Fluimucil, 100 mg/ml 3 ml 5 pcs

Pharmgroup:

A expectorant (mucolytic) drug.

Pharmic action:

Fluimucil is a mucolytic drug. Liquefies sputum, increases its volume and facilitates its separation. Action of acetylcysteine is related to the ability of its sulfhydryl groups to break intra- and intermolecular disulfide bonds of acidic mucopolysaccharides of sputum, which leads to depolarization of mucoproteins and reduction of sputum viscosity. Remains active in the presence of purulent sputum.

Increases secretion of less viscous sialomucins by bocalytic cells, reduces bacterial adhesion on the epithelial cells of the bronchial mucosa. It stimulates bronchial mucosa cells, the secret of which lyses fibrin. It has the same effect on the secretion produced by inflammatory diseases of ENT organs.

It has an antioxidant effect due to the presence of SH-group that can neutralize electrophilic oxidizing toxins.
Acetylcysteine easily penetrates cells and is deacetylated to L-cysteine from which intracellular glutathione is synthesized.

Glutathione is a highly reactive tripeptide, a powerful antioxidant and cytoprotector that neutralizes endogenous and exogenous free radicals and toxins. Acetylcysteine prevents depletion and promotes increased synthesis of intracellular glutathione that participates in redox processes of cells, contributing to detoxification of harmful substances. This explains the effect of acetylcysteine as an antidote in paracetamol poisoning.

Protects alpha1-antitrypsin (elastase inhibitor) from inactivating effect of BOSI – an oxidizing agent produced by myeloperoxidase of active phagocytes. It also has anti-inflammatory effect (by inhibiting the formation of free radicals and active oxygen-containing substances responsible for the development of inflammation in lung tissue).

Indications

Respiratory diseases, accompanied by sputum formation of high viscosity (acute and chronic bronchitis, pneumonia, bronchiectasis, cystic fibrosis, bronchial asthma).

Active ingredient

Composition

Active ingredient:

acetylcysteine 300 mg;

Associates:

dinatrium edetate – 3 mg;

sodium hydroxide – 74 mg;

water for injection – up to 3 ml

How to take, the dosage

The solution for injection can be administered parenterally, inhaled, endobronchially.

In adults, intramuscularly deeply or intravenously – usually 300 mg (1 ampoule 3 ml) 1-2 times a day. For children 6-14 years old, 1/2 the adult dose. Daily dose for children under 6 years of age is 10 mg/kg. The duration of treatment should be established according to the results of changes in the patient’s condition. High local and general tolerance to the drug allows long courses of treatment.

Inhalation: usually 300 mg (1 ampoule) 1-2 times a day for 5-10 days or longer courses; the frequency of administration and the dose amount can be changed by the doctor depending on the patient’s condition and the therapeutic effect. Children are prescribed in the same dosage.

Endobronchial administration: administered appropriately by standing tubing, bronchoscope, etc. at 300-600 mg (1-2 ampoules) or more per day depending on the clinical indication.

Interaction

Combined use of acetylcysteine with cough suppressants may increase sputum stasis due to suppression of the cough reflex.

In concomitant use with antibiotics such as tetracyclines (excluding doxycycline), ampicillin, amphotericin B, they may interact with the thiol group of acetylcysteine, which leads to decreased activity of both drugs.

Hence, the interval between the intake of these drugs should be at least 2 hours.

The simultaneous administration of acetylcysteine and nitroglycerin may increase the vasodilator and disaggregant effect of the latter.

Acetylcysteine eliminates the toxic effects of paracetamol.

Special Instructions

Caution is used in patients prone to pulmonary bleeding, hemoptysis, with liver disease, kidney disease, impaired adrenal function, patients with bronchial asthma and obstructive bronchitis (and under systematic monitoring of bronchial patency).

When dissolving acetylcysteine it is necessary to use glassware, avoid contact with metal and rubber surfaces. When opening the bag there may be a smell of sulfur, it is the smell of the active ingredient, not an indication of the poor quality of the drug.

Ampoule of Fluimucil is opened before use. The opened ampoule may be stored in the refrigerator for 24 hours. Using the drug from a previously opened ampoule for injection is prohibited.

Fluimucil solution must not come into contact with rubber and metal surfaces.

Contraindications

Hypersensitivity to acetylcysteine, acute gastric and duodenal ulcer,

Patients with liver or kidney diseases should be treated with caution.

Side effects

The digestive system: rarely – heartburn, nausea, vomiting, diarrhea, stomatitis.

Allergic reactions: rare – skin rash, itching, urticaria, bronchospasm.

Other: rare – nasal bleeding, tinnitus, collapse, decreased platelet aggregation.

Local reactions: when parenteral use mild burning sensation at the injection site is possible; when inhalation – reflex cough, local airway irritation, stomatitis, rhinitis; bronchospasm is rare (in this case we should prescribe bronchodilators).

Overdose

Acetylcysteine at doses of 500 mg/kg per day did not cause signs and symptoms of overdose.

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