E84.0 Cystic fibrosis with pulmonary manifestations
X.J00-J06.J06 Acute upper respiratory tract infections of multiple and unspecified sites
X.J10-J18.J18 Pneumonia without clarification of the pathogen
X.J30-J39.J31 Chronic rhinitis, nasopharyngitis and pharyngitis
X.J30-J39.J32 Chronic Sinusitis
X.J40-J47.J40 Bronchitis, not specified as acute or chronic
X.J40-J47.J42 Chronic bronchitis, unspecified
X.J40-J47.J45 Asthma
X.J40-J47.J47 Bronchoectasia
XVIII.R00-R09.R05 Cough
XVIII.R00-R09.R09.3 Sputum
Contraindications:Hypersensitivity, peptic ulcer of the stomach and duodenum (in the phase of exacerbation), pregnancy (I trimester), phenylketonuria (for forms containing as a sweetener aspartame), children under 15 years (for syrup for children - up to 2 years), chronic glomerulonephritis (in the phase of exacerbation), cystitis.
Carefully:Pregnancy (II-III trimesters), breast-feeding, gastric ulcer and duodenal ulcer in history, chronic glomerulonephritis in the anamnesis.
Pregnancy and lactation:FDA recommendations in category B. Adequate and well-controlled studies in humans have not been conducted. Do not apply in the first trimester! With caution in II-III trimesters!Lactation. There is no information on the penetration into breast milk. Carefully!
Dosing and Administration:Inside. Adults - 2 capsules or 15 ml (3 teaspoons) 5% syrup 3 times a day; after the improvement - 1 capsule or 10 ml (2 teaspoons) 5% syrup 3 times a day.
Children aged 2-4 years - 2.5-5 ml 5 syrup 2 times a day or 5 ml 2.5% syrup 2-4 times a day.
Children aged 4-12 years - 5 ml 5% syrup 3 times a day or 10 ml 2.5% syrup 3 times a day.
Side effects:Sometimes there are nausea, vomiting, diarrhea and epigastric pain. Single cases of allergic reactions (itching, hives, exanthema) were noted. In patients with bronchial asthma and in elderly patients, airway obstruction may occur. Rarely there is a headache.
Overdose:Symptoms: diarrhea, heartburn, nausea, vomiting, pain in the stomach. Treatment is symptomatic.
Interaction:Antitussives and m-holinoblokatory weaken the effect of carbocysteine. Theophylline strengthens the bronchodilator effect.
Special instructions:Treatment with mucolytics leads to a slight decrease in the frequency of exacerbations and a somewhat greater decrease in the number of days of incapacity for work in persons with chronic bronchitis and / or chronic obstructive pulmonary disease. When deciding whether the treatment with mucolytics is sufficient to justify their regular use in patients with chronic lung diseases during the period of remission, the judgment of the doctor and patient will play a decisive role. The incidence of side effects in treatment with mucolytics is comparable to placebo. Insufficient evidence of the effectiveness of mucolytics in pneumonia (4 studies, 224 participants).
In patients with diabetes it is necessary to take into account the content of sucrose in the syrup form of carbocysteine: 5.25 g per 1 tablespoon in syrup for adults and 3.5 g for 1 teaspoon in syrup for children.
Violation of the speed of psychomotor reactions, associated with the presence of alcohol in the preparation in the form of a syrup,can be dangerous when driving vehicles.