How many days do you take ambrohexal tablets? What does Ambrohexal help with? Instructions for use

Ambrohexal is a drug that has mucolytic, secretolytic and expectorant effects, 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 of breaking disulfide bonds in the molecules, enhancing the release of active hydrolyzing enzymes from Clark cells.

On this page you will find all the information about Ambrohexal: complete 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. Would you like to leave your opinion? Please write in the comments.

Clinical and pharmacological group

A drug that has secretolytic, mucolytic and expectorant effects.

Conditions for dispensing from pharmacies

No recipe 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 approximately 103 rubles per 100 ml.

Release form and composition

Today the drug is sold in the following dosage forms:

Tablets, 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 bottles 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 production. The drug copes with a number of therapeutic tasks: reducing cough, improving bronchial secretion, normalizing sputum production, promoting sputum along the bronchopulmonary tract.

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, occurring due to infection and other causes;
– this pathology is of allergic origin, when the bronchi narrow, and thick sputum accumulates in their lumen;
cystic fibrosis - this disease is hereditary in nature and is distinguished by its severity (characterized by the production of viscous sputum);
(pneumonia), occurs due to the presence of various bacteria;
infectious (chronic or acute course) – when 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 dilation 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

Ambrohexal should not be used in the treatment of hypersensitivity to the active components of the drug, as well as gastric or duodenal ulcers. In case of severe damage to the liver and kidneys, the mucolytic is used with great caution. If the cough reflex is impaired, 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 stimulator of lung development in the perinatal period, by increasing the synthesis of surfactant and blocking its breakdown, it is prescribed to pregnant women if the development of fetal malnutrition is suspected to stimulate lung maturation, as well as when there is a 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.

Pills adults and children over 12 years of age are prescribed a dosage of 30 mg (1 tablet) three times a day for the first 2-3 days. Then 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. You should not take the drug for more than 4-5 days without a doctor's prescription. During the entire treatment, the patient is recommended to drink more fluid to enhance the mucolytic effect.
A drug in capsule form 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. It is also not recommended to take capsules 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 in 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 old – 1 ml three times a day. Children under two years old - 1 ml 2 times a day only under the supervision of a doctor. 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 in a dosage of 2-3 ml, for children under 5 years old - 2 ml. Inhalations should be carried out using a special device.

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

Side effects

Ambroxol in AmbroHEXAL tablets is well tolerated. Sometimes it is possible to develop its side effects, which are characterized by the following manifestations:

Symptoms of digestive system dysfunction are nausea, vomiting, periodic bloating, which are accompanied by dry mucous membranes. Somewhat less often, abdominal pain may appear, which is spastic in nature.
From the nervous system – a slight disturbance of taste sensations.
A change in a person’s general well-being after taking the drug, which is accompanied by headache, fever, and 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 slight swelling, 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 a progressive decrease in systemic blood pressure and loss of consciousness occurs.

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

Drug interactions

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

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

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

INSTRUCTIONS
on the use of a medicinal product for medical use

Registration number:

P N012596/01-261107

Trade name of the drug:

Ambrohexal ® .

International nonproprietary name:

ambroxol.

Dosage form:

pills.

Compound:

One tablet contains:
active substance: ambroxol hydrochloride – 30.0 mg;
Excipients: lactose monohydrate – 102.0 mg; calcium hydrogen phosphate dihydrate – 50.0 mg; corn starch – 10.0 mg; sodium carboxymethyl starch – 4.0 mg; magnesium stearate – 2.0 mg; colloidal silicon dioxide – 2.0 mg.

Description: white, round, flat tablets with beveled edges, scored on one side.

Pharmacotherapeutic group:

expectorant, mucolytic agent.

ATX Code: R05CB06.

Pharmacological properties

Pharmacodynamics
It has a secretomotor, secretolytic and expectorant effect, stimulates the serous cells of the glands of the bronchial mucosa, increases the content of mucous secretion and the release of 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 Clara cells, it reduces the viscosity of sputum. Increases the motor activity of the ciliated epithelium, increases mucociliary transport, and facilitates the removal of mucus from the respiratory tract.
On average, the effect of taking ambroxol orally occurs within 30 minutes and lasts 6-12 hours, depending on the size of the single dose.
Pharmacokinetics
Ambroxol after oral administration is quickly and almost completely absorbed.
The time to reach maximum concentration (TCmax) after oral administration is 1-3 hours.
Metabolized in the liver to form metabolites excreted through the kidneys (dibromanthranilic acid, glucuronides).
Plasma protein binding is approximately 85%.
The half-life (T1/2) from blood plasma is 7-12 hours.
T1/2 of ambroxol and its metabolites is approximately 22 hours. 90% of ambroxol in the form of metabolites is excreted through the kidneys. Less than 10% of ambroxol is excreted unchanged through the kidneys.
Due to high protein binding and a large volume of distribution, as well as slow re-penetration from tissues into the blood, significant elimination of ambroxol does not occur during dialysis or forced diuresis.
The clearance of ambroxol in patients with severe liver failure is reduced by 20-40%.
In severe renal failure, T1/2 of ambroxol metabolites increases. Ambroxol penetrates the placental barrier and into breast milk.

Indications for use

Acute and chronic diseases of the respiratory tract with the release of viscous sputum:
acute and chronic bronchitis;
chronic obstructive pulmonary disease (COPD);
pneumonia;
bronchial asthma with difficulty in sputum discharge;
bronchiectasis.

Contraindications

Hypersensitivity to any component of the drug;
pregnancy (first trimester);
breastfeeding period;
lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
children under 6 years of age.

Carefully: liver failure, renal failure, peptic ulcer of the stomach and duodenum, pregnancy (II-III trimester).

Use during pregnancy and breastfeeding

The drug is contraindicated for use during the first trimester of pregnancy.
The use of Ambrohexal ® during pregnancy (II-III trimester) is possible only if the expected benefit to the mother outweighs the potential risk to the fetus or infant.
Ambroxol penetrates the placental barrier. Animal studies have shown that the drug has no effect on embryofetal development, childbirth and postnatal development.
Ambroxol is excreted in small quantities into breast milk, so when taking Ambrohexal ® it is necessary to decide whether to stop breastfeeding.

Directions for use and doses

Ambrohexal ® is taken orally after meals with sufficient liquid.
Adults and children over 12 years of age: 1 tablet (30 mg ambroxol) 3 times a day for the first 2-3 days, then the dose of the drug must be reduced to 1 tablet 2 times a day.
Children from 6 to 12 years old: 1/2 (15 mg ambroxol) tablets 2-3 times a day.
It is not recommended to use without medical prescription for more than 4-5 days.
During treatment, it is necessary to drink a lot of liquid (juices, tea, water), as it enhances the mucolytic effect of the drug.

Side effect

According to the World Health Organization (WHO), adverse effects are classified according to their frequency as follows: very common (≥1/10), common (≥1/100 to<1/10), нечасто (от ≥1/1,000 до <1/100), редко (от ≥1/10,000 до <1/1,000), очень редко (<1/10,000); частота неизвестна – по имеющимся данным установить частоту возникновения не представлялось возможным.
Allergic reactions
rarely: skin rash, urticaria;
frequency unknown: anaphylactic reactions, including anaphylactic shock, angioedema, pruritus and other hypersensitivity reactions.
From the gastrointestinal tract
often: nausea;
uncommon: vomiting, diarrhea, dyspepsia and abdominal pain.
From the nervous system
often: change in taste sensations.
Others
often: decreased sensitivity in the mouth or throat;
infrequently: dry mouth;
frequency unknown: dryness of the mucous membranes of the respiratory tract.

Overdose

Symptoms: nausea, vomiting, diarrhea, gastralgia, dyspepsia.
Treatment: artificial vomiting, gastric lavage in the first 1-2 hours after taking the drug; intake of fat-containing foods, symptomatic therapy.

Interaction with other drugs

Simultaneous use with antitussive drugs leads to difficulty in sputum discharge while reducing cough. Increases penetration into bronchial secretions amoxicillin, cefuroxime, erythromycin and doxycycline.

special instructions

Ambroxol should not be taken simultaneously with antitussive drugs that can inhibit the cough reflex, for example, codeine, because this may make it difficult to remove liquefied mucus from the bronchial tree.
Ambroxol should be used with caution in patients with a weakened cough reflex or impaired mucociliary transport due to the possibility of sputum accumulation.
Patients taking ambroxol should not be advised to perform breathing exercises; in severe patients, aspiration of liquefied sputum should be performed.
In patients with bronchial asthma, ambroxol may increase cough.
You should not take ambroxol immediately before bed.
In patients with severe skin lesions (Stevens-Johnson syndrome or toxic epidermal necrolysis), fever, body pain, rhinitis, cough and sore throat may appear in the early phase. During symptomatic treatment, it is possible to erroneously prescribe mucolytic agents such as ambroxol hydrochloride. There are isolated reports of the detection of Stevens-Johnson syndrome and toxic epidermal necrolysis, which coincided with the administration of the drug. However, there is no cause-and-effect relationship with taking the drug.
If the above syndromes develop, it is recommended to stop treatment and consult a doctor immediately.
Instructions for patients with diabetes mellitus: 1 tablet contains less than 0.01 XE.

Impact on the ability to drive vehicles and machinery

Ambrohexal ® does not have a negative effect on the ability to drive a car or operate machinery.

Release form

Tablets 30 mg
10 or 20 tablets in a PVC/aluminum or PP/aluminum blister pack.
1, 2, 3, 5 or 10 blister packs of 10 or 20 tablets per cardboard box along with instructions for use.

Storage conditions

In a place protected from light at a temperature not exceeding 25 ° C.
Keep out of the reach of children!

Best before date

5 years.
Do not use the drug after the expiration date.

Vacation conditions

Over the counter.

Manufacturer

RU holder: Sandoz d.d., Verovshkova 57, 1000 Ljubljana, Slovenia;
Produced: Salutas Pharma GmbH, Germany.

Consumer complaints should be sent to Sandoz CJSC:
125315, Moscow, Leningradsky Prospekt, 72, bldg. 3.

In this article you can read the instructions for use of the drug Ambrohexal. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Ambrohexal in their practice are presented. We kindly ask you to 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, perhaps not stated 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 effect. It has secretomotor, secretolytic and expectorant effects.

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

By activating hydrolyzing enzymes and enhancing 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 appears on the 3rd day of treatment.

Compound

Ambroxol hydrochloride + excipients.

Pharmacokinetics

After oral administration, Ambrohexal is quickly and almost completely absorbed from the gastrointestinal tract. Binding to blood plasma proteins is 80-90%. Ambroxol penetrates 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 viscous secretions:

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 forms

Tablets 30 mg.

Extended-release capsules 75 mg.

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

Instructions for use and method of use

Pills

Adults and children over 12 years of age 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.

Extended release capsules

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

Syrup

Adults and children over 12 years of age are prescribed 2 scoops (30 mg) 2-3 times a day for the first 2-3 days. Then 2 measuring spoons 2 times a day. In severe cases of the disease, the dose is not reduced throughout 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 measuring spoon (7.5 mg) 3 times a day.

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

Solution for oral administration and inhalation

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

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

The oral solution can also be used as inhalation.

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

For inhalation, you should use an appropriate device in compliance with the instructions for use.

Ambrohexal should be taken orally after meals with sufficient 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 it is necessary to use the drug for more than 4-5 days, medical supervision is required.

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

1st trimester of pregnancy;
children under 6 years of age (for tablets);
children under 12 years of age (for extended-release capsules);
hypersensitivity to ambroxol and other components of the dosage forms of the drug.

Use during pregnancy and breastfeeding

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

The use of the drug in the 2nd and 3rd trimesters of pregnancy is possible only if the expected 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 under 12 years of age (for extended-release capsules);

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 cough.

You should not take ambroxol immediately before bed.

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 interactions

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

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

Analogues of the drug Ambrohexal

Structural analogues of the active substance:

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

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Ambrohexal- a medicinal solution that can be used both internally and as inhalations. The drug has excellent mucolytic and expectorant properties.

Registration number: P NO12596/02.

Trademark (name): Ambrohexal, Nonproprietary international name: .

Ambrohexal is available in the form of a solution for inhalation and oral administration.

Compound

One milliliter of the drug contains: ambrohexal active ingredient: ambroxol hydrochloride 7.5 milligrams, as well as additional components: water, methyl parahydroxybenzoate, sodium hydroxide, propyl parahydroxybenzoate, citric acid, sodium metabisulfite. The product is colorless transparent solution.

Ambrohexal is a mucolytic and expectorant.

Pharmacology

The drug exhibits secretomotor, secretolytic and expectorant properties, stimulates glandular serous cells of the bronchial mucosa, increases the amount of mucosal secretion and the release of surfactant in the bronchi and alveoli, restores the normal ratio of mucous and serous components of sputum. In addition, it reduces the viscosity of sputum by activating hydrolyzing enzymes and increasing the release of lysosomes from Clara cells. Increases the movements of the cilia of the ciliated epithelium, accelerates mucociliary transport than promotes the removal of phlegm.

Ambroxol begins to act thirty minutes after ingestion and lasts up to six to twelve hours (in accordance with the single dose taken). After taking the drug absorbed quickly and almost completely. The maximum concentration of ambrohexal is determined after one to three hours. It is converted in the liver, after which metabolites (glucuronides, dibromanthranilic acid) are excreted through the kidneys.

Approximately 85% of the drug binds to blood proteins. The half-life from the blood is seven to twelve hours. The half-life of the drug's metabolites is twenty-two hours. The kidneys excrete ninety percent of ambrohexal in the form of metabolites and only ten percent of the drug is excreted unchanged through the kidneys.

Due to the high binding of the drug to proteins, as well as a large volume of distribution and slow re-penetration into the blood from tissues, during forced diuresis or hemodialysis, a significant amount of ambrohexal is not excreted.

In the presence of severe liver failure, drug clearance is reduced by twenty to forty percent, and the half-life is increased.

Ambrohexal penetrates into mother's milk and passes through the placental barrier.

Indications for use

Indications for prescribing a solution of the drug are chronic or acute pathologies of the respiratory system, which are accompanied by the separation of viscous sputum:

Prevention and treatment of distress syndrome;
Chronic/acute bronchitis;
Bronchiectatic disease;
COPD;
Bronchial asthma with difficult to clear sputum.

Contraindications

High sensitivity to the components of the product;
Pregnancy in the first trimester;
Lactation.

Use with extreme caution when:

Pregnancy 2-3 trimester;
Liver and kidney failure;
Ulcers in the duodenum and stomach.

Moreover, prescribing the drug during pregnancy (2-3 trimester) is justified if the benefits for the pregnant woman are higher than the possible risks for the fetus. Ambrohexal penetrates the placental barrier.

Ambrohexal penetrates into mother's milk in small quantities, and therefore, when prescribing the drug, the issue of stopping breastfeeding should be decided.

Directions for use and dosage

Take ambrohexal orally after meals, after diluting it with water, tea, milk or fruit juices.

One milliliter of ambrohexal (which is twenty drops of solution) contains seven and a half milligrams of ambroxol hydrochloride. For children over 12 years of age and adults, it is recommended to take 80 drops (that is, 4 ml) in the first two to three days three times a day, that is, up to 90 milligrams of ambroxol hydrochloride per day, then the number of doses is reduced to two, that is, eighty drops of the drug (four milliliters) twice a day. The total daily dose is 60 milligrams of ambroxol hydrochloride per day.

Children from five to twelve years old are prescribed forty drops (that is, two milliliters of solution) twice or three times a day (that is, the total daily dosage is thirty to forty-five milligrams of the active substance).

For children from two to five years of age, ambrohexal is prescribed in the amount of 20 drops (that is, 1 milliliter) three times a day, the total daily dosage is 22.5 milligrams of the active substance.

For children under two years of age, the drug is given 20 drops (that is, 1 ml) twice a day. Thus, the total daily dose of ambroxol is 15 milligrams. It is worth noting that for children under two years of age, ambrohexal solution is prescribed only under the strict supervision of the attending physician.

The mucolytic effect of the drug increases in the presence of liquid, and therefore drinking enough water during treatment is the key to successful therapy.

Ambrohexal for inhalation

Adults and children over five years of age are prescribed inhalations up to two times a day, forty to sixty drops (that is, two to three milliliters of solution).

A child under five years of age is prescribed inhalations twice a day, forty drops (2 ml of solution).

Ambrohexal as an inhalation solution can be used in any of the existing inhalers (except steam). For this the drug is mixed with saline solution, and, in order to achieve an optimal level of hydration, you can dilute the drug in a one to one ratio.

Due to the fact that during inhalation, a deep breath provokes a cough, patients are recommended to carry out the procedure in normal breathing mode. In addition, before inhalation the solution is heated to 36-37 degrees. If you have bronchial asthma, the procedure can be performed after taking bronchodilators. The duration of treatment is determined by the doctor in accordance with the severity of the disease. Without a doctor's prescription, you should not take the drug for more than five days.

Side effects

Allergic manifestations (rarely): urticaria, rash, extremely rarely anaphylactic reactions;
Regarding the gastrointestinal tract: abdominal pain, vomiting, dyspepsia, diarrhea;
Regarding the nervous system: perversion of taste;
Among the most common: decreased sensitivity in the pharynx or oral cavity, less commonly: dryness of the mucous membranes of the mouth and respiratory tract.

Overdose

Accompanied by the following symptoms: dyspepsia, nausea, gastralgia, diarrhea, vomiting. Recommended: artificial induction of vomiting, in the first few hours after taking large doses of the drug - gastric lavage, eating fatty foods, symptomatic treatment.

Interactions and special instructions

When ambrohexal is combined with antitussive drugs, sputum discharge becomes difficult.

Ambroxol increases the penetration of erythromycin and cefuroxime into the bronchial secretions.

Ambrohexal is used with extreme caution in patients who have a reduced cough reflex or impaired mucociliary transport, due to possible accumulation of sputum.

Patients taking ambroxol It’s better to refrain from breathing exercises, as this can lead to difficulty in sputum discharge. For severely ill patients, sputum aspiration is recommended.

If you have bronchial asthma, taking the drug may cause a cough.

Due to the presence of sodium metabisulfite in the drug, various allergic reactions may develop: bronchospasm, vomiting, impaired consciousness, anaphylactic shock, diarrhea.

Ambrohexal does not affect ability operate complex mechanisms or a car.

Release form

Ambrohexal is available in the form of a solution for inhalation and oral administration at 7.5 milligrams/milliliter. The packaging with the drug is a dropper bottle (50 or 100 milliliters each) made of dark glass, the lid is plastic, and has a ring for the first opening. The bottle, along with a measuring cup and instructions for use, is located in a cardboard box.

The drug must be stored in a dark place, with a temperature of no more than twenty-five degrees for 4 years from the date of release.

◊ solution for oral administration and inhalation 7.5 mg/1 ml: dropper bottle. 50 ml or 100 ml per set. with measure a glass Reg. No.: P N012596/02

Clinical and pharmacological group:

Mucolytic and expectorant drug

Release form, composition and packaging

◊ transparent, colorless.

Excipients: methyl parahydroxybenzoate, propyl parahydroxybenzoate, sodium disulfite, citric acid, sodium hydroxide, water.

50 ml - dark glass dropper bottle (1) complete with a measuring cup - cardboard packs.

Description of the active components of the drug " Ambrohexal ®»

pharmachologic effect

Mucolytic drug with expectorant action. It has secretomotor, secretolytic and expectorant effects.

A decrease in sputum viscosity occurs as a result of depolymerization of mucopolysaccharides, which, in turn, is associated with the rupture of disulfide bonds in their molecules. Ambroxol increases the motor activity of the cilia of the ciliated epithelium, increases mucociliary transport, and normalizes the ratio of serous and mucous components of sputum.

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

The action of Ambrohexal begins after 30 minutes and lasts 6-12 hours.

Indications

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

- acute and chronic bronchitis;

- pneumonia;

- bronchial asthma with difficulty in sputum discharge;

- bronchiectasis;

- treatment and prevention of respiratory distress syndrome (for syrup and solution for oral administration and inhalation).

Dosage regimen

Pills

Prescribe 1 tablet. (30 mg) 3 times/day for the first 2-3 days. Then the dose of the drug should be reduced to 1 tablet. 2 times/day.

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

Extended release capsules

Adults and children over 12 years of age Prescribe 1 caps. (75 mg) 1 time/day in the morning or evening after meals, without chewing, with a sufficient amount of liquid.

Syrup 3 mg/1 ml

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

Prescribe 1 scoop (15 mg) 2-3 times a day.

Prescribe 1/2 measuring spoon (7.5 mg) 3 times a day.

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

Solution for oral administration and inhalation

1 ml = 20 drops.

For adults and children over 12 years of age prescribed 4 ml (30 mg) 3 times a day in 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 prescribed 2 ml (15 mg) 2-3 times/day.

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

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

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

The oral solution can also be used as inhalation.

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

For inhalation, you should use an appropriate device in compliance with the instructions for use.

For severe liver dysfunction or kidneys You should use lower doses of the drug, or increase the interval between doses.

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.

Side effect

From the digestive system: rarely - abdominal pain, nausea, vomiting, constipation, dry mouth; rarely (<1%) - усиление слюноотделения, диарея.

From the respiratory system: rarely (<1%) - повышение секреции слизи в носовой полости, сухость дыхательных путей.

Allergic reactions: skin rash, exanthema, urticaria, angioedema, shortness of breath, itching, bronchospasm, fever and chills; very rarely (<0.01%) - анафилактический шок.

Others: rarely (<1%) - слабость, головная боль, затруднение мочеиспускания (дизурия).

For Ambrohexal in the form of syrup and solution for oral administration and inhalation: due to the presence of sodium metabisulfite (preservative) in the drug, hypersensitivity reactions may develop (especially in patients with bronchial asthma), manifested in the form of vomiting, diarrhea, acute asthmatic attacks, impaired consciousness or shock. These reactions can be very individual and can also lead to life-threatening consequences.

Contraindications

— I trimester of pregnancy;

- children under 6 years of age (for tablets);

- children under 12 years of age (for extended-release capsules);

- hypersensitivity to ambroxol and other components of the dosage forms of the drug.

WITH caution The drug should be used for gastric and duodenal ulcers (due to possible exacerbation), renal failure, and liver failure.

Pregnancy and lactation

The use of the drug in the second and third trimesters of pregnancy is possible only if the expected 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 for liver dysfunction

WITH caution The drug should be used for liver failure.

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

Use for renal impairment

WITH caution The drug should be used for renal failure.

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

Application for children

Contraindications: children under 6 years of age (for tablets); children under 12 years of age (for extended-release capsules);

special instructions

Ambroxol 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 cough.

You should not take ambroxol immediately before bed.

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 in the form of an oral solution and inhalation.

Patients with diabetes should note that 1 scoop of 3 mg/ml syrup contains 1.75 g of sorbitol (less than 0.15 XE).

Impact on the ability to drive vehicles and operate machinery

Does not affect.

Overdose

Symptoms: nausea, vomiting, gastralgia. There are reports of short-term anxiety and diarrhea. In case of severe overdose, blood pressure may drop.

Treatment: drug withdrawal. You should induce artificial vomiting and rinse the stomach during the first 2 hours; Intake of fat-containing foods is indicated. Symptomatic therapy.

Drug interactions

Conditions for dispensing from pharmacies

The drug is approved for use as a means of OTC.

Storage conditions and periods

The drug in tablet form should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C. Shelf life - 5 years.

The drug in the form of extended-release capsules should be stored out of the reach of children at a temperature not exceeding 25°C. Shelf life - 3 years.

The drug in syrup form should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C. Shelf life - 3 years.

The drug in the form of a solution for oral administration and inhalation should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C. Shelf life - 4 years.

Drug interactions

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

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