What is Lazolvan
A medicine based on the active substance ambroxol hydrochloride. Designed to liquefy viscous mucous secretions and remove them from the lungs. The product is produced in several forms:
- inhalation solution: transparent light brown liquid containing 7.5 mg of ambroxol, in 100 ml bottles with dispensers and measuring cups;
- tablets for oral administration: round, yellowish, 30 mg each, in blisters with cells of 10 pcs.;
- children's syrup: viscous transparent liquid of a sweetish taste containing 15 mg of ambroxol, bottles of 100–200 ml;
- medicinal lozenges for resorption: brown, mint-scented, contain 15 mg of active ingredient.
Syrup 15 mg/5 ml
Use in children
Lazolvan® children's syrup can be used to treat cough with viscous sputum in children. It has a pleasant aroma of forest berries, so children usually do not resist taking the drug.
The instructions for the drug Lazolvan® syrup 15 mg/5 ml recommend the following dosages for children:
- At the age of up to 2 years: 2.5 ml 2 times a day.
- Children aged 2 to 6 years: 2.5 ml 3 times a day.
- Children from 6 to 12 years old: 5 ml 2-3 times a day.
Dosage for adults and children over 12 years of age: 10 ml 3 times a day.
You can take cough syrup regardless of meals.3
During lactation
The period of lactation and breastfeeding is a contraindication for the use of Lazolvan® syrup, as well as tablets, solution and other forms of this drug.3
One of the main reasons for this is the ability of ambroxol hydrochloride, the active ingredient in Lazolvan®, to pass into breast milk. However, no adverse events were observed in children who were breastfed by mothers taking medications with ambroxol. Despite this, it is not recommended to use Lazolvan® syrup for the treatment of mothers while breastfeeding.3
Use during pregnancy
Lazolvan® syrup is not used in the first trimester of pregnancy.3
The active ingredient of the drug, Ambroxol, can penetrate the placental barrier. Studies have not shown that it can affect the course of pregnancy, the fetus and its development, or labor. The experience of using Lazolvan® from the 28th week of pregnancy also did not show any negative effects on the fetus.
However, it is necessary to observe the usual precautions: taking the drug in the first trimester is not recommended, and in the second and third trimesters, treatment with Lazolvan® syrup according to indications is possible only as prescribed by a healthcare professional, under his supervision and if its use is justified by the benefits for the patient. mother, and the risk of exposure to the fetus is lower than the potential benefit. 3
For impaired renal function
If renal function is impaired, Lazolvan® syrup can be used only as prescribed by a healthcare professional. Self-medication in this case is unacceptable for the following reasons:
- Due to kidney failure, toxins can accumulate in the human body. “Adding” another xenobiotic, a foreign substance, can provoke a deterioration in the functionality of the urinary system.
- Against the background of renal failure, many processes change, for which they are directly or indirectly responsible: filtration in the glomerular system; distribution of drugs and their metabolites among organs and systems with the blood; removal of residual amounts of the substance and its derivatives.
- Renal failure is often accompanied by systemic changes in the functioning of the heart, blood vessels, and lymphatic system. It can lead to a decrease in clearance - that is, the rate of purification of the blood (plasma) from a drug or other biological substance.
A healthcare specialist, after assessing the tests and the risks of the impact of any form of Lazolvan® on the kidney function of a particular patient, will decide on the possibility of therapy, select the optimal and safe dose, and the number of doses per day.2, 3
For liver dysfunction
For liver diseases and liver failure, any form of Lazolvan® is prescribed with caution.3
The importance of the liver in the processes of absorption, distribution, neutralization and excretion of various substances is enormous. Diseases of this organ significantly impair its functionality, which also affects the processes of biotransformation of drugs.
In case of liver failure and other pathologies of the organ, the functioning of the enzyme system of the liver and gall bladder is disrupted. This can cause uneven absorption of active substances, changes in the processes of their absorption, which carries the risk of overdose or, conversely, insufficient dosage.1, 2
Only a health care professional can select a dose for a patient with renal failure based on test results, assessment of the dynamics of the patient’s condition and medical history.
Active substance
The therapeutic effect in Lazolvan® syrup is provided by ambroxol hydrochloride: 5 ml of syrup contains 15 mg of this substance. This is a drug from the group of mucolytic and expectorant drugs.3
It affects the production of surfactant - a substance that coats the inside of the walls of the alveoli and prevents them from collapsing.4
Ambroxol improves mucociliary clearance, production, liquefaction of mucus and its excretion. Thanks to this, the discharge of sputum is enhanced and facilitated, and the cough is relieved.3
How Lazolvan works
The medicine increases the volume and production of secretions, promoting its liquefaction, stimulates the work of epithelial cilia, helping to move phlegm out. The effect of aerosol particles of the drug begins 20–30 minutes after inhalation. After oral administration, the active substance begins to function within 2–3 hours.
The therapeutic effect lasts from 6 to 12 hours. The components of the drug are metabolized in the liver and leave the body within 10–15 hours. They do not accumulate in blood and tissues.
Lazolvan solution for oral administration and inhalation 7.5 mg/ml 100 ml
Pharmacological group:
Expectorant, mucolytic agent ATC code: R05CB06
Pharmacodynamics:
Studies have shown that ambroxol, the active ingredient of Lazolvan®, increases secretion in the respiratory tract. It enhances the production of pulmonary surfactant and stimulates ciliary activity. These effects lead to increased mucus flow and transport (mucociliary clearance). Increasing mucociliary clearance improves sputum discharge and relieves cough. In patients with chronic obstructive pulmonary disease, long-term therapy with Lazolvan® (for at least 2 months) led to a significant reduction in the number of exacerbations. There was a significant decrease in the duration of exacerbations and the number of days of antibiotic therapy.
Pharmacokinetics:
All dosage forms of immediate release ambroxol are characterized by rapid and almost complete absorption with a linear dose dependence in the therapeutic concentration range. The maximum concentration in plasma (Cmax) after oral administration is achieved after 1-2.5 hours. The distribution volume is 552 l. In the therapeutic concentration range, binding to plasma proteins is approximately 90%. The transition of ambroxol from the blood to tissues when administered orally occurs quickly. The highest concentrations of the active component of the drug are observed in the lungs. Approximately 30% of the administered oral dose undergoes first pass through the liver. Studies in human liver microsomes have shown that CYP3A4 is the predominant isoform responsible for the metabolism of ambroxol to dibromoantranilic acid. The remainder of ambroxol is metabolized in the liver, mainly by glucuronidation and by partial breakdown to dibromanthranilic acid (approximately 10% of the administered dose), as well as a small number of additional metabolites. The terminal half-life of ambroxol is 10 hours. The total clearance is within 660 ml/min, renal clearance accounts for approximately 8% of the total clearance. Using the radioactive tracer method, it was calculated that after taking a single dose of the drug, about 83% of the dose taken is excreted in the urine over the next 5 days. No clinically significant effect of age and gender on the pharmacokinetics of ambroxol was found, so there is no basis for selecting the dosage based on these characteristics.
For what diseases is Lazolvan needed?
The medicine is indicated for use:
- for pneumonia;
- acute and chronic bronchitis;
- asthma with difficulty producing sputum;
- bronchial obstruction;
- respiratory distress syndrome;
- other pathologies of the respiratory tract, accompanied by excessive secretion synthesis.
Lazolvan improves well-being and makes breathing easier, but does not affect pathogens. It can only be used as a symptomatic remedy.
How to use Lazolvan to treat children
For coughs and other respiratory tract lesions in children under 6 years of age, use the drug in syrup:
- children under 2 years of age: 2–2.5 ml twice a day;
- at 3–6 years: 3 ml, repeating the dose twice;
- from 6 to 12 years: 5 ml up to three times a day.
Adolescents over 12 years of age are allowed to consume 10 ml of syrup 2-3 times a day.
From the age of 6, you can give children lozenges: 1–2 pieces. three times a day. All forms of Lazolvan are compatible with food. Gastric juice does not affect the effect of the drug. During treatment, it is important to give your child plenty of fluids to drink. It is necessary for better separation of sputum.
Lazolvan
Lazolvan is a “branded” German drug based on ambroxol, which is taken for infectious and inflammatory diseases of the respiratory tract to facilitate the evacuation of sputum. It has secretomotor (removal of sputum), mucolytic (thinning of sputum) and expectorant effects. The success of lazolvan in the noble task of cleaning the branched “root system” of the bronchial tree from mucus is based on several of its qualitative functional characteristics. Thus, the drug induces the activity of serous bronchial cells, which produce not a viscous, but a liquid secretion that helps remove mucus from the respiratory tract. At the same time, lazolvan increases the secretion of mucus and the production of endogenous surfactant (a surfactant that performs protective functions and prevents the collapse of pulmonary vesicles). In this case, the action of lazolvan is aimed at normalizing the ratio of serous and mucous components of sputum. The viscosity of the latter is reduced due to the activation of hydrolyzing enzymes by lazolvan and the stimulation of the release of lysosomes (cellular structures specialized in the breakdown of various substances) from large neurons of the spinal cord - Clark cells. The secretomotor effect of lazolvan is realized through the activation of the hairs-cilia of the ciliated epithelium and, accordingly, the transport of mucus (mucociliary clearance). The cough becomes productive and fully performs the function of clearing the respiratory tract of mucus.
Lazolvan begins to implement this entire cascade of necessary and useful functions just half an hour after taking it and remains active for 6-12 hours. The drug is available in four dosage forms: solution for oral administration or inhalation, lozenges, tablets and syrup. More details about the dosage regimen of lazolvan depending on the dosage form and the age of the patient can be found in the instructions for use included in the secondary packaging along with the drug. Dosages of lazolvan for adult patients will also be given here. The oral solution is added to any drink (tea, coffee, milk, juice, water) 4 ml (100 drops) and drunk 3 times a day. The same solution, but for inhalation, should be dosed at 2-3 ml and 1-2 similar procedures should be performed per day. The lozenges are dissolved three times a day, two pieces at a time. Tablets should be taken 30 mg 3 times a day (or, to quickly achieve a clinically significant effect, 60 mg twice a day). The syrup is taken 2 teaspoons (10 ml) three times a day.
Lazolvan can be used independently without a medical prescription (fortunately, the over-the-counter procedure for selling it from pharmacies allows you to do this without problems), however, it is not recommended to take it for more than 4-5 days without supervision from a person in a white coat.
