Ambrohexal cough syrup for children. International non-proprietary name. Special instructions and precautions

Cough is one of the natural defense reactions of the body. In a mild form, the symptom does not require serious treatment. But if it is accompanied by the formation of viscous sputum that is difficult to discharge, it is difficult to do without appropriate therapy. Such a cough delivers to patients, especially children, real torment and is fraught with complications. And then pharmacy mucolytics, such as Ambrohexal, come to the rescue. In this review, we will look at what the drug consists of, how it works and in what cases it helps, get acquainted with reviews about the drug, and also touch on other issues of interest to responsible parents of coughing children.

Ambrohexal is a mucolytic drug with expectorant action.

Composition and features of the action

The main active ingredient of the drug is ambroxol hydrochloride. This component breaks the bonds between secretion molecules, at the same time activating hydrolyzing (decomposing thick mucus when interacting with water) enzymes. As a result, the viscosity of the secret decreases, it liquefies and is easier to remove. Wherein the medicine does not provoke increased sputum formation.

The composition of different forms of Ambrohexal also includes various auxiliary components that serve mainly to give the drug the desired look, consistency, taste and aroma: lactose monohydrate, starch, water, citric acid, sorbitol, povidone, flavorings, microcrystalline cellulose, gelatin, etc. .

Means in a short time and almost completely absorbed from the gastrointestinal tract. The drug begins to work 30 minutes after ingestion, and its action lasts 6-12 hours. The active ingredient is processed in the liver, and excreted through the kidneys along with urine.

The drug reduces the viscosity of sputum, which contributes to its easy movement through the bronchi.

When Ambrohexal is prescribed

With a slight cough, the use of Ambrohexal is inappropriate. But with diseases of the bronchi and lungs, accompanied by a cough with sputum that is difficult to separate, pediatricians often prescribe this drug to patients. The instructions list the main indications:

• bronchial asthma;
• tuberculosis;
• muscoviscidosis;
• pleurisy;
• pneumonia;

The drug will help with pneumonia.

• bronchiectasis pathology;
• , - to maintain the mucolytic (thinning of mucus) effect as an additional therapy;
• complications in infectious diseases (mumps, whooping cough, scarlet fever, etc.).

Ambrohexal is also effective in preventing complications before and after operations on the organs of the respiratory system.

How much does it cost, by whom and in what forms is it produced

Ambrohexal is a product of the German pharmaceutical company Salutas Pharma. The medicine is available in several forms.

1. Cough syrup. Colorless or pale yellow transparent liquid with a pleasant raspberry flavor and a berry-candy smell. It is bottled in dark glass bottles with a capacity of 100 ml or 250 ml. Comes with an easy-to-dosing measuring spoon. Ambrohexal syrup for children of different ages is available with different concentrations of ambroxol:

• 3mg \ 1ml - this is an option for the smallest patients, the average price of the medicine is 100 rubles (100 ml bottle);
• 6 mg \ 1 ml - a remedy with such a dosage can be bought for an average of 220 rubles (100 ml). The syrup is suitable for treating children from 6 years of age. It is also suitable for younger patients, but in this case it is more difficult to dose.

The syrup is best taken after meals.

The capsule is swallowed whole, not chewed.

How to use

The instructions for use for each form of release of Ambrohexal describe in detail the features of taking the medicine and age dosages.

In some cases, the doctor, taking into account the peculiarities of the course of the patient's illness and the state of his health, can adjust the standard treatment regimens. For example, in the presence of severe pathologies of the liver or kidneys, the recommended norms are reduced, and the intervals between doses are increased. Therefore, before starting treatment, consultation with a specialist is required.

For syrup 3mg \ 1ml, the following daily dosages are provided:

• babies under 2 years old - half a scoop (7.5 mg) in the morning and evening;
• preschoolers 2-5 years old - 1/2 measuring container 2-3 times a day;
• children 6-12 years old - 1 scoop (15 mg) 2 or 3 times;
• adolescents over 12 years old - 2 scoops (30 mg) three times during the first 2-3 days, then the number of doses should be reduced to two per day.

For syrup 6 mg\1ml, the regimen is similar to the scheme described above for a dosage of 3mg\1ml, but the dose taken each time should be 2 times less.

Tablets should be washed down with water, and taken in an unchewed and unground form in the dosages prescribed by the instructions:

• children 6-12 years old - half a pill 2 or 3 times a day;
• patients over 12 years old - 1 pill three times a day during the first 2 days of illness, then the number of doses is reduced to 2 times a day.

Tablets should be taken with plenty of water.

For a solution for oral administration, the following norms are provided:

• babies under 2 years old - 1 ml (20 drops) twice a day;
• preschoolers 2-5 years old - 1 ml (20 drops) three times a day;
• children 6-12 years old - 2 ml (40 drops) 2-3 times a day;
• patients over 12 years old - 4 ml (80 drops) three times a day for the first 2-3 days, then the number of doses is reduced to 2.

Droplets dissolve in liquid- milk, water, juice, compote.

The solution is also suitable for inhalation. You can use any nebulizer (with the exception of steam models). The medicine is mixed in equal proportions with saline. The resulting liquid is heated to about 37 degrees. During the procedure, ask the child not to take deep breaths - this can provoke a coughing fit. Normal shallow breathing is enough. Patients older than 5 years of inhalation are done a couple of times a day. The recommended dosage is 2-3 ml (40-60 drops) of the drug.

Cough will help inhalation.

Long-acting capsules are prescribed only to patients over 12 years old, 1 piece 1 time per day.

Ambrohexal It is recommended to take after meals, preferably long before bedtime. This applies to all forms of release. During the period of drug therapy, let the child drink as much as possible - water, tea, juice, compote, etc. This enhances the effectiveness of the remedy, speeds up recovery.

It is important for parents of children with diabetes to know: a scoop of syrup (3 mg) is less than 0.15 XE.

As for the interaction of Ambrohexal with other pharmaceutical preparations, during treatment (, erythromycin, etc.), an increase in their concentration in the lungs and bronchi is observed. Co-administration of antitussives is not recommended.(especially if they contain codeine) - this will lead to stagnation of sputum.

On average, treatment with Ambrohexal lasts about 5 days.

It is impossible to combine taking the medication with Sinekod.

Contraindications and adverse events

Before giving Ambrohexal to a child, read the contraindications and undesirable effects indicated in the instructions. Children should not be treated with this medicine if:

• personal high sensitivity to ambroxol or any of the additional ingredients;
• ulceration of the gastrointestinal tract.

With caution and in an adjusted dosage, the drug is prescribed for severe damage to the liver and kidneys. With a disturbed cough reflex, Ambrohexal can cause sputum accumulation.

During treatment with the drug in rare cases (usually when ignoring the rules of the instruction), some undesirable effects may occur from the side:

• Gastrointestinal tract - nausea, diarrhea or constipation, vomiting, abdominal pain, increased salivation;

Possible adverse reactions are abdominal pain and nausea.

• immune system - skin rashes, urticaria, edema, fever, itching, shortness of breath;
• respiratory system - increased secretion of mucus in the nasal passages, a feeling of dry mucous membranes.

Other possible effects are weakness, migraine, dysuria (difficulty urinating).

Similar funds

Ambrohexal has structural analogues. These are drugs that contain the same active ingredient - ambroxol hydrochloride. These include:

• - a means for thinning sputum that is difficult to separate, has the same indications as Ambrohexal, in the form of a syrup is also suitable for the treatment of children under 2 years of age (but only under medical supervision). Approximate price - 100 rubles (for a bottle of 100 ml).
• - a safe and effective medication, prescribed for both dry and wet coughs. It is produced in different forms, syrup is suitable for children, its approximate price (per 100 ml) is 130 rubles.
• - a medicine that softens the cough, as well as diluting sputum and facilitating its excretion. In the form of a syrup (100 ml) it costs about 200 rubles.

An analogue of Ambrohexal is Lazolvan.

On the shelves of pharmacies there are drugs that have a similar effect to Ambrohexal, but have a different composition:

• - a medicine based on salbutamol, bromhexine and guaifenesin. The remedy relaxes the muscles of the bronchi, improves their patency, increases the vital capacity of the lungs, makes sputum thinner and facilitates its removal. The most suitable form for children is syrup, the average cost of which (100 ml bottle) is 300 rubles.
• - a drug with an active active ingredient acetylcysteine. There are several forms of release - syrup, syrup granules and effervescent tablets. It is intended for the treatment of diseases of the elements of the respiratory system with symptoms in the form of a wet cough for children from the 10th day of life. The medicine makes sputum more liquid, facilitates its expectoration and has an anti-inflammatory effect. The average price of syrup (100 ml) is 260 rubles.
• Bromhexine-based agent that effectively thins sputum and facilitates its discharge, as well as providing a slight antitussive effect. The average cost of a medicine in the form of a syrup (100 ml) is 135 rubles.
• - a medicine with the active ingredient fenispiride hydrochloride. It has anti-inflammatory, antispasmodic and antihistamine effects. A syrup in a 150 ml bottle costs about 280 rubles.

An expensive analogue of Ambrohexal is Erespal.

It is dangerous, after reading positive reviews, to give the child any of the analogues of Ambrohexal. Each medicine has its own characteristics, only a doctor can choose an adequate therapy. Self-medication can result in serious consequences.

Ambrohexal: instructions for use and reviews

You are a rather active person who cares and thinks about your respiratory system and health in general, continue to play sports, lead a healthy lifestyle and your body will delight you throughout your life. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and strong emotional overload. Try to minimize contact with sick people, in case of forced contact, do not forget about protective equipment (mask, washing hands and face, cleaning the respiratory tract).

Description: Syrup-like transparent or almost transparent, colorless or slightly yellowish solution.

Pharmacotherapeutic group: expectorant, mucolytic
ATC Code: R05CB06

pharmachologic effect
The drug has an expectorant, mucolytic effect. The decrease in sputum viscosity occurs as a result of the depolymerization of mucopolysaccharides, which are found in sputum. Depolymerization of mucopolysaccharides is associated primarily with the breaking of disulfide bonds in their molecules, Ambroxol increases the motor activity of the ciliated epithelium, increases mucociliary transport, and normalizes the ratio of serous and mucous components of sputum. By activating hydrolyzing enzymes and increasing the release of lysosomes from Clark cells, it reduces the viscosity of sputum. Facilitates the removal of mucus from the respiratory tract. Ambroxol stimulates prenatal lung development by increasing the synthesis and secretion of surfactant in the alveoli. Surfactant synthesis is reduced as a result of chronic diseases of the respiratory system, in addition, the properties of the surfactant change due to the formation of bonds between surface-active phospholipids and inflammatory proteins.

Pharmacokinetics
Absorption is high, the time to reach the maximum concentration is 0.5 - 3 hours, the connection with blood plasma proteins is 80-90%, it penetrates the blood-brain barrier, the placental barrier, and is excreted in breast milk.
The drug is metabolized in the liver to inactive metabolites (dibromanthranilic acid and glucuronic conjugates). The half-life (T 1/2) - from 7 to 12 hours. Excreted by the kidneys: 90% as metabolites, 10% unchanged.

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, pneumonia, bronchial asthma with difficulty in sputum discharge, bronchiectasis; treatment and prevention of respiratory distress syndrome.

Contraindications
Hypersensitivity to the components of the drug, pregnancy (I trimester).

Carefully
The drug should be used with caution in patients with gastric and duodenal ulcers, since an exacerbation of peptic ulcers may occur, as well as in patients with renal and hepatic insufficiency.

Use during pregnancy and lactation:
The drug is not recommended for use during the first trimester of pregnancy. If it is necessary to use ambroxol in the II-III trimesters of pregnancy, the potential benefit to the mother with a possible risk to the fetus should be assessed.

During breastfeeding, use the drug with caution, as it is excreted in breast milk.

Dosage and application regimen
Adults: 2-3 days 2-3 times a day, 2 scoops (2-3 times 30 mg of ambroxol), and then - 2 times a day, 2 scoops. In severe cases of the disease, the dose is not reduced during the entire course of treatment. The maximum dose is 2 times a day, 4 scoops (2 times 60 mg).
Children aged 5 to 12: appoint 2-3 times a day for 1 measuring spoon (2-3 times for 15 mg of ambroxol).
Children aged 2 to 5 years: appoint 3 times a day for 1/2 measuring spoon (3 times for 7.5 mg of ambroxol).
Children under 2 years of age: appoint 2 times a day for 1/2 scoop (2 times but 7.5 mg of ambroxol).
For children under the age of 2 years, AmbroGEKSAL® is prescribed only under the supervision of a physician.
AmbroGEXAL® should be taken after meals.
During treatment, it is necessary to drink plenty of fluids (juices, tea, water) to enhance the mucolytic effect of the drug.
The duration of therapy depends on the severity of the disease and is determined by the attending physician. Without a doctor's recommendation, do not take AmbroGEXAL® for longer than 4-5 days.

Side effects
From the digestive system: nausea, vomiting, gastralgia, diarrhea, constipation, dry mouth.
Allergic reactions: skin rash, urticaria, angioedema, bronchospasm attack, fever with chills, very rare (<0,01%) - анафилактический шок.
Rarely (<1%): слабость, головная боль, ринорея, усиление слюноотделения, сухость в дыхательных путях, нарушение мочеиспускания (дизурия).
Due to the presence of metabisulfite (a preservative) in the composition of sodium, hypersensitivity reactions may develop (especially in patients with bronchial asthma), which manifest themselves 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.

Overdose
Symptoms: nausea, vomiting, gastralgia. There are reports of short-term restlessness and diarrhea. With a severe overdose, a drop in blood pressure is possible. Treatment: artificial vomiting, gastric lavage in the first 1-2 hours after taking the drug, taking fat-containing products.

Interaction with other drugs
When used with antitussive drugs, sputum discharge may be difficult as a result of suppression of the cough reflex. With simultaneous use with amoxicillin, cefuroxime, erythromycin, doxycycline, ambroxol increases their concentration in bronchial secretions.

special instructions
Ambroxol should not be taken concomitantly with antitussive drugs that can inhibit the cough reflex, such as codeine, because. this can make it difficult to remove thinned sputum from the bronchial tree.
AmbroGEXAL® 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 seriously ill patients, aspiration of diluted sputum should be performed.
In patients with bronchial asthma, ambroxol may increase coughing.
Ambroxol should not be taken immediately before bedtime.

Release form
Syrup 3 mg/ml.
100 ml or 250 ml in a dark glass bottle. A bottle with a measuring spoon in a cardboard box with instructions for use.

Storage conditions
In a place protected from light and out of the reach of children at a temperature not exceeding 25 ° C!

Best before date
3 years.
Do not use the drug after the expiration date.

Vacation from pharmacies
Without recipe.