Contraindications
Hypersensitivity to the existing components of the drug, fructose .
The syrup is not recommended for children under 3 years of age, as well as for patients with bronchial asthma , gastroesophageal reflux disease , gastritis with high acidity of gastric juice , gastric and duodenal ulcers, severe liver or kidney diseases.
Eucabal ointment is contraindicated for significant skin damage, acute skin diseases , high fever, infectious diseases, heart failure and hypertension .
Eucabalus
Eucabal is a herbal medicine that has an expectorant and anti-inflammatory effect and is used for the complex treatment of inflammatory diseases of the upper and lower respiratory tract, occurring with numerous episodes of spasmodic cough with thick sputum (inflammation of the mucous membrane of the trachea, bronchi, pharynx, larynx, nasal cavity). Available in the form of syrup and balm. The effectiveness of the drug increases when combining both dosage forms. It is used not only for therapeutic, but also for preventive purposes. It has a well-balanced composition. Does not contain allergens, incl. menthol is a plant component that in some cases causes hypersensitivity reactions in patients. The natural ingredients of the drug are absolutely safe, so it can be used in patients regardless of their age. The syrup can be used in six-month-old children, and the balm can be used in children starting from three months. Eucabal syrup contains aqueous extracts of plantain and thyme. Thyme contains a whole range of biologically active substances, including the phenol monoterpenides thymol and carvacrol. as well as phytoncides. The plant has a bactericidal effect against streptococci and staphylococci and is bacteriostatic against many representatives of gram-negative microflora. In addition to this, phenols are active against microflora that are resistant to antibiotics, including bacteria that are partially or completely devoid of a cell wall, but retain the ability to develop, as well as fungi.
Even a small concentration of phenols in the liquid preparation provides antimicrobial and antifungal effects. The syrup is not used in case of individual intolerance to the active or auxiliary components of the drug. Caution should be exercised when prescribing the drug to persons suffering from diabetes mellitus, because The composition contains sugar as one of the auxiliary components. Single dose – 1 teaspoon (children from 6 months to 6 years), 1 tablespoon (school age children), 1-2 tablespoons (adults). Frequency of administration: 1 time per day (children from 6 months to 6 years), 2 times per day (children from 6 to 18 years), 3-5 times per day (adults). The syrup is taken in concentrated (undiluted) form. The duration of use depends on the clinical picture and is determined by the doctor. Mild forms of inflammation of the respiratory tract usually require no more than two weeks of taking the drug. The syrup should be taken for another 2-3 days after symptoms have completely disappeared. If the patient's condition does not improve after two to three weeks of drug therapy, medical advice should be sought. Eucabal syrup potentiates the effects of sedatives, tranquilizers and other drugs that suppress the activity of the central nervous system.
Instructions for Eucabal (Method and dosage)
Eucabal syrup, the instructions for which vary the dosage depending on age, involves taking the product undiluted after meals. Recommended doses:
- for children from 6 to 12 months. the dose is 1 teaspoon. l 1 time per day;
- under 6 months - 1 teaspoon. l 2 times a day;
- for schoolchildren - 1 table. l 2 times a day;
- for adults – 1-2 tables. l 3-5 times a day.
The duration of treatment must be determined individually, based on the severity of the condition and disease, for example, for mild forms it is up to 2 weeks plus 2-3 days after the complete disappearance of symptoms.
Eucabal balm, the instructions for which suggest not only external use - rubbing a 3-5 cm strip of balm on the chest and back, but also preparing steam inhalation (inhalation of vapors): stirring a 5 cm strip of balm in 2-3 tablespoons of hot boiled water.
The ointment is recommended for infants in the form of baths (estimated time of taking 10 minutes, contact with eyes should be avoided). To do this, add a 5-10 cm strip of balm to 20 liters of water at a temperature of 36-37 °C and stir evenly throughout the entire volume of water. They can be repeated until the symptoms disappear completely.
Introduction
Cough is one of the most widespread respiratory symptoms that affects people regardless of age, place of residence and social status; it often disrupts people’s lifestyle and activity.
From year to year, patients with infectious diseases of the upper respiratory tract and ENT organs occupy first place in the structure of overall morbidity not only in our country, but also in the world [1]. For example, in European countries, cough affects over 30% of the population aged 23 to 50 years, and the number of such patients increases every year. The high incidence rate is associated with a number of negative factors: an increase in the number of viral diseases, an increase in antibiotic-resistant strains of bacteria, and an increase in the number of immunodeficiency and allergic diseases. The urgency of the problem of cough treatment is associated with incorrect treatment of inflammatory diseases of the nasal cavity and upper respiratory tract, which leads to chronicity of the process. In this regard, it is necessary to take a more careful approach to the selection and prescription of drug therapy [2]. The cause of the development of the vast majority of cases of acute inflammation in the upper respiratory tract, accompanied by cough, are viruses. The most common are corona and rhinoviruses, which cause reactive changes in the mucous membrane. Recently, the increasing role of “atypical” bacterial pathogens, such as mycoplasma and chlamydia, has been noted [3].
A cough is considered acute if it lasts less than 4 weeks, and chronic if it lasts more than 9 weeks. This classification, based solely on the duration of the symptom, is arbitrary: a cough lasting from 4 to 9 weeks does not fit into either of these categories, since in an acute upper respiratory tract infection a cough can persist for more than 4 weeks (and is called post-viral), and a chronic The cough always starts as an acute cough.
A cough symptom occurs due to mechanical, inflammatory, thermal and chemical irritation of cough receptors. During the inflammatory process, as a result of swelling and increased secretion, irritation of the mucous membrane of the upper and lower respiratory tract occurs. As a rule, coughing is a defensive reaction aimed at clearing the tracheobronchial tree of copious secretions. The development of cough is associated with irritation of the receptors of the cough center of the medulla oblongata (cough of central origin) and peripheral receptors n. vagus for diseases of the cardiovascular system and gastrointestinal tract. When carrying out diagnostic measures, it is necessary to clarify whether the cough is chronic or acute, dry or productive. Taking into account the many causes of acute cough, the doctor, especially in the outpatient department of the medical service, faces difficult tasks. This activity is impossible without algorithmization [4].
Throughout history, humanity has encountered “colds” so often that it has given rise to a kind of mythology. To this day, there are two opposing opinions among the population: “there is no need to treat a cold, it will go away on its own” and “should we use the latest means, and treatment with herbal remedies is a thing of the past.” The first statement is false and dangerous. Yes, a simple cough can clear the lungs of excess secretions, but with “colds”, swelling of the mucous membrane of the bronchial wall may develop along with the cough. Thick and viscous sputum is difficult to separate and makes breathing increasingly difficult. Stagnant secretions accumulate microorganisms that can lead to severe bronchitis and pneumonia. And a strong cough closes a vicious circle, exhausting the patient.
The second statement, when the patient wants to be treated with the most powerful drugs, also requires serious clarification. Such therapy is reminiscent of shooting sparrows from a cannon: although the virus belongs to a primitive form of life, it also contains proteins and nucleic acids characteristic of the human body. Thus, antiviral chemicals may be harmful to the patient. Based on this, targeted treatment of an acute inflammatory process, the manifestation of which is cough, is considered important [5].
People are susceptible to colds at any time of the year, and no one is immune from seasonal epidemics of acute respiratory viral infections (ARVI). A simple attitude to the problem can lead to a long-term cough becoming a chronic process [6].
Cough treatment
When treating cough, suppressants can be used that reduce the increased activity of the cough reflex to normal levels, but do not affect the pathophysiological causes of cough. The effectiveness of all cough suppressants is very low, many of them have not been studied in sufficiently evidence-based (randomized placebo-controlled) studies. Central cough suppressants in various combinations with muco- and bronchodilators and peripheral antitussives are included in many over-the-counter antitussives. Peripheral suppressants reduce the activity of peripheral cough receptors in the mucous membrane of the upper respiratory tract by softening, moisturizing and enveloping. These include plant extracts and oils, menthol, sodium bicarbonate, which are used both separately and as part of combined over-the-counter antitussive drugs.
Herbal and combination over-the-counter cough remedies should be prescribed with caution due to possible side effects associated with the likelihood of interaction with other pharmacological agents, as well as in patients with pollen allergies. The clinical effectiveness of herbal preparations for the treatment of cough has not been confirmed due to the small number of clinical studies conducted.
The effect of mucolytics on cough is variable. Sometimes thinning sputum and improving the functioning of the mucociliary escalator reduce the severity of chronic cough, although in most cases the frequency and severity of cough do not depend on the rheological properties of sputum, especially in patients with a chronic process.
In 2004–2005 In Russia, two randomized open multicenter studies were conducted that studied the effects of the drug fenspiride in ARVI and chronic obstructive pulmonary disease (COPD). In both studies, among other results, a significant reduction in the severity of cough was obtained in patients with ARVI of the respiratory tract and in patients with stable COPD when taking the drug at a dose of 160–240 mg/day for 10–14 days and 6 months, respectively. However, due to a lack of highly evidence-based clinical studies, this drug is not included in international clinical guidelines for the treatment of cough.
Evidence of the effectiveness of mucoactive drugs to control cough during exacerbation of the disease is limited.
Thus, despite the widespread prevalence of cough, it represents a serious problem for both the patient and the attending physician, and this is due not only to the multifaceted differential diagnosis of conditions that cause cough, but also to the lack of sufficiently effective drugs for nonspecific treatment of this symptom. This necessitates the need for further searches for new pharmacological drugs with high antitussive efficacy and minimization of side effects. To this end, the world is currently studying new representatives of opiates, antagonists of neurokinin and bradykinin receptors, inhibitors of prostaglandin synthesis, modulators of ion (potassium, chloride, etc.) channels and other new classes of drugs for the treatment of cough.
The most popular and widely used in medical practice are traditional expectorants [6]. Among them, the most numerous is a group of drugs with reflex action, including substances, usually of plant origin. Herbal preparations have a mild effect, cause side effects much less frequently, are better tolerated and can be used for a long time in both adults and children [7]. Currently, in Russia, herbal medicines account for 30–40% of all medicines used in practical medicine [8]. It is known that plants have a wider spectrum of action compared to synthetic drugs, but they are multicomponent and their pharmacokinetics have been little studied. In addition, there may be contraindications to the use of herbal remedies, as well as other medications [9]. In general, the use of reflex expectorants is most effective in acute inflammatory processes in the respiratory tract, when there are no pronounced structural changes in goblet cells and ciliated epithelium. Decoctions and infusions of medicinal plants are now increasingly being replaced by their modern dosage forms, in particular extracts, tinctures, syrups, which are most convenient for use in pediatric practice. Combination drugs are becoming increasingly popular. The level of development of the modern pharmaceutical industry makes it possible to produce high-quality multicomponent (combined) herbal medicines containing a strictly dosed amount of the active substance, which ensures guaranteed safety and effectiveness of treatment. In this regard, natural expectorant drugs are increasingly used in medical practice [10].
Currently, aromatherapy is a very popular, “fashionable” alternative method of healing the body. Volatile plant substances are traditionally used in folk medicine in the treatment of colds. It has long been noted that inhalations using oils of eucalyptus, mint, juniper and other plants contribute to the regression of symptoms caused by ARVI and enhance prevention at the time of year when the risk of the disease increases. Since ancient times, essential oils have been used for preventive purposes in a steam bath, where their inhalation effect is especially pronounced [11].
WHO imposes the following requirements on over-the-counter medicines for the treatment of cough: the drug must be well known, frequently used in medical practice, must be safe for children and not have a toxic effect on the body.
Use of the drug Eucabal
As an example of a modern expert of plant origin, we can cite Eucabal® preparations. The drug in syrup form contains liquid plantain extract and liquid thyme extract as active ingredients. Essential vegetable oils contained in extracts, due to their indirect reflex effect through the gastric mucosa and direct effect on the bronchial glands, enhance their activity. This helps to increase, dilute and dissolve bronchial secretions, as well as enhance the transport of secretions by the ciliated epithelium. In addition, essential oils, due to their surface activity, reduce the binding ability of highly viscous mucus on the tracheobronchial mucosa, thereby promoting the discharge of sputum during convulsive coughing. Essential oils, flavonoids, phytoncides and phenols (thymol and carvacrol) of thyme and plantain mucins have bactericidal and bacteriostatic effects against a number of bacteria, thereby reducing catarrhal manifestations on the mucous membrane of the respiratory tract.
Also on the market is the drug Eucabal® Balsam C in the form of an emulsion for external use. Essential oils of eucalyptus and pine needles determine its nonspecific antiviral, antibacterial and antifungal effects. Coniferous oil affects the regulation of the functions of the central nervous system, reduces bronchospasm and significantly facilitates breathing [12]. The effectiveness of the drug is enhanced by several routes of administration into the body. During steam inhalation, eucalyptus and pine oils directly reach the respiratory tract. The active substances of eucalyptus oil and pine needles are well absorbed through the skin and enter organs and tissues, incl. lungs, where they are partially eliminated during breathing. The effect that occurs during inhalation is enhanced by taking warm baths. Improved blood circulation in the muscles and skin as a result of taking warm baths with essential oils leads to increased sweating and the elimination of microorganisms and toxins that cause the disease [13, 14].
In vivo and in vitro studies have shown that eucalyptus oil and its main active substance, 1,8-cineole, increases phagocytic activity, significantly inhibits the release of many anti-inflammatory mediators and the secretion of mucin from the tracheal and bronchial epithelium. The anti-inflammatory effect of 1,8-cineole was confirmed in a double-blind, placebo-controlled study in patients with bronchitis. A number of studies have confirmed the antimicrobial effect of eucalyptus oil. Thus, in one of them, all tested gram-positive bacteria (Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Bacillus subtilis) turned out to be highly sensitive to it [15].
Pine oil also has an antimicrobial effect, and due to pinene it can significantly improve microcirculation. That is, the therapeutic effectiveness of Eucabal® Balsam C is due to the mutually potentiating effect of the active components of eucalyptus and pine oils. The positive effects of Eucabal® syrup have been demonstrated in a number of experimental and clinical studies. In particular, the results of one of the open comparative multicenter studies of the clinical effectiveness of Eucabal syrup in acute bronchitis [15] showed that already on the 3rd day of therapy in all patients, coughing of sputum improved, the severity of cough decreased (in 85%), its pain (in 80%). On average, fewer cough shocks were required to obtain a portion of sputum compared to the start of treatment: if before the start of treatment it was necessary to make 6.5 ± 1.3, then after 3 days of taking Eucabal - 4.1 ± 1.1 (p < 0.005 ). Characteristic for all patients was a decrease in cough pain. Improvement in sputum expectoration correlated with a decrease in sputum adhesive properties. Compared to the start of treatment, sputum adhesiveness decreased by almost 2.3 times. The drug was well tolerated in all patients [16].
It can also be noted that Eucabal® is well tolerated even by patients with mild manifestations of atopic dermatitis and allergic rhinitis. No effect was recorded in any of the cases. The drug combines well with antibiotics (for example, roxithromycin), inhaled corticosteroids, antihistamines, immunotropics, anti-inflammatory drugs, etc.” (N.D. Soroka).
The drug Eucabal® syrup is recommended for use as part of complex therapy for inflammatory diseases of the upper respiratory tract, accompanied by a cough with difficult to separate sputum (rhinosinusitis, tracheobronchitis), as well as spasmodic cough. Orally, undiluted, for adults – 1–2 tablespoons 3–5 times a day; children from 6 months to 1 year – 1 teaspoon 1 time per day; from 1 year to 6 years – 1 teaspoon 2 times a day; school-age children – 1 tablespoon 2 times a day. Eucabal® Balsam C is recommended mainly for children from 2 months for rubbing and baths, as well as for steam inhalation for children from 5 years, in complex therapy - in the treatment of diseases of the upper respiratory tract.
Baths: for infants from 2 months, 1 strip of emulsion 8–10 cm long is added to 20 liters of water at a temperature of 36–37°C. Rubbing: 1 strip of emulsion about 3-5 cm long is applied to the skin of the chest and interscapular area and rubbed well 2-3 times a day.
Baths: for young children, add 2 strips of emulsion 10 cm long per 40 liters, bathe children for about 10 minutes. Inhalations: 1 strip of emulsion 3–5 cm long is added to 1–2 liters of hot water, mixed, and the child is allowed to breathe the steam under a towel.
After taking a bath, you should not shower or rub yourself with a towel. The baths are repeated until the symptoms of the disease completely disappear. You can take baths 3-4 times during the week.
Conclusion
In conclusion, it can be noted that cough is the most common and, in the vast majority of cases, obligatory symptom in various diseases of the respiratory system. A detailed clinical description of the cough symptom in combination with anamnesis, physical data and the results of additional examinations greatly facilitates the diagnostic search. The choice of specific antitussive or expectorant drugs and the duration of their use must be strictly differentiated and depend on the clinical and pathogenetic characteristics of the disease, the pharmacological characteristics of the drugs themselves, as well as the individual characteristics of each patient. Rational choice and timely inclusion of expectorants and antitussives in the complex therapy of respiratory diseases accompanied by cough significantly increase the effectiveness of treatment. Despite the large number of drugs that relieve cough, the search for effective and safe drugs remains relevant. As for the preparations Eucabal® syrup and Eucabal® Balsam S, they characterized themselves as the best selection of combinations of medicinal plants. Thanks to their multicomponent composition, they have therapeutic effects proven in clinical studies.
Analogs
Level 4 ATC code matches: Cashnol
Anise oil
Bronchophyte
Pine buds
Pertussin
Bronchosan
Gedelix
Mixture for inhalation
Herbion ivy syrup
Herbion plantain syrup
Herbion primrose syrup
Mukaltin
Sinupret Forte
Dr. Theiss syrup with plantain
Bronchosept
Joset
Thermopsol
Tussamag
Marshmallow syrup
Dry cough syrup
- Tusavit
- Bronchodilator collection
- Altemix Broncho
Eucabal price, where to buy
The approximate price of the balm is 193 rubles, the price of the ointment is 125-130 rubles, the price of Eucabal syrup is 166-200 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
ZdravCity
- Eucabal balm with emulsion.
for in. and outside approx. 40ml Lichtenheldt GmbH/Esparma GmbH RUR 303 order
Pharmacy Dialogue
- Eucabal (cough syrup 100ml)Esparma
RUB 365 order
- Eucabal C emulsion for inhalation and external use 40mlEsparma
RUB 310 order
- Eucabal (syrup 100ml)Pharma Wernigerode GmbH
RUB 365 order
- Eucabal (syrup 100ml)Pharma Wernigerode GmbH
RUB 365 order
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Pharmacy24
- Eucabal 100 ml syrup Pharma Wernigerode GmbH, Nimetchina
73 UAH.order - Eucabal 1 mg/ml 10 ml No. 1 spray Pharma Wernigerode GmbH, Nimecchina
56 UAH order
- Eucabal C balm 40 ml Lichtenheldt GmbH FF, Nimecchina
58 UAH order
- Eucabal 1 mg/ml 10 ml No. 1 drops Pharma Wernigerode GmbH, Nimecchina
40 UAH order
- Eucabal 0.5 mg/ml 10 ml No. 1 drops Pharma Wernigerode GmbH, Niemecchina
47 UAH order