Contraindications
Ambroxol should not be taken by people who have hypersensitivity to at least one component of the drug. Women in the first trimester of pregnancy should avoid taking it.
The drug in tablet form should not be used by people with stomach and duodenal ulcers, as well as in cases of epileptic syndrome.
Other contraindications include hereditary fructose intolerance. The medicine should not be taken for a dry cough that occurs with colds and viral diseases.
special instructions
To purchase medicine at a pharmacy you do not need a doctor's prescription. Shelf life – 3 years. Do not use after expiration date. Store at room temperature.
When using mucolytic drugs, it is advisable to drink as much liquid as possible: tea, compote, juices.
Patients with bronchial asthma should take a bronchodilator before inhalation to prevent irritation of the respiratory tract.
Taking tablets and syrup in parallel with antibiotics increases the content of the active component of the latter in the lung mucosa, which has a positive effect on the patient’s condition.
Ambroxol for pregnant women
Pregnant women should not take the drug only in the first 13 weeks of pregnancy. In the 2nd and 3rd trimester, you can use the medicine if the benefit to the expectant mother outweighs the threat to the fetus.
If we are talking about taking it while breastfeeding, then it is better not to use Ambroxol, since the active component can penetrate into the milk, and, consequently, into the baby’s body.
An interesting study was conducted in which results were obtained regarding the use of medication to treat problems with the respiratory system in an unborn baby. The constituent components are able to penetrate the placenta, which makes it possible to take the drug when the child begins to collect sputum in the lungs. Also, if you take Ambroxol during pregnancy, the baby activates the synthesis of pulmonary surfactant.
Instructions for use
Pills
The drug in tablet form is taken orally. You need to drink a small amount of drinking water.
Adults and children over 12 years of age can be given 1 tablet 2 times a day. In some cases, you can take 3 times a day.
In case of exacerbation of chronic diseases, you can increase the dosage to 2 tablets 2 times a day.
Cough tablets can be given to children from 6 years of age. From 6 to 12 years old you can give half a tablet 3 times a day.
The duration of treatment depends on the severity of the disease and the individual reaction of the body. On average it takes 10-12 days.
Syrup
Children over 12 years of age and adults can take 10 ml of syrup during the first 2 days of illness. Then you can take 5 ml 3 times a day.
The dose for children under 12 years of age is determined taking into account age. A child aged 5-12 years can be given 5 ml 2 times a day. In case of severe disease, the dosage frequency can be increased to 3.
If the doctor has prescribed long-term treatment, it is better to reduce the dose by half.
For inhalation and injection
An adult can take no more than 2 inhalations per day using 3 ml of solution. A child over 5 years old should take 1 inhalation per day using 2 ml of solution.
If the medicine is used for injection, the dosage for an adult patient is 40-60 mg per day, divided into 3 doses per day.
Injections are usually given into a muscle or vein, but they can also be administered subcutaneously.
The mechanism of action of ambroxol is multifactorial
It helps to liquefy bronchial secretions by breaking down acidic mucopolysaccharides and deoxyribonucleic acids, activates the movement of cilia of the ciliated epithelium, exerting a secretomotor effect and restoring mucociliary transport.
The drug has anti-inflammatory and antioxidant properties associated with its effect on the release of oxygen radicals and interference with the metabolism of arachidonic acid at the site of inflammation [39]. It may inhibit the release of mediators involved in allergic inflammation [40]. A very important property of ambroxol is the ability to increase the amount of surfactant, increasing its synthesis and inhibiting its breakdown in type 2 alveolar pneumocytes [41]. Surfactant plays an important role in maintaining the surface tension of the lungs and improving their compliance. Being a hydrophobic boundary layer, it facilitates the exchange of non-polar gases, has an anti-edematous effect on the alveolar membranes and ensures the stability of alveolar cells during respiration [36].
Surfactant is an important factor in the local protection of the lungs, preventing the penetration of pathogenic microorganisms into epithelial cells [41]. It is involved in ensuring the transport of foreign particles from the alveoli to the bronchi, where mucociliary transport begins, and improves the “sliding” of bronchopulmonary secretions along the epithelium of the bronchial mucosa [31, 36]. Thus, by increasing the amount of surfactant, ambroxol indirectly enhances mucociliary transport.
There is evidence that ambroxol normalizes the functions of altered serous and mucosal glands of the bronchial mucosa, reduces mucosal cysts and activates the production of the serous component [31]. This effect of the drug is especially important for patients with chronic lung diseases, who experience hypertrophy of the bronchial glands with the formation of cysts and a decrease in the number of serous cells.
Ambroxol differs from derivatives of acetylcysteine and partially bromhexine
Ambroxol differs from acetylcysteine derivatives and partially bromhexine in that it does not provoke bronchospasm [31, 38, 42]. Moreover, in a double-blind, placebo-controlled, parallel study, the ability of ambroxol to reduce bronchial hyperreactivity was proven [43], and in another study, its use was able to demonstrate a statistically significant improvement in external respiratory function indicators and a decrease in hypoxemia in patients with bronchial obstruction [44] .
The advantage of ambroxol over acetylcysteine is that it has an immunomodulatory effect, which helps strengthen local immunity. Ambroxol not only does not suppress the production of secretory IgA, but, on the contrary, increases it. It also activates tissue macrophages. The drug is able to inhibit the production of inflammatory mediators interleukin-1 and tumor necrosis factor [45] and stimulate the activity of macrophages [46]. It has been suggested that inhibition of the synthesis of proinflammatory cytokines can improve the course of leukocyte-mediated pulmonary injury [31]. In vitro experiments showed the inhibitory effect of ambroxol on neutrophil chemotaxis [47].
Ambroxol is one of two mucolytics (the second drug is domiodol), the use of which in adequate clinical studies has proven subjective improvement in the condition of patients with exacerbation of COPD [60].
The high efficiency and good tolerability of ambroxol, as well as the significant degree of patient adherence to treatment, allow some foreign authors to recommend it as the drug of choice for the prevention of chronic bronchitis [57]. Russian specialists who studied the effectiveness of ambroxol in outpatients with COPD also came to the conclusion that the mucolytic properties of the drug are maximally realized in dys- and hypercrinia, i.e. in patients with chronic bronchitis [61].
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Adverse reactions and overdose
Side effects after taking the drug appear extremely rarely. Ambroxol has no toxic effect and is well absorbed in the human body.
In rare cases, skin problems may occur, manifested by a rash, as well as allergies, angioedema, lethargy and headache.
When taken simultaneously with incompatible drugs, isolated cases of severe skin lesions have been recorded.
In case of overdose, the patient experiences vomiting, nausea, and diarrhea. If such symptoms appear, you need to induce vomiting and rinse the stomach as quickly as possible. Then for a couple of days you need to eat food that contains fats.
In what cases is it used?
The degree of elasticity and viscosity of sputum can only be determined by how easily it is expectorated.
Ambroxol is especially effective for respiratory diseases and conditions in which phlegm appears and accumulates in the lungs.
The drug can be used for the following conditions:
- pneumonia;
- acute or chronic bronchitis;
- laryngitis;
- asthma;
- rhinitis;
- pharyngitis;
- respiratory tract disorder syndrome in newborns, including premature babies.
