Ambrohexal, 3 mg/ml syrup 100 ml

Ambrohexal is a drug with mucolytic, secretolytic and expectorant action, and the active ingredient of the drug is ambroxol. The mechanism of action of this drug is associated with reduction of sputum viscosity as a result of depolymerization of sputum mucopolysaccharides, which consists in breaking disulfide bonds in molecules, increasing the release of active hydrolyzing enzymes from Clark cells.

Ambrohexal also increases the activity of the cilia of the bronchial epithelium, and normalizes the ratio of all components of sputum and in this regard stimulates its mucociliary transport. This facilitates expectoration of sputum from the respiratory tract and stimulates secretion and blockage of surfactant breakdown.

Ambrohexal is rapidly absorbed from the gastrointestinal tract with high absorption capacity, and its optimal plasma concentration is reached within two hours after taking the drug: tablets, syrup, sustained release capsules and inhalation solution.

The action of the drug starts after 30 minutes after taking the syrup or tablets and depends on the speed of absorption of the drug in the stomach and intestines. The drug is metabolized in the liver, where it is converted to dobromanthranilic acid and glucuronic conjugates and excreted by the kidneys.

Indications

Bronchitis, Respiratory tract infections, Cough, Bronchial asthma, Lung inflammation (pneumonia), Chronic obstructive pulmonary disease

Acute, bronchitis with sputum retention, pneumoconiosis, bronchial asthma, tuberculosis and cystic fibrosis, bronchiectatic disease, acute pneumonia, pleurisy, emphysema, acute, prolonged and chronic sinusitis, chronic rhinitis.

Active ingredient

Ambroxol

How to take, the dosage

Ingestion.

Adults and children over 12 years of age – 1 scoop (5 ml) 3 times a day for the first 2-3 days, then 1 scoop (5 ml) 2 times a day.

Children:

• From 6 to 12 years of age, 1/2 scoop (2.5 ml) 2 to 3 times daily;
• 2 to 5 years old – 1/4 scoop (1.25 ml) 3 times a day;
• under 2 years old – 1/4 scoop (1.25 ml) 2 times a day.

In children under 2 years of age Ambrohexal® is prescribed only under medical supervision.

Interaction

Concomitant use with anti-cough drugs leads to difficulty of expectoration of sputum against the background of suppression of the cough reflex. It increases penetration into the bronchial secretion of amoxicillin, cefuroxime, erythromycin and doxycycline.

Special Instructions

In case of impaired bronchial motility and increased amount of secretion (e.g. immobile cilia syndrome) due to the danger of mucus accumulation, the drug may only be taken after consultation with the attending physician and under medical supervision. In severe renal or hepatic impairment, lower concentrations should be used or the interval between doses should be increased.

Hint for patients with diabetes mellitus: 1 scoop (5 ml syrup) contains 2.525 g sorbitol (0.21 IU).

Contraindications

• High sensitivity to ambroxol or to any of the ingredients of the drug
• pregnancy (first trimester);
• breastfeeding
• fructose intolerance.

With caution, the drug should be used in patients with peptic ulcer disease and duodenal ulcer disease, because the aggravation of the ulcer may occur, as well as in patients with renal and hepatic failure, pregnancy (II-III trimester).

Side effects

According to the World Health Organization (WHO) adverse effects are classified according to their frequency of development as follows: very common (≥1/10), common (≥1/100 to < 1/10), infrequent (≥1/1,000 to < 1/100), rare (≥1/10,000 to < 1/1,000), very rare (< 1/10,000); frequency is unknown – according to available data it was impossible to determine the frequency of occurrence.

Allergic reactions
rare: skin rash, urticaria;
frequency unknown: anaphylactic reactions, including anaphylactic shock, angioedema, pruritus and other hypersensitivity reactions.

Gastrointestinal tract
often: nausea;
infrequently: heartburn, vomiting, diarrhea, dyspepsia and abdominal pain.

Nervous system
often: change in taste.

Other
often: decreased sensitivity in the oral cavity or pharynx;
infrequent: dry mouth;
frequency unknown: dry mucous membranes of the respiratory tract.

Overdose

Symptoms: nausea, vomiting, diarrhea, gastralgia, dyspepsia.

Treatment: artificial vomiting, gastric lavage during the first 1-2 hours after taking the drug; intake of fat-containing products, symptomatic therapy.

Pregnancy use

The drug is contraindicated during the first trimester of pregnancy.

Use of the drug Ambrohexal® during pregnancy (II-III trimester) is possible only if the estimated benefit to the mother exceeds the potential risk to the fetus.

Ambroxol penetrates through the placental barrier. Animal studies have shown that the drug has no effect on foetal development, childbirth and postnatal development.

Ambroxol is excreted in small amounts into the breast milk, so when taking the drug Ambrohexal® the question of stopping breast-feeding should be decided.

Similarities

Ambrohexal, Lazolvan, Halixol, Ambroxol, Ambrobene, Orvis Broncho, ORVIS, Lazolvan Max, Zvezdochka, Zvezdochka for colds