Ambroxol. Instructions for use syrup for children, for inhalation solutions, tablets

The cough may last up to several months after the treatment of provoking disease. The reason - the stagnation of dead mucous in the bronchi. Ambroxol thins the mucous membrane, accelerates its conclusion.

Details on the application and properties of drugs (drug) can be found in the instructions for use. Strong long-lasting cough, not only causes discomfort, but also leads to the rupture of the capillaries - bleeding from the nose, mikrotrombov in the nasopharynx, brain.

release Form

Ambroxol (user application provides concise information about the release of a number of forms) is selected physician or LORom, and depending on the patient's age, the dynamics of the flow and the degree of severity disease.

release Form	The content of active substance in the unit milligrams (MG)	Packaging
Tablets for oral (liquid drink) Hour	30	The blister pack of 10 pieces. The carton 1,2,3,4,5 blisters
effervescent tablets	60	The plastic bottle of 10, 20 pcs. The carton 1,2 vial
Capsules of the prolonged action	75	1 blister pack of 10 pieces. 1,2,5 blisters in a carton
Syrup	15mg / 5ml	Glass or polymeric bottle 50, 100 ml
30 mg 5 ml
Oral drops (buried in the mouth)	7.5 mg / ml 10 drops in 1 ml	100 ml in a vial with a dropper,
15 mg / ml 10 drops to 1 ml
A solution for inhalation	7.5 mg / ml	100 ml in a vial with a measured cap
Injection	15 mg / ml	50, 100 ml in a vial with a metering syringe

Structure and mechanism of action

All forms of release of the active substance ambroxol hydrochloride. Excipients depend on the form.

Pills:

• lactose monohydrate - possibility suction intestinal walls at low pH in the gastrointestinal tract (GI tract).
• Colloidal silicon dioxide: GI uniformity suction walls; improved sliding tablet.
• magnesium stearate: Softening irritation gastrointestinal mucosa, preventing cleavage of the active substance with high acidity.
• Potato starch - protection from exposure to gastric juice.

Effervescent tablets:

• Glycerol - soothes irritation of the gastrointestinal tract.
• Saccharin - acceleration of absorption at low acidity.
• propylene glycol - uniformity of suction.
• hydroxyethyl - Prolongation of the action with high acidity.
• Menthol - Elimination of nausea, thinning of the mucous in the respiratory tract.
• flavors: Citric acid, orange, apricot.
• dyes - sodium benzoate.
• sorbitol - as environmental preservative.

capsules:

• magnesium stearate.
• Acrylates - prolongation of the suction period and excretion of the active compound.
• Titanium dioxide - antioxidant (slows down oxidation processes).
• Red iron oxide - light stimulation digestion.

Syrup:

• Saccharin.
• Glycerol.
• Propylene glycol.
• Flavorings: citric acid, apricot, orange, menthol.
• Water.

Drops: 9% sodium chloride. A solution for inhalation, and for injection: purified water.

pharmacological properties

Ambroxol hydrochloride:

• airway mucosa thins;
  
• normalizes the serous glands;
• It stimulates the activity of the cilia of ciliated epithelium - accelerated promotion of sputum;
• lysosomes release of Clara cells - reducing the viscosity and increasing the lubricity of sputum;
• increase immune protection of mucosal epithelium of the respiratory tract;
• strengthening cell membranes pneumocytes, increasing their elasticity.

Period achieve peak concentration in the body and the time for the complete withdrawal of ambroxol hydrochloride dependent release form.

release Form	The period of maximum concentration	Period complete withdrawal from the body
Tablets for oral Hour	2 hours	12 hours
effervescent tablets	30 minutes.	6 hours
Capsules of the prolonged action	3 h	22 hours
Syrup	1 hour	6 hours
Drops	15 minutes.	2-3 hours
Inhalation	5 minutes.	To 30 min. after the end of inhalation
intravenous injection	10 min.	1.5 hours
infusions	15 minutes.	12 hours after drip

Instructions for use Ambroxol indicates average values. Time to reach maximum concentration depends on the functionality of the liver; A complete withdrawal - by the kidneys and then the permeability of the skin.

testimony

Ambroxol syrup, solution for internal application and the drops may be administered starting at 2 years of age. Inhalation do only after reaching 5 years of age. Capsules and tablets for oral admission from 12 years. Effervescent tablets with 16 years.

Admission syrup solution for internal use, drops to 2 years, 5 years before inhalation, tablets and capsules to 12, effervescent tablets to 16 years - only by prescription. Ambroxol (instruction manual comprises a number of readings) are recommended in various diseases and conditions of the organism.

For example:

• Acute bronchitis with paroxysmal cough.

  

• Chronic bronchitis prolonged cough 2 weeks. and more.
• Pneumonia.
• Exudative pleurisy; front wall when the liquid transudativnom pleurisy.
• With respiratory distress syndrome.
• Respiratory distress syndrome due to accumulation of viscous mucus.
• Upper respiratory disease accompanied by thickening nasopharyngeal mucosa.
• rhinitis; vasomotor only after reducing the swelling.
• During the recovery period after surgery on the lungs.
• With some antibiotics in the treatment of diseases of the upper and lower respiratory tract to enhance the action of antibiotics.
• In the complex during the course of the flu.
• After passing the acute stage of viral diseases other if there is a dry cough.

Contraindications

Instructions specifies general contraindications based on the action of the active substances and excipients. When assigning drugs, doctors guided integrated diagnostic results and the dynamics of the disease that causes cough and rhinitis.

Contraindications:

• Allergy 1 or more components for a given release form.
• Damage to the gastrointestinal mucosa (Ulcers, gastritis, colitis) - can not be oral forms.
  
• Age: Effervescent tablets to 16; tablet and capsule long acting to 12; inhalation to 5; drops, syrup to 2; injection and infusion at any age only on prescription (symptomatic treatment).
• bot - possible asphyxia in high concentrations of larvae or adults in the airways.
• exudative pleurisy - with caution only on prescription; transudativny - only under medical supervision.
• chronic diseases respiratory tract with a term of more than 3 months.
• Diabetes - with caution to form with saccharin.
• kidney failure - O prolongation metabolites (decay products) PM. Increasing the level of sugar and urea in the blood.
• For tablets galactosemia, Goiter with an excess of lactic acid bacteria; for all forms except solutions, bloating, constipation - difficulty splitting fructose flavors. The slow uptake of saccharin, glycerin deposited on the walls of the colon.
• 1st trimester pregnancy.
• Not suitable for thinning sputumCaused by chemicals.

Ambroxol is not antipyretic contrast, while taking drugs body temperature can rise to 38 and above - to activate the immune system. If the cough is caused by a viral infection - not to shoot down the temperature and continue to receive Ambroxol. When the level exceeds 38.5 - ibuprofen or knock Nurofenom. Message with acetylsalicylic acid should not be under 16 years old.

Side effect

The high frequency of adverse events observed in children under the age of 12 years. The main reason - receiving improper release form. The main manifestation - an allergy to one or more components. High probability of allergy to multi syrup, capsules, tablets. Low - on solutions.

Main symptoms: skin rash, severe itching; swelling of the face, extremities less frequently; anaphylactic reactions.

If the allergy is caused by the oral form - immediately wash out the stomach; solutions, regardless of application - purifying infusion.

Other side effects:

• Diarrhea - normalize the composition of bile - phospholipid preparations.
  
• Dyspepsia - Change release form.
• Nausea - strong simultaneous release of gastric juice, bile.
• Anti-inflammatory herbal teas: 0.5 l of boiling water for 1 hour. l. chamomile, corn stigmas, Helichrysum; composition boil 3 min.; It can be taken at any age; decoction of flax seeds - 0.5 liters of cold water 25 g of flax seed, the composition of boil for 10 minutes.
• Headache, weakness - give preference to dishes from beets, black pudding, hematogenous, children up to 12 years in the black pudding to add a minimum of garlic, peppers deleted.
• Activation of fungal diseases - antifungal (children - Nystatin); folk remedies for external use: 3 liters of water 15 large sheets horseradish glass dry onion peels; composition boil for 15 minutes. over low heat; Add 1.5 cups of finely chopped plantain; turn off the stove and infuse means 24 h; drain structure, heat and take the tub; then rinse the limbs water.

Overdose

Ambroxol (instruction manual contains provisions daily dose or course) it is important to take the proper form of release, as accelerated absorption (absorption) creates a momentary excess concentration to the manifestation of symptoms common overdose.

In addition to the gain side effects were also observed:

• Significant swelling of the mucous non-allergic nature - an urgent need to call an ambulance. It should drink much, throat rinse composition prepared according to the recipe: 200 ml boiling water take 0.5 hours. l. hypericum, chamomile, boil for 1 min.; drain structure, add on the tip of hours. l. salt; Capacity put in cold water.
• Reduced levels of blood clotting - drugs with vitamin K; more foods with vitamin E: pumpkin, fennel seeds, buckwheat and millet porridge, pudding, salad refill sunflower oil, carrots with sour cream.
  
• White plaque on the tonsils - the development of fungi. It is necessary to reduce the dosage, do not use their own antifungal mouthwash because it can be allergies, irritation or inflammation of the mucous membrane.
• microthrombuses - injection, infusion.
• dysbacteriosis 1, 2 degree - tablets, capsules, syrup.

Mode of application

The maximum tolerable daily dosage of ambroxol hydrochloride:

• 90 mg for adults.
• 45 mg for children 6-12 years old, with the expectation of 4.5 mg / kg divided into 3 stages from 2 to 6 years.
• In respiratory distress syndrome, or intravenous infusion calculation 10 mg / kg, regardless of age. Entering a single.
• In acute symptoms permissible increase in the daily dosage of not more than 1.5 times no longer than 3 days. In the absence of speakers to improve the general condition within 5 days - welcome to stop.
• If there is no clinical abnormalities during therapy, the average daily dose is reduced by 1.5 times, starting at 5 days. The maximum duration of treatment - 14 days.

Features of the application for kids

Up to 12 years only in the form of syrup of 15 mg / 5 ml;

• 5-12 years 5 ml 3 times a day.
  
• 2-5 years - 2.5 ml three times per day.
• Up to 2 years (on purpose) - 2.5 ml twice a day.

The first 2-3 days - double single dosage. Taken after meals. Minimum single dose - ½ jiggers.

To prepare the inhalation using 9% sodium chloride solution. Sold in a pharmacy - inhalation solution, saline. Inhalation is best done using a nebuliser (a device with the function of aerosol injection). Dilute with sodium chloride in proportions: 2-5 years 2 ml 2 ml; 5-12 years - 3 ml for 3 ml. Do no more than 2 treatments per day. If you have to skip the procedure - to give a syrup.

Drops - 7.5 / 10 drops:

• Up to 2 years 3 drops 2 times a day.
• 2-5 years - 5 drops 2-3 times a day.
• 5-12 years - 10 drops 3 times a day.

Injection of 1.5 mg / kg. For injection diluted with 9% saline for infusion - saline or dextrose. Release forms are made by different manufacturers.

Initial age inhalation application can vary within 2-6 years. To minimize adverse events inhalation use only need for the therapist appointment, otolaryngologist, an infectious disease specialist, pulmonologist pediatrician.

Interaction with other drugs

When co-administered with other agents, the following changes in the properties:

• It enhances the action of natural antibiotics fungal pathogens - penicillins, cephalosporins.
• It increases the effectiveness of certain semi-synthetic antibiotics: erythromycin, amoxicillin, doxycycline, cefuroxime.
• Reduced effectiveness flemoksin, macrolides increase toxicity.
• With antitussive drugs - reducing the effectiveness of the two drugs, mucous congestion - transudativny pleurisy.
• Syrup with probiotics and prebiotics causes flatulence.
• Reduced efficacy of rosuvastatin.
  
• Prolongation O theophylline, increasing its toxicity.
• Do not mix in the same syringe with drugs whose PH, below 6.3 - reduction efficiency Ambroxol, early deposition of salts, slowing phospholipid metabolism.

Increasing the concentration of rifampicin in the lower respiratory tract - recommended the combined use.

special instructions

Ambroxol (User application recommends taking syrup diabetics because of the presence of sorbitol in an equivalent unit 1 grain per 5 ml of syrup) in the form of syrup contains saccharin. Use only as intended, irrespective of the type and stage of diabetes.

The nebulizer or other inhaler can not pour the syrup or solution for injection. Drops - only if the concentration in 5 ml of the same. Do not change the rhythm of breathing during inhalation. If cough - stop the procedure - cough - renew inhalation. The amount of solution and time does not change.

When liver problems during maximum concentration increases. Depending on the degree of damage to the hepatocytes (liver cells). When serious pathologies - drop and inhalation. If you experience cramping, 5-10 minutes during the procedure. before the procedure to adopt or use a bronchodilator inhaler. When asthma for 20-30 min. before the procedure.

On the 1st trimester of pregnancy use only under medical supervision, if the benefits outweigh the harm to the mother and fetus. Despite entering the mother's milk, the manufacturer does not refer to contraindications during lactation.

Children with impaired cough reflex to take the medicine only under the supervision of stationary as possible asphyxia (suffocation) due to accumulation of phlegm.

Do breathing exercises throughout the course. Not exposed organism contrast changes in temperature and humidity. Before walking outdoors in winter wear gauze avoid sharp supercooling airways or cancel nose scarf. Walk slowly. If breathing becomes more frequent - immediately go to a warm room.

In bronchial asthma or severe paroxysmal cough not take the medication at bedtime. If the cough severe headaches, you should see a doctor to make reduction dosage or switch to the release form with a stable maintenance of the concentration of Ambroxol - tablets, capsules.

Rhinitis - instilled into the nose, oral drops by the same schedule. If burning - hot drip oil droplets and stop Ambroxol.

Under no circumstances should not be taken without consulting a doctor under the following conditions:

1. Autoimmune diseases.
2. During and after therapy with non-steroidal anti-inflammatory and / or corticosteroids.
3. Aching in the bones at normal body temperature.
4. Undertreated or progressive fungal diseases - candidiasis (also in remission), athlete's foot, onychomycosis, scab (regardless of cause or origin).
   
5. vascular fragility, bone fragility, unhealed fractures - only drops inhalation.

Use in dry cough

Depending on the flow comorbidities and duration of symptoms of cough, receiving medications, different circuit Hour Ambroxol applied.

For example:

• Sputum does not depart, the lungs by coughing with large concentrations of liquid sounds - 5 days inhalation, syrup, 6-14 day.
• Cramps in the lungs, there is the urge to cough, wheezing in the lungs - antibiotics that interact with ambroxol; Ambroxol intramuscularly 2 times a syrup.
• No wheezing and fluid accumulation in the bronchi of sounds, a strong urge to cough, itching - an urgent diagnostics.
• Dry cough and dryness in the mouth - a drop.

Ambroxol independently applied regardless of age only the second time, to accelerate expectoration after suffering disease. In other cases, only on prescription. Children - only for its intended purpose.

Storage conditions and shelf life

For all forms of release of the same storage conditions: temperature 15-25 degrees without access of light. The shelf life of 3 years, and for the effervescent tablets 5 years.

After opening the package, the vial with a solution, syrup:

• Tablets, capsules - 1 year.
• Syrup - 30 days.
• Drops, and the solution for inhalation - 60-90 days, depending on the access of light.
• Injection: 6 hours; divorced with dextrose in the system for drip - 4-6 hours.

Synthetic preparation Ambroxol serves to liquefy and acceleration output viscous mucus of the respiratory tract. PM comes in several forms. Guided by the instructions for use and the results of several diagnostic methods, it is possible to choose the most suitable option for children.

To reduce the chance of adverse events reported for the first time to take on prescription or after its approval.

Registration of the article: Lozinski Oleg

Video of ambroxol

Ambroxol tablets, instructions for use: