Ambrohexal side effects. Ambrohexal solution - instructions for use. Interaction with other drugs

Ambrohexal - medicinal product, which has a mucolytic, secretolytic and expectorant effect, and the active ingredient of the drug is ambroxol. The mechanism of action of this drug is associated with a decrease in sputum viscosity as a result of depolymerization of sputum mucopolysaccharides, which consists in breaking disulfide bonds in molecules, enhancing 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 sputum components and, in this regard, stimulates its mucociliary transport. This makes it easier to expectorate mucus from respiratory tract, and also stimulates the secretion and blocking the breakdown of surfactant.

Ambrohexal is rapidly absorbed from the gastrointestinal tract, having a high absorption capacity, and its optimal plasma concentration is reached within two hours after taking the drug: tablets, syrup, capsules with prolonged action and inhalation solution. The effect of the drug occurs when taken in the form of syrup or tablets - after 30 minutes and depends on the rate of absorption of the drug in the stomach and intestines. This drug is metabolized in the liver, where it is converted to dobramanthranilic acid and glucuronic conjugates and excreted by the kidneys.

Ambrohexal application

Indications for the use of Ambrohexal are: acute, obstructive bronchitis, pneumoconiosis, bronchial asthma, tuberculosis and cystic fibrosis of the lungs, bronchiectasis, acute pneumonia, pleurisy, pulmonary emphysema, acute, prolonged and chronic sinusitis, chronic rhinitis. He is also assigned congenital pathology respiratory tract and complicated course infectious diseases(whooping cough, scarlet fever, mumps, chicken pox, measles and rubella).

Contraindications and side effects

Contraindications to the use of Ambrohexal is hypersensitivity to the active active ingredient (Ambroxol hydrochloride) or excipients included in dosage form drug and pregnancy, especially in the early stages.

Side effects of Ambrohexal are local allergic skin reactions in the form of angioedema, urticaria and contact dermatitis, and with prolonged uncontrolled use of the drug, nausea, gastralgia, vomiting or heartburn may occur.

Mode of application

This drug has a release form: syrup for children and adults (3 mg in one milliliter and 6 milligrams in one milliliter) 100 and 250 milliliters in a bottle, 30 milligram tablets, and retard capsules (prolonged action) - 0.75 grams ambroxol hydrochloride. As well as a solution for inhalation and oral administration, which has 7.5 milligrams of ambroxol hydrochloride in one milliliter and is produced by Salutas Pharma.

Contraindications

Contraindications to the use of Ambrohexal is hypersensitivity to ambroxol or the components that make up this drug and during pregnancy.

Ambrohexal during pregnancy

Taking Ambrohexal during pregnancy is contraindicated during pregnancy, because there is always a risk of negative effects on the developing fetus. However, due to the fact that Ambroxol is a stimulant of lung development in the perinatal period, by increasing the synthesis of surfactant and blocking its decay, it is prescribed to pregnant women with suspected fetal malnutrition to stimulate lung maturation, as well as with the threat of premature birth.

Ambrohexal for inhalation

Solution for inhalation contains 7.5 milligrams active substance in one milliliter.

Ambrohexal inhalation solution, adults and children from the age of five are used:

The duration of treatment is determined by the attending physician, but should not exceed five days.

Ambrohexal inhalation solution can be used in any inhalation device except steam inhalers. The drug is mixed with saline (in equal proportions) and heated to 36 - 37 C. Inhalations are carried out without deep breaths, so as not to provoke a cough, in normal breathing mode.

Ambrohexal syrup

The syrup contains active active substance- ambroxol hydrochloride, as well as a number of components that serve to impart a pleasant taste, aroma and consistency. The syrup has a thick consistency, a pleasant berry flavor and a slightly yellowish solution, which is sold in dark amber glass bottles of 100 and 250 milliliters. It has two concentrations - 3 milligrams of ambroxol hydrochloride in one milliliter of syrup and 6 milligrams of the active substance in one milliliter of syrup.
Ambrohexal syrup 3 mg / ml is used in children over twelve years of age and adults - first, two scoops are prescribed two to three times a day for the first two days, and then two spoons twice a day.

IN pediatric practice Ambrohexal is prescribed for children under two years old - ½ teaspoon twice a day, for children from two to five years old - ½ teaspoon three times a day, from five to twelve years old - one measuring spoon two to three times a day.

Ambrohexal tablets

Ambrohexal in tablet form has the appearance of white, round, flat tablets with a notch on one side, containing 30 milligrams of ambroxol hydrochloride. They are prescribed in adults, adolescents and children over twelve years of age by mouth, after meals, one tablet three times a day, but if necessary, the dose can be increased to two tablets twice a day. IN childhood older than six years, Ambrohexal is used ½ tablet two to three times a day.

Ambrohexal price

Any of the forms of Ambrohexal is freely sold in the pharmacy network of the city and is an over-the-counter drug. The cost of Ambrohexal in syrup 3 mg / ml in a 100 ml bottle ranges from 160 -165 rubles, Ambrohexal tablets - 85 - 87 rubles, retard capsules - 139 - 145 rubles.

Ambrohexal reviews

Ambrohexal is a drug that is a unique development of the pharmaceutical company Salutas Pharma, and is currently considered very effective. medicine, which is used in the medical practice of pediatricians and therapists, as a drug for the treatment of cough in children and adults, as well as in otolaryngology as one of the components complex therapy sinusitis and chronic rhinitis to thin the viscous secretion in the sinuses.

Ambrohexal refers to secretolytic, secretory and expectorant antitussive drugs, has excellent efficacy and dilutes the viscous mucous secretion that accumulates in the lumen of the bronchi, trachea and alveoli, as well as the thick mucus of the nasopharynx and paranasal sinuses. This therapeutic effect is due to a change in the structure of the mucous or mucopurulent secretion. The main feature of Ambrohexal is its ability to thin sputum without increasing its quantity and complete absence negative reactions unlike many other expectorant drugs.

It is widely used to treat cough caused by inflammatory diseases respiratory tract - bronchitis, pneumonia and laryngotracheitis of infectious and inflammatory origin, accompanied by a pronounced wet cough.

Similar instructions:

Mucolytic drug with expectorant action. It has a secretomotor, secretolytic and expectorant action. Stimulates the serous cells of the bronchial mucosa, increases the content of mucous secretion and the release of a surfactant (surfactant) in the alveoli and bronchi, normalizes the disturbed ratio of the serous and mucous components of sputum.

By activating hydrolyzing enzymes and increasing the release of lysosomes from Clara cells, ambroxol reduces the viscosity of sputum. Raises motor activity ciliated epithelium, increases mucociliary transport, facilitates the removal of sputum from the respiratory tract.

When taking Ambroxol orally, the effect, on average, occurs after 30 minutes and lasts 6-12 hours, depending on the size of a single dose.

Pharmacokinetics

Suction

After oral administration, Ambroxol is rapidly and almost completely absorbed. T max is 1-3 hours.

Distribution

Plasma protein binding is approximately 85%. Ambroxol crosses the placental barrier and is excreted in breast milk.

Metabolism

It is metabolized in the liver to form metabolites (dibromanthranilic acid, glucuronic conjugates), which are excreted by the kidneys.

breeding

It is excreted mainly by the kidneys - 90% in the form of metabolites, less than 10% unchanged. T 1/2 from plasma is 7-12 hours. T 1/2 of ambroxol and its metabolites is approximately 22 hours.

Pharmacokinetics in special clinical situations

Ambroxol clearance in patients with severe liver failure reduced by 20-40%.

With severe kidney failure T 1/2 ambroxol metabolites increases.

Release form

Syrup from colorless to light yellow, transparent or almost transparent.

Excipients: benzoic acid - 2 mg, glycerol 85% - 127.5 mg, hyetellose - 1 mg, sorbitol (70% solution) - 250 mg, apricot flavor - 2.5 mg, propylene glycol - 30 mg, levomenthol - 0.08 mg, purified water - up to 1 ml.

100 ml - dark glass bottles with a dosing device (1) complete with a measuring spoon - packs of cardboard.

Dosage

During treatment with Ambrohexal ®, it is necessary to drink plenty of fluids (juices, tea, water) to enhance the mucolytic effect of the drug.

The duration of treatment with Ambrohexal ® is determined by the doctor individually and depends on the severity of the disease. If it is necessary to use the drug for more than 4-5 days, a doctor's consultation is required.

Tablets

The drug should be taken orally after a meal with a sufficient amount of liquid.

Adults and children over the age of 12 are prescribed 1 tab. (30 mg) 3 times / day for the first 2-3 days. Then the dose of the drug should be reduced to 1 tab. 2 times/day

Children aged 6 to 12 years are prescribed 1/2 tab. (15 mg) 2-3 times / day.

Syrup 3 mg/1 ml

The drug should be taken orally after meals. 1 scoop of Ambrohexal ® syrup (5 ml) contains 15 mg of ambroxol hydrochloride.

Adults and children over the age of 12 are prescribed 2 scoops 2-3 times / day (60-90 mg / day) for the first 2-3 days, then 2 scoops 2 times / day (60 mg / day). In severe cases of the disease, the dose is not reduced during the entire course of treatment. Maximum dose- 4 scoops (60 mg) 2 times / day (120 mg / day).

Children aged 5 to 12 years are prescribed 1 scoop 2-3 times / day (30-45 mg / day).

Children aged 2 to 5 years are prescribed 1/2 scoop 3 times / day (22.5 mg / day).

Children under 2 years of age are prescribed 1/2 scoop after 2 times / day (15 mg / day). The drug is prescribed only under the supervision of a physician.

Syrup 6 mg/1 ml

The drug should be taken orally.

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

Children aged 6 to 12 years are prescribed 1/2 scoop (2.5 ml) 2-3 times / day.

Children aged 2 to 6 years are prescribed 1/4 scoop (1.25 ml) 3 times / day.

Children under 2 years old: 1/4 scoop (1.25 ml) 2 times / day. The drug is prescribed only under the supervision of a physician.

Solution for oral and inhalation

Ingestion

The drug should be taken orally after meals in a diluted form with tea, fruit juices, milk or water.

1 ml of solution (20 drops) contains 7.5 mg of ambroxol hydrochloride.

Adults and children over the age of 12 are prescribed 4 ml (80 drops) 3 times / day (90 mg / day) for the first 2-3 days, then 4 ml (80 drops) 2 times / day (60 mg / day ).

Children aged 5 to 12 years are prescribed 2 ml (40 drops) 2-3 times / day (30-45 mg / day).

Children aged 2 to 5 years are prescribed 1 ml (20 drops) 3 times / day (22.5 mg / day).

Children under 2 years of age are prescribed 1 ml (20 drops) 2 times / day (15 mg / day). The drug is prescribed only under the supervision of a physician.

Application in the form of inhalations

Adults and children over the age of 5 years are recommended to carry out inhalations 1-2 times / day, 2-3 ml (40-60 drops, which corresponds to 15-45 mg of ambroxol).

The solution for inhalation can be used using any modern equipment for inhalation (except for steam inhalers). The drug is mixed with saline, to achieve the optimal level of air humidification in the respirator, the drug can be diluted in a ratio of 1:1. Since during inhalation therapy a deep breath can provoke coughing shocks, inhalations should be carried out in normal breathing mode. Before inhalation, it is usually recommended to warm the inhalation solution to body temperature. Patients with bronchial asthma it is possible to recommend carrying out inhalation after taking bronchodilators.

Overdose

Symptoms: nausea, vomiting, diarrhea, gastralgia, dyspepsia, increased salivation (syrup 6 mg / ml).

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

Interaction

With the simultaneous use of the drug Abrohexal ® with antitussives (including codeine), there is a difficulty in sputum discharge against the background of a decrease in cough.

Abrohexal ® increases the penetration of amoxicillin, cefuroxime, doxycycline, erythromycin into the bronchial secretion.

Side effects

Classification of undesirable effects according to the frequency of their development (WHO): very often (≥1/10), often (from ≥1/100 to<1/10), нечасто (от ≥1/1000 до <1/100), редко (от ≥1/10 000 до <1/1000), очень редко (<1/10 000), частота неизвестна - по имеющимся данным установить частоту возникновения не представлялось возможным.

Allergic reactions: rarely - skin rash, urticaria; the frequency is unknown - anaphylactic reactions, including anaphylactic shock, angioedema, pruritus and other hypersensitivity reactions. For syrup 6 mg / ml additionally: rarely - exanthema, swelling of the face, shortness of breath, itching, fever; very rarely - angioedema; frequency unknown - allergic contact dermatitis.

From the digestive system: often - nausea; infrequently - vomiting, diarrhea, dyspepsia, pain in the abdominal cavity. For syrup 3 mg / ml additionally: infrequently - heartburn. For syrup 6 mg / ml: often - oral and pharyngeal hypesthesia; infrequently - with prolonged use in high doses - gastralgia, nausea, vomiting; rarely - diarrhea.

From the nervous system: often - a change in taste sensations.

On the part of the skin: for syrup 6 mg / ml: very rarely - severe skin reactions (epidermal necrolysis, Stevens-Johnson syndrome).

Other: often - decreased sensitivity in the oral cavity or pharynx; infrequently - dry mouth; frequency unknown - dryness of the mucous membranes of the respiratory tract. For syrup 6 mg / ml: rarely - dry mouth and respiratory tract, rhinorrhea, dysuria, weakness, headache.

Indications

Acute and chronic diseases of the respiratory tract with the release of viscous sputum:

acute and chronic bronchitis;
pneumonia;
COPD;
bronchial asthma with difficulty in sputum discharge;
bronchiectasis;
treatment and prevention of respiratory distress syndrome (for 3 mg/ml syrup and oral and inhalation solution).

Contraindications

I trimester of pregnancy;
lactation period (breastfeeding);
children's age up to 6 years (for tablets);
lactase deficiency, lactose intolerance, glucose-galactose malabsorption (for tablets);
hereditary fructose intolerance (for syrup);
hypersensitivity to ambroxol and other components of the dosage forms of the drug.

With caution, the drug should be used for peptic ulcer of the stomach and duodenum (due to possible exacerbation), renal failure, liver failure, in the II and III trimesters of pregnancy.

Application features

Use during pregnancy and lactation

The drug is contraindicated for use in the first trimester of pregnancy.

The use of the drug in the II and III trimesters of pregnancy is possible only if the intended benefit to the mother outweighs the potential risk to the fetus.

Ambroxol crosses the placental barrier. In experimental animal studies, it has been shown that the drug has no effect on embryofetal development, childbirth and postnatal development.

Ambroxol is excreted in small amounts in breast milk, therefore, when using the drug Ambrohexal ®, it is necessary to resolve the issue of stopping breastfeeding.

Application for violations of liver function

The drug should be used with caution in hepatic insufficiency.

In severe liver dysfunction, lower concentrations should be used, or the interval between doses of the drug should be increased.

Application for violations of kidney function

The drug should be used with caution in renal failure.

In severe renal impairment, lower concentrations should be used, or the interval between doses of the drug should be increased.

Use in children

Contraindicated in children under 6 years of age (for tablets).

special instructions

Ambroxol should not be taken concomitantly with antitussive drugs that can inhibit the cough reflex, such as codeine, because. this can make it difficult to remove liquefied sputum from the bronchi.

Ambroxol should be used with caution in patients with a weakened cough reflex or impaired mucociliary transport due to the possibility of sputum accumulation.

Ambroxol should not be taken immediately before bedtime.

In patients with bronchial asthma, ambroxol may increase coughing.

In patients with severe skin lesions - Stevens-Johnson syndrome or toxic epidermal necrolysis - an influenza-like condition may be observed in the early phase: fever, body pain, rhinitis, cough, pharyngitis. With symptomatic therapy, the erroneous prescription of mucolytic agents, such as ambroxol hydrochloride, is possible.

There are isolated reports of the detection of Stevens-Johnson syndrome and toxic epidermal necrolysis, coinciding in time with the appointment of the drug. However, there is no causal relationship with drug use.

With the development of the above syndromes, it is recommended to stop taking the drug; the patient should immediately consult a doctor.

The solution for oral administration and inhalation contains sodium metabisulphite (preservative), which can cause the development of hypersensitivity reactions (especially in patients with bronchial asthma), which manifests itself in the form of vomiting, diarrhea, bronchospasm attacks, impaired consciousness or anaphylactic shock. These reactions can be very individual and can also lead to life-threatening consequences.

For syrup 6 mg / ml additionally: in case of bronchial motility disorders and an increase in the amount of secretion (for example, immobile cilia syndrome) due to the risk of mucus accumulation, the drug can be taken only after consultation with the attending physician and under medical supervision. In case of severe impairment of kidney and liver function, lower concentrations should be used, or the interval between doses of the drug should be increased.

Note for diabetic patients: 1 tablet contains less than 0.01 XE; 1 scoop (5 ml) of 3 mg/ml syrup contains 1.75 g of sorbitol (less than 0.15 XE); 1 scoop (5 ml) of 6 mg/ml syrup contains 2.525 g of sorbitol (0.21 XE).

Influence on the ability to drive vehicles and control mechanisms

Ambrohexal ® does not adversely affect the ability to drive vehicles or work with mechanisms.

Composition and form of release of the drug

◊ Tablets white, round, flat, with bevelled edges, with a notch on one side.

Excipients: lactose monohydrate - 102 mg, calcium hydrophosphate dihydrate - 50 mg, corn starch - 10 mg, sodium carboxymethyl starch - 4 mg, magnesium stearate - 2 mg, colloidal silicon dioxide - 2 mg.

10 pieces. - cellular contour packings (2) - packs of cardboard.

pharmachologic effect

Mucolytic and expectorant, is an active N-demethylated metabolite. It has a secretomotor, secretolytic and expectorant action. Stimulates the serous cells of the bronchial mucosa, increases the motor activity of the ciliated epithelium by acting on type 2 pneumocytes in the alveoli and Clara cells in the bronchioles, enhances the formation of endogenous surfactant - a surfactant that ensures the sliding of bronchial secretions in the lumen of the respiratory tract.

Ambroxol increases the proportion of the serous component in the bronchial secretion, improving its structure and helping to reduce the viscosity and thin the sputum; as a result of this, mucociliary transport is improved and sputum removal from the bronchial tree is facilitated.

When taking Ambroxol orally, the effect, on average, occurs after 30 minutes and lasts 6-12 hours, depending on the single dose.

Pharmacokinetics

After oral administration, Ambroxol is rapidly and almost completely absorbed. T max is 1-3 hours. Protein binding is approximately 85%. Penetrates through the placental barrier, excreted in breast milk. It is metabolized in the liver to form metabolites (dibromanthranilic acid, glucuronic conjugates), which are excreted by the kidneys. It is excreted mainly by the kidneys - 90% in the form of metabolites, less than 10% unchanged. T 1/2 from plasma is 7-12 hours. T 1/2 of ambroxol and its metabolites is approximately 22 hours.

Due to the high protein binding and large V d , as well as the slow reverse penetration from the tissues into the blood, during dialysis or forced diuresis, significant excretion of ambroxol does not occur. The clearance of ambroxol in patients with severe is reduced by 20-40%. In severe renal failure T 1/2 ambroxol metabolites increases.

Indications

For oral administration

Diseases of the respiratory tract, accompanied by the release of viscous sputum and difficulty in expectoration of sputum: acute and chronic bronchitis; pneumonia; ; bronchiectasis; COPD

For intravenous administration

Diseases of the respiratory tract with the release of viscous sputum and with difficulty in sputum discharge in cases where it is necessary to obtain a quick therapeutic effect or it is impossible to take the drug orally: acute and chronic bronchitis; pneumonia; bronchial asthma; bronchiectasis; stimulation of surfactant synthesis in respiratory distress syndrome in premature babies and newborns (as part of complex therapy).

Contraindications

Hypersensitivity to ambroxol or auxiliary components of drugs; I trimester of pregnancy; lactation period (breastfeeding); congenital intolerance to fructose (for dosage forms containing fructose); children's age up to 6 years (for tablets); children's age up to 12 years (for long-acting capsules).

Carefully: impaired bronchial motility and increased secretion of mucus (for example, with a rare syndrome of immobile cilia); renal failure and / or severe liver failure; peptic ulcer of the stomach and duodenum (including history); II and III trimesters of pregnancy; children under 2 years of age (solution for oral administration; only as prescribed by a doctor).

Dosage

The duration of treatment is determined by the doctor individually and depends on the severity of the disease. If it is necessary to use the drug for more than 4-5 days, a doctor's consultation is required.

For oral administration

It is taken orally after a meal with a sufficient amount of liquid.

Dosage forms of usual duration of action (tablets, syrup, oral solution, lozenges)

Adults and children over the age of 12: 30 mg 2-3 times / day for the first 2-3 days, then 30 mg 2 times / day.

Children aged 5 to 12: 30-45 mg / day in 2-3 doses.

Children aged 2 to 5 years: 22.5 mg / day in 3 divided doses.

Children under 2 years of age: 15 mg/day in 2 divided doses. The drug is prescribed only under the supervision of a physician.

Long-acting capsules

Adults and children over 12 years of age: 75 mg 1 time / day.

For intravenous administration

Enter in / in slowly jet or drip.

Adults: 30-45 mg/day, 2-3 times/day in divided doses. In severe cases, the dose may be increased by 60-90 mg/day, 2-3 times/day in divided doses.

For children the daily dose is usually 1.2-1.6 mg/kg of body weight.

Children over the age of 6: 30-45 mg/day, 2-3 times/day in divided doses.

Children aged 2 to 6 years: 22.5 mg/day, 3 times/day in divided doses.

Children under 2 years of age: 15 mg/day, 2 times/day in divided doses.

At respiratory distress syndrome at newborns and premature babies the daily dose is 30 mg and is usually divided into 4 separate injections.

Treatment children under 2 years old should only be done under medical supervision.

Parenteral use is stopped after the disappearance of acute manifestations of the disease and they switch to taking Abmroxol orally in the appropriate dosage forms.

At patients with renal insufficiency And severe renal failure Ambroxol should be used at longer intervals or at reduced doses.

Side effects

Allergic reactions: rarely - skin rash, urticaria, exanthema, swelling of the face, shortness of breath, itching, fever; frequency unknown - anaphylactic reactions, including anaphylactic shock, angioedema, pruritus, allergic contact dermatitis.

From the digestive system: often - nausea; infrequently - vomiting, diarrhea, dyspepsia,.

From the nervous system: often - dysgeusia.

From the skin and subcutaneous tissues: very rarely - toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome; frequency unknown - acute generalized eczematous pustulosis.

From the respiratory system: often - decreased sensitivity in the oral cavity or pharynx; rarely - dryness of the mucous membrane of the respiratory tract, rhinorrhea; in isolated cases - dryness of the mucous membrane of the pharynx.

drug interaction

Antitussives (such as codeine)- due to the suppression of the cough reflex, sputum may accumulate in the lumen of the respiratory tract with difficulty in its removal (simultaneous use is not recommended).

, doxycycline, cefuroxime, erythromycin- increased penetration of antibiotics into bronchial secretions.

special instructions

Ambroxol should not be taken concomitantly with antitussive drugs that can inhibit the cough reflex, such as codeine, because. this can make it difficult to remove liquefied sputum from the bronchi.

Ambroxol should be used with caution in patients with a weakened cough reflex or impaired mucociliary transport due to the possibility of sputum accumulation.

Ambroxol should not be taken immediately before bedtime.

In patients with bronchial asthma, ambroxol may increase coughing.

Pregnancy and lactation

Ambroxol is contraindicated in the first trimester of pregnancy. If necessary, use in the II and III trimesters should evaluate the potential benefit of therapy for the mother and the possible risk to the fetus.

If it is necessary to use ambroxol during lactation, the issue of stopping breastfeeding should be resolved.

Application in childhood

Application is possible in accordance with the dosing regimen.

Use in the elderly

The drug is approved for use in elderly patients

In this article, you can read the instructions for using the drug Ambrohexal. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Ambrohexal in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Ambrohexal in the presence of existing structural analogues. Use for the treatment of bronchitis and pneumonia in adults, children, as well as during pregnancy and lactation.

Ambrohexal- mucolytic drug with expectorant action. It has a secretomotor, secretolytic and expectorant action.

The decrease in sputum viscosity occurs as a result of the depolymerization of mucopolysaccharides, which, in turn, is associated with the breaking of disulfide bonds in their molecules. Ambroxol (active ingredient of the drug Ambrohexal) increases the motor activity of the cilia of the ciliated epithelium, increases mucociliary transport, normalizes the ratio of serous and mucous components of sputum.

By activating hydrolyzing enzymes and increasing the release of lysosomes from Clark cells, ambroxol reduces the viscosity of sputum, facilitating its removal from the respiratory tract.

As a result of chronic diseases of the respiratory system, properties change (due to the formation of bonds between surface-active phospholipids and inflammatory proteins) and surfactant synthesis decreases. Ambroxol stimulates prenatal lung development by increasing the synthesis and secretion of surfactant in the alveoli.

The action of Ambrohexal begins after 30 minutes and lasts 6-12 hours. The maximum therapeutic effect is manifested on the 3rd day of treatment.

Composition

Ambroxol hydrochloride + excipients.

Pharmacokinetics

After oral administration, Ambrohexal is rapidly and almost completely absorbed from the gastrointestinal tract. Binding to plasma proteins - 80-90%. Ambroxol crosses the blood-brain barrier (BBB), the placental barrier, and is excreted in breast milk. The drug is metabolized in the liver to inactive metabolites (dibromanthranilic acid, glucuronic conjugates). It is excreted mainly in the urine - 90% in the form of metabolites, 10% unchanged.

Indications

Acute and chronic diseases of the respiratory tract, accompanied by the formation of a viscous secret:

acute and chronic bronchitis;
pneumonia;
COPD;
bronchial asthma with difficulty in sputum discharge;
bronchiectasis;
treatment and prevention of respiratory distress syndrome (for syrup and solution for oral administration and inhalation).

Release form

Tablets 30 mg.

Long-acting capsules 75 mg.

Solution for inhalation and oral administration (sometimes erroneously called drops).

Instructions for use and method of use

Tablets

Adults and children over the age of 12 are prescribed 1 tablet (30 mg) 3 times a day for the first 2-3 days. Then the dose of the drug should be reduced to 1 tablet 2 times a day.

Children aged 6 to 12 years are prescribed 1/2 tablet (15 mg) 2-3 times a day.

Long-acting capsules

Adults and children over the age of 12 are prescribed 1 capsule (75 mg) 1 time per day in the morning or evening after meals, without chewing, drinking plenty of liquid.

Syrup

Adults and children over the age of 12 are prescribed 2 scoops (30 mg) 2-3 times a day for the first 2-3 days. Then 2 scoops 2 times a day. In severe cases of the disease, the dose is not reduced during the entire course of treatment. The maximum dose is 4 scoops (60 mg) 2 times a day.

Children aged 5 to 12 years are prescribed 1 scoop (15 mg) 2-3 times a day.

Children aged 2 to 5 years are prescribed 1/2 scoop (7.5 mg) 3 times a day.

Children under the age of 2 years are prescribed 1/2 scoop (7.5 mg) after meals 2 times a day. The drug is prescribed only under the supervision of a physician.

Solution for oral and inhalation

Adults and children over the age of 12 are prescribed 4 ml (30 mg) 3 times a day for the first 2-3 days. Then the dose of the drug should be reduced to 4 ml 2 times a day.

Children aged 5 to 12 years are prescribed 2 ml (15 mg) 2-3 times a day.

Children aged 2 to 5 years are prescribed 1 ml (7.5 mg) 3 times a day.

Children under the age of 2 years are prescribed 1 ml (7.5 mg) 2 times a day.

The drug should be taken orally after meals in a diluted form with tea, fruit juices, milk or water.

The oral solution can also be used as an inhalation.

Adults and children over the age of 5 years are recommended to carry out inhalations 1-2 times a day for 2-3 ml (40-60 drops, which corresponds to 15-22.5 mg of ambroxol).

For inhalation, use the appropriate device in compliance with the rules of use.

Ambrohexal should be taken orally after meals with a sufficient amount of liquid.

During treatment, it is necessary to drink plenty of fluids (juices, tea, water) to enhance the mucolytic effect of the drug.

The duration of treatment is determined by the doctor individually and depends on the severity of the disease. If necessary, the use of the drug for more than 4-5 days requires medical supervision.

Side effect

stomach ache;
nausea;
constipation;
dry mouth;
increased salivation;
increased secretion of mucus in the nasal cavity;
dry airways;
skin rashes;
hives;
angioedema;
bronchospasm;
fever and chills;
anaphylactic shock;
weakness;
headache;
difficulty urinating (dysuria).

Contraindications

1 trimester of pregnancy;
children's age up to 6 years (for tablets);
children's age up to 12 years (for capsules of prolonged action);
hypersensitivity to ambroxol and other components of the dosage forms of the drug.

Use during pregnancy and lactation

The use of the drug in the 1st trimester of pregnancy is contraindicated.

The use of the drug in the 2nd and 3rd trimesters of pregnancy is possible only if the intended benefit to the mother outweighs the potential risk to the fetus.

The drug should be used with caution during breastfeeding, since Ambroxol is excreted in breast milk.

Use in children

Contraindications: children under 6 years of age (for tablets); children's age up to 12 years (for capsules of prolonged action);

special instructions

Ambrohexal should be used with caution in patients with a weakened cough reflex or impaired mucociliary transport due to the possibility of sputum accumulation.

In patients with bronchial asthma, ambroxol may increase coughing.

Ambroxol should not be taken immediately before bedtime.

In case of severe impairment of liver and / or kidney function, lower concentrations should be used, or the interval between doses of the drug should be increased.

Patients with impaired fructose tolerance should consult a doctor before using Ambrohexal.

drug interaction

With the simultaneous use of Ambrohexal with antibiotics (including amoxicillin, cefuroxime, doxycycline, erythromycin), the concentration of the latter increases in the bronchial secretion.

With the simultaneous use of Ambrohexal with antitussives (including codeine), due to the suppression of the cough reflex, it may be difficult to discharge sputum from the bronchial tree.

Analogues of the drug Ambrohexal

Structural analogues for the active substance:

Ambrobene;
Ambroxol;
Ambrolan;
Ambrosan;
Ambrosol;
Bronchoxol;
Bronchorus;
Deflegmin;
Drops Bronchovern;
Lazolangin;
Lazolvan;
Medox;
Mucobron;
Neo Bronchol;
Remebrox;
Supreme coffee;
Fervex for cough;
Flavamed;
Halixol.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Ambrohexal is a drug that has a mucolytic, secretolytic and expectorant effect, and the active ingredient of the drug is ambroxol.

The mechanism of action of this drug is associated with a decrease in sputum viscosity as a result of depolymerization of sputum mucopolysaccharides, which consists in breaking disulfide bonds in molecules, enhancing the release of active hydrolyzing enzymes from Clark cells.

On this page you will find all the information about Ambrohexal: full instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Ambrohexal. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

A drug with secretolytic, mucolytic and expectorant effects.

Terms of dispensing from pharmacies

No prescription needed.

Prices

How much does Ambrohexal cost? The average price in pharmacies depends on the form of release:

The cost of Ambrohexal tablets is about 84 rubles for 20 pieces.
Long-acting capsules will cost 120 rubles for 10 pieces.
A bottle of liquid for inhalation costs about 92 rubles per 50 ml.
The syrup costs about 103 rubles per 100 ml.

Release form and composition

To date, the drug is sold in the following dosage forms:

Tablets of 10 pieces in a blister, in one box 2, 5 or 10 blister packs;
Capsules - 10 pieces in a blister, in cardboard packs of 1, 2 or 5 blister packs;
Solution for inhalation and oral administration - 50 or 100 ml in vials with a measuring cup included;
Syrup - in bottles of 100 or 250 ml with a measuring spoon included.

The active ingredient of the drug is ambroxol. Auxiliary components are different and depend on the form of release.

Pharmacological effect

The mechanism of action is based on increased stimulation of the movement of the ciliated epithelium of the bronchi. Ambrohexal improves bronchial motility and stimulates sputum secretion. The drug copes with a number of therapeutic tasks: reduction of cough, improvement of bronchial secretion, normalization of sputum separation, promotion of sputum along the bronchopulmonary pathways.

Indications for use

The doctor prescribes Ambrohexal cough tablets in case of a disease of the lungs or respiratory tract, accompanied by thick sputum, the removal of which is problematic (often the patient also suffers from a dry cough).

The list of such ailments is as follows:

- inflammation in the tracheal mucosa due to infection and other causes;
- such a pathology is of an allergic origin, with it the bronchi narrow, and thick sputum accumulates in their lumen;
cystic fibrosis - such a disease is hereditary, distinguished by its severity (characterized by the production of viscous sputum);
(inflammation of the lungs), occurs due to the presence of various bacteria;
infectious (chronic or acute course) - with it, the mucous membrane of the bronchi becomes inflamed, which is provoked by bacteria or viruses;
bronchiectasis, which is a pathological chronic process characterized by partial expansion of the bronchi and bronchioles (places of accumulation of viscous sputum);
- most often provoked by long-term irritation of the bronchial mucosa by smoking and the influence of various chemical compounds.

First of all, after taking the medicine, the protective function of the respiratory tract improves.

Contraindications

You can not use Ambrohexal in the treatment of hypersensitivity to the active components of the drug, as well as with a stomach or duodenal ulcer. In severe liver and kidney damage, the mucolytic is used with great care. If the cough reflex is disturbed, congestion may occur due to the accumulation of sputum.

Use during pregnancy and lactation

Taking Ambrohexal during pregnancy is contraindicated, because there is always a risk of negative effects on the developing fetus.

However, due to the fact that Ambroxol is a stimulant of lung development in the perinatal period, by increasing the synthesis of surfactant and blocking its decay, it is prescribed to pregnant women with suspected fetal malnutrition to stimulate lung maturation, as well as with the threat of premature birth.

Instructions for use Ambrohexal

The instructions for use indicate that the drug in the form of tablets and capsules is taken orally with water after meals.

Tablets adults and children over 12 years of age are prescribed at a dosage of 30 mg (1 tablet) three times a day for the first 2-3 days. Further, the dosage is reduced to 1 tablet twice a day. Children aged 6 to 12 years are prescribed half a tablet (15 mg) two to three times a day. Do not take the drug for more than 4-5 days without a doctor's prescription. During the entire treatment, the patient is advised to drink more fluids to enhance the mucolytic effect.
A drug in the form of capsules prescribed for adults and children over 12 years of age at a dosage of 1 capsule (75 mg) per day after meals in the morning or evening. Capsules are also not recommended to be taken for more than 5 days without a doctor's prescription.
Solution for oral administration and preparation of inhalations adults and children over 12 years of age are prescribed 4 ml (30 mg) 3 times a day for the first 2-3 days, then 4 ml once a day. Children from 5 to 12 years old are prescribed 2 ml two to three times a day. Children from 2 to 5 years - 1 ml three times a day. Children under two years old - 1 ml 2 times a day only under medical supervision. The solution should be dissolved in tea, water, juice or milk.

Inhalations with Ambrohexal solution for adults and children over 5 years old are carried out 1-2 times a day at a dosage of 2-3 ml, for children under 5 years old - 2 ml each. Inhalations should be carried out using a special device.

The course of treatment can be prescribed only by the attending physician.

Side effects

Ambroxol as part of AmbroGEKSAL tablets is well tolerated. Sometimes it is possible to develop its side effects, which are characterized by such manifestations:

Symptoms of disruption of the digestive system - nausea, vomiting, periodic bloating, which are accompanied by dryness of the mucous membranes. Somewhat less often, pain in the abdomen, which is spastic in nature, may appear.
On the part of the nervous system - a slight violation of taste sensations.
A change in the general well-being of a person after taking the drug, which is accompanied by headache, fever, general weakness.
Allergic reactions to any of the components of the drug, including ambroxol, manifest themselves in the form of a rash on the skin, which may be accompanied by itching. With a more pronounced reaction of the body, urticaria develops (a rash on the skin appears against the background of a slight edema, which looks like a nettle burn), Quincke's edema (angioedema of the skin and subcutaneous tissue in the face or external genitalia). It is extremely rare to develop anaphylactic shock - a severe allergic reaction in which there is a progressive decrease in systemic blood pressure and loss of consciousness.

Cases of the development of severe skin lesions (Stephen-Jones syndrome) have been described, the appearance of which was associated with the use of drugs based on ambroxol. However, such skin lesions are associated more with the underlying disease than with ambroxol. In the event of any manifestations, symptoms or reactions to taking AmbroGEXAL tablets, you must stop taking them and consult a doctor.

drug interaction

Simultaneous use with antibiotics (erythromycin, amoxicillin) leads to an increase in their concentration in sputum and bronchopulmonary secretions.

When combined with antitussives containing codeine, sputum stagnation is possible due to inhibition of the cough center.

Ambrohexal can be used with drugs used in bronchial syndrome (bronchospasmolytics, glucocorticosteroids, cardiac glycosides, diuretics).