Description
Ambroxol Pharmacodynamics
Ambroxol is the active N-demethylated metabolite of bromhexine. It has secretomotor, secretolytic and expectorant action. It stimulates bronchial glands, increases motor activity of the atrial epithelium by influencing type 2 pneumocytes in alveoli and Clara cells in bronchioles, increases formation of endogenous surfactant – a surfactant that ensures gliding of bronchial secretion in the airway lumen. Ambroxol increases the proportion of serous component in bronchial secretion, improving its structure and contributing to reduction of viscosity and thinning of sputum; as a result, mucociliary transport (mucociliary clearance) improves. Increased mucociliary clearance improves the excretion of sputum from the bronchial tree and facilitates coughing.
On average, when taken orally, the action of the drug comes within 30 minutes, duration of action – 6-12 hours, depending on the dose taken.
Indications
Acute and chronic respiratory diseases with the production of viscous sputum:
– Acute and chronic bronchitis;
– pneumonia;
– Chronic obstructive pulmonary disease;
– Bronchial asthma with difficulty in passing sputum;
– bronchiectatic disease.
Contraindications .
Hypersensitivity to ambroxol or other components of the drug, pregnancy (I trimester), breast-feeding.
Caution
Renal failure and / or severe hepatic failure; gastric and duodenal ulcer in the period of exacerbation; pregnancy.
(II-III trimester); impaired bronchial motility and increased mucus secretion (in immobile cilia syndrome).
Administration during pregnancy and lactation
It is contraindicated to use the drug during the first trimester of pregnancy and breast-feeding. It is possible to use the drug in II and III trimesters of pregnancy only after careful evaluation of ratio of benefits from treatment and possible risks.
Dosage and administration method
- Oral administration (1 ml = 25 drops).
Adults and children over 12 years of age: the first 2-3 days, 4 ml (100 drops) 3 times a day (corresponding to 90 mg ambroxol daily), then 4 ml 2 times a day (corresponding to
60 mg ambroxol per day). - Children from 6 to 12 years of age: 2 ml (50 drops) 2 to 3 times a day (corresponding to 30 or 45 mg ambroxol per day).
- Children from 2 to 6 years of age: 1 ml (25 drops) 3 times a day (corresponding to 22.5 mg ambroxol per day).
- Children under 2 years of age: 1 ml (25 drops) 2 times a day (corresponding to 15 mg of ambroxol per day).
- For children under 2 years of age, the drug is prescribed only under a physician’s supervision.
- Maximum daily dose when taken orally: for adults – 90 mg, for children
for children aged 6-12 years old – 45 mg, for children aged 2-6 years old – 22.5 mg, for children under 2 years old – 15 mg.
The drug is used after meals, adding it to water, tea, milk or fruit juice.
During treatment, it is necessary to drink a lot of liquid (water, tea, juice) to enhance the - The mucolytic effect of the drug.
Inhalations
Adults and children over 6 years: 1-2 inhalations with 2-3 ml (50-75 drops) of the solution a
a day (which corresponds to 15-45 mg of ambroxol a day). - Children under 6 years of age: 1-2 inhalations for 2 ml (50 drops) of solution per day (which corresponds to
15-30 mg ambroxol per day).
The drug can be administered using any modern inhalation equipment (except steam inhalers). For optimal hydration during inhalation, the drug is mixed with 0.9% sodium chloride solution at a ratio of 1:1. Since
during inhalation therapy, deep inhalation may provoke coughing, inhalation should be performed in normal breathing mode. Before inhalation, it is usually advisable to warm the inhalation solution to body temperature. Patients with bronchial asthma are recommended to inhale after taking bronchodilators, to avoid nonspecific irritation of the airways and their spasm. - In case of preservation of symptoms within 4-5 days from the beginning of intake it is recommended to consult a doctor.
