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Mechanism of action

Mucolytic agent, stimulates prenatal development of the lungs (increases synthesis, secretion of surfactant and blocks its disintegration). Possesses sekretomotorny, sekretolitichesky and expectorant action; stimulates the serous cells of the glands of the mucous membrane of the bronchi, increases the content of mucous secretions and the release of surfactant (surfactant) in the alveoli and bronchi; normalizes the disturbed ratio of serous and mucous components of sputum. Activating hydrolyzing enzymes and enhancing the release of lysosomes from Clark cells, reduces the viscosity of sputum. Increases the motor activity of cilia of the ciliated epithelium, increases mucociliary transport of sputum. After ingestion, the action occurs after 30 minutes, with rectal administration - after 10-30 minutes and lasts for 6-12 hours. With parenteral administration, the action comes quickly and lasts for 6-10 hours.

Absorption - high (with any routes of administration), TCmax - 2 h, the connection with plasma proteins - 80%, Penetrates the BBB, placental barrier, excreted in breast milk. Metabolism - in the liver, forms dibromantranilic acid and glucuronic conjugates. T1 / 2 - 1.3 h, and for prolonged forms - 10-12 h.Excreted by the kidneys: 90% in the form of water-soluble metabolites, unchanged - 5%. T1 / 2 increases with severe CKD, but does not change with abnormal liver function.

Indications and usage

Diseases of the respiratory tract with the release of viscous sputum: acute and chronic bronchitis, pneumonia, COPD (including bronchial asthma with difficulty in sputum discharge), bronchiectasis. Stimulation of prenatal maturation of the lungs, treatment and prevention (with the threat of premature birth and with demonstrated artificial premature birth between 28 and 34 weeks of gestation, if the clinical picture suggests a prolongation of gestation by 3 days) of respiratory distress syndrome in premature babies and newborns.

Inside, during a meal, with a small amount of liquid. Adults and children over 12 years old are prescribed: tablets: 30 mg 3 times a day for the first 2-3 days, then 30 mg 2 times or 15 mg 3 times a day, or 1 capsule of retard (75 mg) in the morning; children 6-12 years old - 15 mg 2-3 times a day; The solution for oral administration (7.5 mg / ml) for adults during the first 2-3 days is 4 ml, and then 2 ml 3 times a day or 4 ml 2 times a day; children under 2 years old - 1 ml 2 times a day, 2-5 years - 1 ml 3 times a day, 5-12 years - 2 ml 2-3 times a day. Syrup (3 mg / ml) for adults - in the first 2-3 days - 10 ml, and then - 5 ml 3 times a day or 10 ml 2 times a day. In severe cases of the disease, the dose is not reduced during the entire course of treatment. Children 5-12 years old should be prescribed 15 mg 2-3 times a day, 2-5 years - 7.5 mg 3 times a day, up to 2 years - 7.5 mg 2 times a day.In the form of inhalations prescribed for adults and children over 5 years old at 15-22.5 mg, for children up to 2 years old - 7.5 mg, for children from 2-5 years old - 15 mg 1-2 times per day. In the case when it is not possible to carry out more than one inhalation per day, additionally used tablets, solution or syrup orally. Parenterally administered intramuscularly, intravenously (slowly, in a jet or drip) or n / a: for adults - 15 mg, in severe cases - 30 mg 2-3 times a day; children - 1.2-1.6 mg / kg 3 times a day. Usually for children up to 2 years old - 7.5 mg 2 times a day, from 2 to 5 years old - 7.5 mg 3 times a day, from 5 years old - 15 mg 2-3 times a day. For the treatment of respiratory distress syndrome in preterm and newborn infants administered intravenously or intramuscularly - 10 mg / kg / day, the frequency of administration - 3-4 times, if necessary, the dose can be increased to 30 mg / kg / day. For intravenous drip administration, 50 ml is diluted in 500 ml of infusion solution (0.9% sodium chloride solution, 5% dextrose solution, Ringer-Locke solution or other basic solution with a pH not higher than 6.3 is used as a solvent), injected for 2 h with a speed of 84 drops / min. Repeated treatment according to the above scheme can be carried out after 14 days (while maintaining the indications). Parenteral administration is terminated after the disappearance of the acute manifestations of the disease (they go on ingestion or rectal administration). Rectally, adults and children over 12 years old - 1 suppository (30 mg) 3 times a day, 2-3 days, then 60 mg 2 times a day, the maximum daily dose is 0.12 g; children 6-12 years old - 15 mg 2-3 times a day. It is not recommended to apply without a medical appointment for more than 4-5 days.

Adverse reactions

Allergic reactions: skin rash, urticaria, angioedema, in some cases - allergic contact dermatitis, anaphylactic shock. Rarely - weakness, headache, diarrhea, dry mouth and respiratory tract, exanthema, rhinorrhea, constipation, dysuria. With prolonged use in high doses - gastralgia, nausea, vomiting. With rapid on / in the introduction - a feeling of numbness, weakness, intense headaches, lowering blood pressure, shortness of breath, hyperthermia, chills. Overdose. Symptoms: nausea, vomiting, diarrhea, dyspepsia. Treatment: artificial vomiting, gastric lavage in the first 1-2 hours after taking the drug; reception of fat-containing products.


Hypersensitivity, pregnancy (I trimester), lactation, peptic ulcer and duodenal ulcer, epileptic syndrome. With care - renal and / or liver failure, pregnancy (II and III trimester).

Special notes

It should not be combined with antitussive agents that impede the excretion of sputum. Inhalation solution can be applied using any modern equipment for inhalation (except steam inhalers). Before inhalation, the drug is mixed with 0.9% sodium chloride solution (for optimal air moistening, it can be diluted in a 1: 1 ratio) and warmed to body temperature. Inhalation should be carried out in the mode of normal breathing (so as not to provoke cough tremors).Patients suffering from bronchial asthma, in order to avoid nonspecific irritation of the respiratory tract and their spasm before inhalation of Ambroxol should use bronchodilators. Patients suffering from diabetes, can be prescribed in the form of syrup (5 ml of syrup contain sorbitol and saccharin in an amount corresponding to 0.18 XE). For children under 5 years old, suppositories of 15 mg are not recommended, up to 12 years - 30 mg (15 mg suppositories are used for them).

Drug Interactions

Compatible with drugs that inhibit generic activity. Combined use: with antitussive drugs leads to difficulty in sputum discharge on the background of cough reduction. Increases bronchial secretions in Amoxicillin, cefuroxime, Erythromycin and Doxycycline. Injection solution cannot be used with solutions having a pH above 6.3.

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