Ambroxol tablets and syrup: instructions for use. Ambroxol tablets - instructions for use Ambroxol method of administration for adults

The autumn-winter period is invariably characterized by the presence of colds and viral diseases. Most often, these ailments are accompanied by a runny nose and cough, which requires separate therapeutic measures. There are many different treatments for dry cough, but how do you choose the safest and most effective treatment?
One of the most popular drugs are Ambroxol tablets, reviews of which are very numerous. They inform about the effectiveness of the drug, and also that its great advantage is the permission to treat children.

Release form

"Ambroxol" is a herbal mucolytic preparation with a pronounced expectorant properties. It effectively dilutes and removes even stubborn phlegm from the lungs. It is produced in two main forms - syrup and Ambroxol tablets. With a dry cough in children under 6 years of age, a liquid form of the drug is prescribed, in adults and children over 6 years of age - a tablet form.
Ambroxol tablets are flat, cylindrical and white. Placed in blisters with separate contour cells, which are packed in packs. A cardboard box contains from 1 to 5 blisters.

Composition of the preparation

One Ambroxol cough tablet contains 30 mg of the main active ingredient - ambroxol hydrochloride. In addition, the composition includes additional components:

Medicinal properties

The drug is an effective herbal medicine. Reviews of Ambroxol tablets indicate that they have the ability to cure dry cough with difficult to separate phlegm.
The effect of the drug is due to the restoration of mucociliary transport, which lowers the viscosity of the secretion by changing the chemical composition of its mucopolysaccharides. In addition to an expectorant, the drug has the following properties:

• antioxidant;
• anti-inflammatory.

The tool prevents the penetration of pathogenic microorganisms into the respiratory tract, which accelerates the appearance of positive dynamics. From the plant Adhatoda vasica, an element was removed - vazicin, which was then synthesized into a substance - bromhexine. Ambroxol is its active metabolite, but it is characterized by the absence of toxicity and greater effectiveness.

How does it work?

The action of Ambroxol tablets, patient reviews confirm this, begins literally 30 minutes after use. Its therapeutic effect lasts for 10 hours, the absorption of the drug into the blood and tissues is observed almost immediately, it is completely absorbed.

It reaches its highest concentration in blood plasma already from 30 minutes to 3 hours. The percentage of its binding to blood proteins is very high, reaching 90%. The active ingredient quickly settles in the tissues of the body, its greatest amount enters the lungs. The liver is involved in the process of metabolization, and the drug is excreted by the kidneys, 5% comes out in its original form.

In what cases is it applied?

A complete instruction to "Ambroxol" informs that the drug is successfully used for all types of diseases, accompanied by the presence of difficult to separate sputum. It is prescribed for such ailments as:

• bronchitis in acute and chronic form;
• obstructive bronchitis;
• COPD (chronic obstructive pulmonary disease);
• bronchial asthma;
• pneumonia;
• bronchiectasis;
• cystic fibrosis;
• trancheobronchitis.

Contraindications and side effects

Despite the relatively safe composition, the drug has some restrictions on its intake. It is contraindicated for:

In addition, as the reviews confirm, the expectorant Ambroxol can provoke a number of negative phenomena:

• from the gastrointestinal tract - nausea, vomiting, diarrhea, thirst, heartburn, dyspepsia;
• from the side of the central nervous system - headache, weakness, drowsiness;
• allergic manifestations - urticaria, skin rash and itching, angioedema.

Stevens-Johnson syndrome and Lyell's syndrome are extremely rare. Considering these factors, it is imperative to consult a specialist before taking the drug.

How to take it right?

Depending on the form of the drug, treatment with "Ambroxol" has a different scheme.
1. The syrup has a different concentration of the active substance, this directly affects the dosage. It is calculated as follows: a single dose should not exceed more than 30 mg of the drug for adults and children over 12 years of age. For children under 12 years of age, 15 mg of the drug is sufficient for a single dose. In such an amount, the agent is taken three times a day.
2. Tablets "Ambroxol" are intended for oral administration. They need to be consumed at the same time with food, washed down with water. The unit of the tablet form of the drug contains 30 mg of the main component, therefore the therapeutic dose is calculated as follows: adults and children over 12 years old should take 1 tablet three times a day for the first three days. After that, change the scheme - take 0.5 tablets three times a day, or whole, but twice a day.
Children under 12 years of age are treated as follows: 0.5 tablets twice to three times a day, the dosage is prescribed by the doctor individually.

The duration of therapy ranges from 3 to 5 days, if necessary, the course can be extended, but only with the permission of the attending physician.

Reception of "Ambroxol" during pregnancy and children

Taking pills is strictly contraindicated in babies under 6 years old. During the first trimester of pregnancy, it is also not prescribed, since this period is the most dangerous. Starting from the second trimester, Ambroxol can be discharged only on strict indications.
During lactation, a specialist can prescribe a remedy only if the potential threat to the baby is much less than the benefit to the mother.

Overdose

Excessive intake of funds can provoke intoxication of the body. This manifests itself in symptoms such as:

• nausea;
• vomit;
• diarrhea.

In such cases, first aid should be provided - induce vomiting, take a product containing fat, and call an ambulance. The victim will be gastric flushed and supportive therapy will be prescribed.

Simultaneous administration of drugs

It is unacceptable to take "Ambroxol" simultaneously with drugs with antitussive properties - this will reduce the effectiveness of treatment. The passage of amoxicillin, erythromycin and dioxycillin into the bronchial secretion increases.

Description

Tablets are white or white with a yellowish sheen, flat-cylindrical, with a chamfer and a score.
The risk on the pill has a functional purpose, to be divided into two halves equal in dosage.

Compound

Each tablet contains: active ingredient - ambroxol hydrochloride - 30 mg; auxiliary substances - lactose monohydrate, potato starch, calcium stearate, colloidal anhydrous silicon dioxide.

Pharmacotherapeutic group

Means used for coughs and colds. Mucolytic agents.
ATX code- R05СВ06.

Pharmacological properties

Pharmacodynamics
Mucolytic agent, increases the synthesis, secretion of surfactant and blocks its breakdown. It has a secretomotor, secretolytic and expectorant effect; stimulates serous cells of the glands of the bronchial mucosa, increases the content of mucous secretions and the release of a surfactant (surfactant) in the alveoli and bronchi; normalizes the disturbed ratio of serous and mucous components of sputum. By activating hydrolyzing enzymes and enhancing the release of lysosomes from Clarke cells, it reduces the viscosity of sputum. Increases the motor activity of the ciliated epithelium, increases mucociliary transport.
After oral administration, the effect occurs after 30 minutes and lasts for 6-12 hours.
Pharmacokinetics
Suction
Absorption of ambroxol hydrochloride from oral forms with immediate release is rapid and fairly complete with a linear relationship in the therapeutic range. The maximum concentration in blood plasma is achieved within 1–2.5 hours after ingestion of the immediate-release dosage form and, on average, 6.5 hours after taking the prolonged-release dosage form.
The absolute bioavailability after taking 30 mg tablets was 79%.
Distribution
The distribution of ambroxol hydrochloride from the blood into the tissue is rapid and pronounced, with the highest concentration of the active substance found in the lungs. The volume of distribution after oral administration is 552 liters.
In the therapeutic range, the plasma protein binding is about 90%.
Metabolism and excretion
About 30% of the dose taken orally is excreted as a result of presystemic metabolism. Ambroxol hydrochloride metabolism occurs predominantly in the liver by glucuronidation and partial cleavage to dibromantranilic acid (approximately 10% of the dose). Studies of human liver microsomes have shown that CYP3A4 is responsible for the metabolism of ambroxol hydrochloride to dibromantranilic acid.
Within 3 days of oral administration, approximately 6% of the dose is found in free form, and about 26% of the dose appears in the urine in the form of conjugates.
The half-life of ambroxol hydrochloride from the body is 10 hours. The total clearance is in the range of 660 ml / min, renal clearance provides approximately 8% of the total clearance. After 5 days, about 83% of the dose taken is excreted in the urine.
Pharmacokinetics in special patient groups
In patients with impaired liver function, the excretion of ambroxol hydrochloride decreases, which leads to an increase in its level in blood plasma by 1.3-2 times. Due to the high therapeutic index of the drug, no dose adjustment is required.
The pharmacokinetics of ambroxol are clinically independent of age and gender, therefore, dose changes are not required.
The bioavailability of ambroxol hydrochloride is independent of food intake.

Indications for use

Secretolytic therapy for acute and chronic bronchopulmonary diseases associated with impaired formation and excretion of sputum.
Contraindications
Hypersensitivity to the active substance, ambroxol hydrochloride, or any of the excipients listed in the "Composition" section.
Ambroxol, 30 mg tablets, not suitable for children under 6 years of age, due to the high content of the active ingredient.

Method of administration and dosage

Inside, with or without food, with enough liquid (for example, water, tea or fruit juice) to swallow the tablet.
Adults and adolescents from 12 years old: in the first 2-3 days, 1 tablet (30 mg) 3 times a day. Then 1 tablet (30 mg) 2 times a day.
For adults and adolescents from 12 years of age, to increase the therapeutic efficacy, the dose can be increased to 2 tablets 2 times a day (which is equivalent to 120 mg of ambroxol hydrochloride / day).
Children aged 6 to 12: 1/2 tablet (15 mg) 2 - 3 times a day.
The duration of treatment is determined by the doctor individually and depends on the severity of the disease.

Side effects

Side effects are classified by frequency of occurrence: very often (≥1 / 10), often (≥1 / 100, but<1/10), нечасто (≥1/1000, но <1/100), редко (≥1/10000, но <1/1000), очень редко (<1/10000), частота неизвестна (на основании имеющихся данных оценить невозможно).
Immune system disorders: rarely - hypersensitivity reactions; frequency unknown - anaphylactic reactions, including anaphylactic shock, angioedema, itching.
Respiratory, chest and mediastinal disorders: frequency unknown - shortness of breath (as a symptom of hypersensitivity).
Gastrointestinal disorders: often - nausea, infrequently - vomiting, diarrhea, dyspepsia, abdominal pain; very rarely - drooling.
Skin and subcutaneous tissue disorders: rarely - skin rash, urticaria; frequency unknown - severe skin reactions (including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis).
Kidney and urinary tract disorders: very rarely - dysuria.
General disorders and reactions at the injection site: infrequently - fever, reactions from the mucous membranes.
Reporting adverse reactions
It is important to report suspected adverse reactions after registration of a medicinal product in order to ensure continuous monitoring of the benefit-risk ratio of the medicinal product. Medical professionals are encouraged to send information about any suspected adverse reactions and drug ineffectiveness to the address: Republican Unitary Enterprise "Center for Expertise and Testing in Healthcare", per. Tovarishchesky, 2a, 220037, Republic of Belarus, e-mail: [email protected].

Interaction with other medicinal products

Combined use with antitussive drugs leads to difficulty in sputum discharge against the background of a decrease in cough, therefore Ambroxol is not recommended to be combined with antitussives that impede the excretion of sputum. This combination should only be used after careful medical assessment of the benefit / risk ratio.
Ambroxol increases the penetration of amoxicillin, cefuroxime, erythromycin and doxycycline into the bronchial secretions, the clinical significance of this has not been established.

Precautionary measures

There are reports of the possibility of developing severe skin reactions such as erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis when taking ambroxol.
It is necessary to immediately stop using the drug if symptoms of a progressive skin reaction appear (including those associated with the development of blisters and damage to the mucous membranes).
In case of impaired renal function or severe liver disease, the drug can be taken only after consulting a doctor. As with any drug that is metabolized in the liver and excreted by the kidneys, in the case of severe renal impairment, the accumulation of ambroxol metabolites formed in the liver is expected.
In patients with impaired motor function of the bronchi and the formation of a large amount of secretion (as, for example, in the syndrome of primary ciliary dyskinesia), Ambroxol is recommended to be used with caution because of the possible accumulation of sputum in the airway lumen.
The drug contains lactose, so it should not be taken by patients with rare congenital galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome.

Pregnancy and lactation

Adequate and strictly controlled clinical studies on the safety of the use of Ambroxol during pregnancy and lactation have not been conducted.
Ambroxol crosses the placental barrier. Animal studies have not shown any direct or indirect negative effects on pregnancy, embryo / fetal development, childbirth. Extensive clinical experience has shown that there are no signs of adverse effects on the fetus after 28 weeks of gestation. However, the usual precautions for the use of medicines during pregnancy should be followed. Ambroxol is not recommended for use especially during the first trimester of pregnancy.
Ambroxol passes into breast milk. Although no adverse effects of the drug on the child are expected, Ambroxol is not recommended for mothers who are breastfeeding.

In this article, you can read the instructions for using the medicinal product. Ambroxol... The reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Ambroxol in their practice are presented. A big request to more actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, which may not have been declared by the manufacturer in the annotation. Analogs of Ambroxol in the presence of available structural analogs. Use to treat cough and get rid of phlegm in various respiratory diseases in adults, children, as well as during pregnancy and lactation.

Ambroxol- a mucolytic agent with an expectorant effect. Stimulates serous cells of the glands of the bronchial mucosa, increasing the content of mucous secretions and, thus, changes the disturbed ratio of serous and mucous components of sputum. At the same time, hydrolyzing enzymes are activated, and the release of lysosomes from Clara cells is enhanced, which leads to a decrease in the viscosity of the sputum. Ambroxol increases the content of surfactant in the lungs, which is associated with an increase in its synthesis and secretion in alveolar pneumocytes, as well as with a violation of its decay. Increases mucociliary sputum transport. Slightly suppresses cough.

Pharmacokinetics

Absorption is high. Penetrates the blood-brain barrier, placental barrier, excreted in breast milk. Excreted by the kidneys: 90% in the form of water-soluble metabolites, unchanged - 5%.

Indications

Respiratory tract diseases with the formation of viscous sputum:

• acute and chronic bronchitis
• pneumonia
• chronic obstructive pulmonary disease (COPD)
• bronchial asthma with difficulty in sputum discharge
• bronchiectasis
• cystic fibrosis;
• respiratory distress syndrome in newborns and premature babies.

Forms of issue

Tablets 15 mg and 30 mg.

Syrup (ideal for children).

Instructions for use and dosage regimen

Tablets

Inside, during meals, with a small amount of liquid.

Adults and children over 12 years of age are prescribed 30 mg 3 times a day for the first 2-3 days, then 30 mg 2 times a day or 15 mg (half a tablet) 3 times a day.

Children 6-12 years old - 15 mg (half a tablet) 2-3 times a day.

Syrup

Inside for adults and children over 12 years old - 30 mg 2-3 times a day.

Dosing regimen for children under 12 years of age:

5-12 years old - 15 mg - 2-3 times a day;

2-5 years old - 7.5 mg - 3 times a day;

up to 2 years - 7.5 mg - 2 times a day.

In the form of inhalation for adults and children over 5 years old - 15-22.5 mg 1-2 times a day.

Parenteral (intramuscular, intravenous) adults - 15 mg, in severe cases - 30 mg 2-3 times a day; children - 1.2-1.6 mg / kg 3 times a day.

For the treatment of respiratory distress syndrome in premature and newborn babies, ambroxol is administered intravenously or intramuscularly at a dose of 10 mg / kg per day, the frequency of administration is 3-4 times a day, if necessary, the dose can be gradually increased to 30 mg / kg per day.

Side effect

• skin rash;
• hives;
• angioedema;
• allergic contact dermatitis;
• anaphylactic shock;
• weakness;
• headache;
• diarrhea;
• dry mouth and respiratory tract;
• rhinorrhea;
• constipation;
• dysuria;
• abdominal pain;
• nausea, vomiting.

Contraindications

• hypersensitivity;
• children under 6 years of age;
• pregnancy (1 trimester).

Application during pregnancy and lactation

The drug is not recommended for use during the 1st trimester of pregnancy. If it is necessary to use Ambroxol in 2-3 trimesters of pregnancy and during breastfeeding, the potential benefit to the mother with a possible risk to the fetus / child should be assessed.

special instructions

Should not be combined with antitussive drugs that impede the excretion of sputum.

Drug interactions

Combined use with antitussive drugs leads to difficulty in sputum discharge against the background of a decrease in cough.

Increases penetration into the bronchial secretions of amoxicillin, cefuroxime, erythromycin and doxycycline.

Analogues of the drug Ambroxol

Structural analogues for the active substance:

• Ambrobene;
• AmbroGEXAL;
• Ambroxol Vramed;
• Ambroxol retard;
• Ambroxol-Werte;
• Ambroxol-Vial;
• Ambroxol-Richter;
• Ambroxol-Teva;
• Ambroxol-Hemofarm;
• Ambrolan;
• Ambrosan;
• Ambrosol;
• Bronchoxol;
• Bronchorus;
• Dephlegmin;
• Bronhovern drops;
• Lazolangin;
• Lazolvan;
• Medox;
• Mucobron;
• Neo-Bronchol;
• Remebrox;
• Suprima-kof;
• Fervex for cough;
• Flavamed;
• Haliksol.

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

Content

This drug has a pronounced mucolytic expectorant effect. It is often prescribed to patients who have been diagnosed with pathologies of the bronchopulmonary system with the presence of difficult to separate sputum. The medicine has several forms of release, which have a certain specificity of use.

Ambroxol - what helps

The main task of the medicine is to thin the phlegm so that the body can get rid of it more easily. But this is not all that Ambroxol tablets can help from. The drug has a number of properties that not all patients are aware of, and doctors prefer to use other drugs. Scientific studies have confirmed that Ambroxol is able to increase local immunity and reduce inflammation.

The instructions are not written, but the use of the drug increases the activity of tissue macrophages. These are cells that are aimed at absorbing microbes. The drug improves the production of class A immunoglobulin, which takes part in the formation of local immune defenses. Another useful effect of using this medication is the suppression of the synthesis of inflammatory mediators (substances that trigger this process).

Each medication has analogues that can be ordered from an online pharmacy. Some of them have a lower price, others a higher one. The most popular options are:

• Bronhovern;
• Ambrolan;
• Ascoril;
• Ambroxan;
• Bromhexine.

Composition of Ambroxol

Initially, the substance of Ambroxol hydrochloride is produced, which has a bitter taste. Then different medications are made from it. The composition of Ambroxol tablets is as follows:

• potato starch - 35 mg;
• aerosil - 1.8 mg;
• lactose monohydrate - 170 mg;
• magnesium stearate - 1.2 mg.

For ease of use and different methods of application, a medication is produced in the following forms:

• tablets for adults, 30 mg, for resorption, 15 mg;
• capsules;
• solution in ampoules for injections;
• syrup for an adult / child;
• drops for oral administration.

Indications for use

The reason for prescribing this medication according to the instructions is chronic, acute pathologies of the respiratory tract in adults / children. The use of Ambroxol is necessary if there is a discharge of thick sputum that cannot be cough up. The main diseases for which the drug is prescribed:

• bronchial asthma;
• chronic / acute bronchitis of any type of origin;
• bronchiectasis;
• chronic obstructive pulmonary disease;
• cystic fibrosis.

According to the instructions, taking the medication is shown even when:

• rhinitis;
• before and after bronchoscopy;
• at 28-34 weeks of gestation with the risk of premature birth to avoid respiratory distress syndrome in the baby.

Syrup

This variant of the form of the medication is optimal for the treatment of a child. Ambroxol cough syrup is designed for younger children, the concentration of the drug per 5 ml of the substance is 15 mg. The scheme is designed for 5 days, maximum a week. This rule can be changed as prescribed by a doctor in a severe course of the disease. The dosage for taking in this case is as follows:

• 2.5 ml per day for children under 2 years old;
• 2.5 ml, but 3 times a day, for a child 2-5 years old;
• 3 times 5 ml of syrup should be taken by children over 5.

Tablets

This form of release is designed for adults, therefore it is forbidden to give them to children (it is difficult to calculate the dosage). Ambroxol tablets contain 30 mg of the active drug. According to the instructions, the use of this medication is necessary in the treatment of inflammatory processes in the respiratory tract, bronchitis, to prevent mucus from entering the lungs. The course of therapy is designed, as a rule, for 1-2 weeks, but it can be longer if prescribed by the attending physician. The method of application is as follows:

• you should drink after meals, you need to drink a glass of water;
• 1 tablet for the first 3 days 3 times a day;
• then 2 a day.

For inhalation

The main advantage of nebulizer therapy is the rapid penetration of the drug into the target organs. Tablets, for example, begin to act only after absorption (after about 30 minutes), and Ambroxol solution by spraying begins to have an effect after 5 minutes. With this method of drug delivery, there is a minimal loss of the active substance, which makes inhalation an ideal option for administering the drug for the treatment of bronchi and lungs.

The possibility of using it in the form of inhalation is the advantage of Ambroxol. The ability to increase the concentration of antibiotics is retained by nebulizer administration. Unlike analogues, the solution in question does not increase the risk of developing bronchospasm. This is important in the treatment of patients with chronic obstructive pulmonary disease, bronchial asthma. According to the instructions, the use of Ambroxol in this form is allowed from a young age.

Ambroxol hydrochloride - instructions for use

This medicine is named according to its main active ingredient. Ambroxol's instruction completely repeats all recommendations for the use of tablets. Mechanism of action: half an hour after administration, the medicinal properties of the substance begin to actively manifest. The effect lasts for 10 hours. The main difference between Ambroxol hydrochloride is that it is a long-acting drug. Positive results from the use of the drug were recorded in secretolytic therapy, acute / chronic bronchopulmonary pathologies associated with poor sputum production.

For kids

In all the variety of dosage forms of this medication for a child, syrups are the best option. Ambroxol can be given to children from infancy, only the dosage will differ:

• up to 2 years - 2.5 ml each;
• over 2 years old - 2.5 ml three times a day;
• in the period of 6-12 years, give 5 ml of syrup three times a day.

For inhalation - instructions for use

The procedure can be carried out using any modern warm-humid nebulizer. They are used in special forms or drops, solutions that do not contain flavorings, sugar. Before use, the preparation is diluted with a solution of sodium chloride (0.9%) 1: 1, heated to 36 degrees Celsius. Instructions for the use of Ambroxol:

• 7-15 mg of a substance for 1-2 procedures per day is prescribed for children under 2 years old;
• 2-6 years - 2 times a day, 15-30 mg;
• children older are given 2 inhalations of 15-45 mg of the substance.

During pregnancy

The effect of the substance has been studied only on pregnant animals; there is no research data on the effect of the drug on humans. The results of the experiments showed that there was no teratogenic effect on the fetus. It is not recommended to use Ambroxol during pregnancy until 28 weeks, then the appointment is allowed. It has been proven to have a positive effect on the risk of premature birth. It helps stimulate the production of surfactant in the baby.

The main purpose of the remedy under such conditions is to take it sequentially for three days to achieve the effect. The drug tends to penetrate into milk, therefore, during breastfeeding, the use of the drug without special need is not recommended. If, for some reason, you need to take this medication, the doctor may prescribe it.

With a dry cough

The main task of this medication is to simplify the removal of sputum, but the drug can cope with dry coughs. This symptom occurs with the development of pneumonia, bronchial asthma, acute bronchitis. Ambroxol cough tablets can be drunk in small quantities before visiting a doctor. It is impossible to treat the disease only with this medication, because it does not eliminate the main cause of the development of dry cough.

The presence of phlegm in the bronchi can be masked, and taking Ambroxol will help to thin it and remove it. In such cases, a dry cough turns into a wet cough and this is a normal reaction to medication. This is one of the stages of preventing the development of complications, the penetration of mucus into the lungs. It is not recommended to take the drug on your own, even according to the instructions. Only a doctor can prescribe a treatment regimen.

How to take Ambroxol

There are many forms of release of the drug, so the question arises: how to drink Ambroxol? Each package of the product contains instructions that describe the method of using the medicine. A more detailed scheme will have to be prescribed by your doctor based on the severity of the disease and additional symptoms. What not to do during treatment with this remedy:

1. It is not recommended to perform breathing exercises.
2. Do not combine Ambroxol with antitussive drugs that inhibit the cough reflex (codeine).
3. Do not take the product before bed.
4. Taking the medication should be under the supervision of a doctor if the patient has a violation of mucociliary transport, a weakened cough reflex.

Ambroxol side effects

The instructions for the drug indicate that in case of an overdose of the medication or violation of the rules for taking it, side effects of Ambroxol may appear. All of them disappear after the cessation of the use of the remedy. The main manifestations include an allergic reaction:

• convulsions;
• alcohol consumption;
• duodenal ulcer;
• hypersensitivity to drug components;
• impaired carbohydrate tolerance.

The price

Compared to analogues, this medication can be bought inexpensively in a pharmacy without a prescription. The cost will depend on the region of purchase, manufacturer, form of drug release. Below are indicative data on how much Ambroxol costs:

• Ambroxol tablets 30 mg, price - from 38 rubles;
• syrup 100 ml, price - 44 rubles;
• Ambroxol solution, 0.0075 ml, price - from 99 rubles.

We want to tell you about a drug that is known everywhere today. Everyone - young and old. The popularity of this medicine was brought about by popular rumor, supported by regular advertising blocks on each television channel. Well-known magazines, regardless of their focus (perhaps, except for children's editions) all winter tell us about the wonderful properties of Ambroxol and its analogues.

Invariably, when remembering this medicine, a bright advertising picture appears before the eyes, which schematically depicts the bronchial tree. Some signs placed here and there in the area of ​​the lungs should symbolize phlegm. Then Ambroxol enters the lungs in some unknown way - and all the bad is miraculously removed from the respiratory tract.

This information corresponds to reality only in general terms. In fact, the action of the drug on the body and its effect are much more multifaceted. In this article we will try to understand how and why Ambroxol preparations work. And let's dwell on security issues: is this tool as harmless as we are told?

Mysterious plant

We have no one to thank for the popular cough medicine: history has not preserved the name of the person who first synthesized Ambroxol. However, something is known about the origin of this medicine.

In the countries of tropical America and Asia - China, Vietnam, India, Malaysia - there is a plant with an unusual name for a Russian person. Do the words Justice vascular or Adatoda vasika tell you about anything? Unlikely. Meanwhile, in the tropics, this plant has long been considered healing.

For several millennia in a row, local residents have been treating coughs and colds with infusions of the leaves of justice. It turns out that the leaves of this evergreen shrub contain several alkaloids - organic compounds containing nitrogen. And among them is the quinazoline derivative vazicin. It is this substance that determines the expectorant effect of Justice. And it is directly related to Ambroxol. What is it?

>> Recommended: if you are interested in effective methods of getting rid of chronic rhinitis, pharyngitis, tonsillitis, bronchitis and persistent colds, then be sure to look at this site page after reading this article. The information is based on the author's personal experience and has helped many people, we hope it will help you too. Now we return to the article.<<

From Justice to Modern Medicines

Pharmacists of the twentieth century were very interested in the transatlantic plant. After careful study and establishment of the main active substance of the leaves of Justice, a chemical analogue of vazicin was synthesized. It turned out to be the same Bromhexine, which we remember very well from Soviet times. But what does Bromhexine have to do with Ambroxol? And the most direct.

Immediately after absorption in the gastrointestinal tract and passage through the liver, Bromhexine decomposes to form active metabolites. They begin to actively act and have a pharmacological effect. And the main metabolite of Bromhexine is Ambroxol.

Thus, the most famous modern expectorant drug is nothing more than a derivative of the old, as the world, cough medicine.

Is it all the same "chemistry"?

This question worries many. Especially those patients who prefer exclusively natural, herbal remedies. And the answer to it cannot be unambiguous.

On the one hand, Ambroxol hydrochloride is definitely synthesized in the laboratory using chemicals. On the other hand, the drug is essentially an analogue of a plant alkaloid. The situation is twofold: a medicine cannot be fully attributed to either natural or so-called chemical medicines.

However, if we compare Ambroxol with another effective and equally popular cough medicine - Acetylcysteine, then the first one certainly has a much greater affinity for herbal medicines.

And in the end, the most important thing is not the very fact of belonging to phytopreparations, but the safety profile. But we will return to this issue a little later.

Composition and release forms

We have already mentioned that Ambroxol contains organic matter with a nitrogenous base. The full chemical name of this compound is a polysyllabic one-line word, so we skip the details.

Ambroxol hydrochloride substance is available in the form of a white powder with a bitter taste. On its basis, many dosage forms are produced. The range of release forms is surprising - it is so extensive. Let's try to list the Ambroxol forms and not forget anything:

• tablets with a dosage of 30 mg for adults;
• lozenges (lozenges) with a dosage of 15 mg;
• long-acting capsules with a dosage of 75 mg;
• syrup for children and adults at a dose of 15 mg / 5 ml and 30 mg / 5 ml, respectively;
• solutions for internal use 15 mg / 5 ml and 30 mg / 5 ml;
• solutions for inhalation 7.5 mg / 1 ml;
• drops for internal use 7.5 mg / 1 ml;
• solution for injection 7.5 mg / 1 ml.

Some manufacturers also produce solutions for infusion and concentrates for the preparation of infusion solutions. Such an abundance of release forms is a vivid confirmation of the effectiveness and enormous popularity of the drug. How does it work?

Main pharmacological properties

Ambroxol acts on the bronchopulmonary system in many ways. The drug affects the various stages of secretion and excretion of tracheobronchial secretions, and the result is:

• liquefaction of viscous sputum.
  The composition of the tracheobronchial secretion includes complex proteins - mucopolysaccharides. It is due to the increased content of these substances that sputum becomes viscous and difficult to separate. Ambroxol, by changing the structure of mucopolysaccharides, helps to liquefy pathological tracheobronchial secretions;
• stimulation of the production of liquefied sputum.
  The drug also affects the secretion of another protein contained in sputum - glycoprotein. Due to an increase in the concentration of glycoproteins, the viscosity of the secretion decreases;
• an increase in the activity of the ciliated epithelium lining the mucous membrane of the respiratory tract along their entire length - from the nose to the smallest bronchioles.
  The cilia of the ciliated epithelium become more active and stimulate the movement of sputum into the upper respiratory tract until it is completely eliminated.

Ambroxol and inflammation

We used to think that Ambroxol is a cough medicine that helps thin phlegm and remove it. However, the drug has a number of properties that only a few patients know about and, unfortunately, not all doctors.

Research data confirm that Ambroxol preparations are able to reduce inflammation and increase local immunity. It turns out that the drug increases the activity of tissue macrophages - cells that absorb microbes. In addition, it stimulates the production of class A immunoglobulin, which is involved in the formation of local immunity. But the list of "good deeds" does not end there. The drug also inhibits the synthesis of inflammatory mediators - substances that "start" the inflammatory process.

Unknown properties of a known drug

It has been proven that Ambroxol hydrochloride has a positive effect on the serous and mucosal glands located in the bronchial mucosa. Thanks to this effect, mucosal cysts, which are often formed in chronic lung diseases, dissolve.

In addition, the drug increases the synthesis of the so-called serous component in the serous cells of the bronchial glands. In such a complex way, the drug contributes to an additional increase in the activity of the ciliated epithelium and, consequently, to improve the excretion of sputum.

More recently, another inexhaustible property of Ambroxol has been revealed. It turned out that it suppresses replication, that is, copying of respiratory viruses - the causative agents of ARVI.

Lung protection in babies

In addition to influencing the consistency of sputum and the activity of the cilia of the ciliated epithelium, Ambroxol has another unique property. The drug is able to increase the production of lung surfactant, which is a complex complex of surfactants that prevent alveoli from sticking together.

The surfactant serves as a kind of interlayer between the air that enters the pulmonary alveoli, and the liquid located there in small quantities. Without surfactants, the alveoli would inevitably adhere as a result of a decrease in the surface-active tension of the fluid.

Neonatology, the branch of medicine that deals with the treatment of newborns, is rich in tragic examples describing cases of low surfactant content in the alveoli. Full of bitterness, the phrase "the baby's lungs did not open" essentially describes the process of alveoli collapse as a result of insufficient surfactant content in a premature baby. After all, the main amount of surfactant is produced after 32 weeks of pregnancy.

Therefore, children born earlier than this time need special care, including artificial ventilation of the lungs, additional administration of surfactants and drugs that increase their secretion. And just Ambroxol hydrochloride is a prominent representative of such drugs.

The mechanism for influencing surfactant production is simple. The drug affects:

• type II pneumocytes, which are the initial source of surfactant - these cells are located in the pulmonary alveoli and produce surfactants;
• Clara cells located in the epithelium of the bronchioles and synthesizing one of the surfactant components.

Pharmacokinetic properties

15 minutes after you have taken the Ambroxol tablet, the drug will already be in the stomach, and after another 15 minutes it will begin to act. The effect of one dosage lasts from 6 to 12 hours, depending on the content of the active substance. The maximum concentration of Ambroxol in the blood plasma is detected within 1–2.5 hours after taking the pill. The drug penetrates into various organs and biological fluids of the body, including the cerebrospinal fluid.

When injected, the action begins within 5-10 minutes and lasts about 6 hours. The speed of the onset of the effect of nebulizer treatment is comparable to the speed of the action of injections.

Note that the placental barrier that protects the fetus in the womb of a pregnant woman is not an obstacle to Ambroxol. With the same ease, the drug penetrates into breast milk.

The drug is excreted by the kidneys partially unchanged, but its main share leaves the body in the form of metabolites, that is, decay products. Patients suffering from severe liver diseases should be aware that in their case, the accumulation of metabolites of the active substance in the blood is likely. This must be taken into account when choosing a dosage and determining a course of treatment.

And one more question that often worries patients - does food intake affect the effect of Ambroxol? The answer will delight undisciplined patients. Lunch, as well as dinner or any other meal do not have any effect on the bioavailability of the drug.

Ambroxol: indications for use

Typical indications for the use of Ambroxol are acute and chronic pathologies of the respiratory tract in children and adults, accompanied by the release of thick sputum, which is difficult to cough up, namely:

• acute and chronic bronchitis, regardless of origin (viral, bacterial, allergic, etc.);
• pneumonia;
• chronic obstructive pulmonary disease;
• bronchial asthma;
• bronchiectasis;
• cystic fibrosis (pulmonary form);
• tracheitis;
• laryngotracheitis.

In addition, the drug is indicated for:

• inflammatory diseases of the nasopharynx (rhinitis) and paranasal sinuses (sinusitis, sinusitis);
• laryngitis (inflammation of the vocal cords);
• preparation for the study of the bronchi - bronchoscopy - and after it as an antiseptic;
• the threat of premature birth in the period from 28 to 34 weeks of pregnancy in order to avoid respiratory distress syndrome in the child.

Ambroxol for sore throat?

In connection with the proven anti-inflammatory and immunomodulatory properties, pharmacists have proposed another use of the known expectorant drug. Until now, many buyers are perplexed how the absorption of tablets or lozenges in the mouth dilutes and helps to remove phlegm. And on the whole, this surprise is quite justified. But the solution to the riddle lies on the surface.

Lozenges containing Ambroxol are used to treat ... sore throat. The pronounced anti-inflammatory properties of the drug are complemented by a local anesthetic effect. Yes, it turns out that the drug also has an anesthetic effect, which comes in handy when treating a sore throat. In addition, with pharyngitis and laryngitis, excessive swelling of the mucous membrane is observed, and the same Ambroxol comes to the rescue with its decongestant effect. And that's not all.

Recall that most pharyngitis and laryngitis are caused by infection with respiratory and some other viruses. Microbes, penetrating through the oral cavity, are adsorbed on the surface of the epithelial cells of the pharyngeal mucosa and tonsils. By sucking lozenges with Ambroxol, we deliver the antiviral drug directly to the place of "colonization" of microbes and provide the drug with an excellent opportunity to actively act.

Antibiotics and Ambroxol: the synergism of the two drugs

To all the positive properties, one more should be added. Ambroxol increases the content of antibacterial drugs in the tracheobronchial secretions. The first information about such an effect appeared back in 1987 and was based on experimental data.