Ambrohexal (tablets, syrup and solution for inhalation) - instructions for use, features, 3 best analogues

Colds in children are almost always accompanied by a cough. This is a natural reaction of the body to the inflammatory process in the respiratory tract, an attempt to remove excess mucus and waste products of pathogenic microorganisms from the surface of the epithelium. Cough therapy involves the use of mucolytics - substances that thin sputum and promote its removal from the body. One of the modern, effective and safe mucolytic drugs is Ambrohexal.

For what diseases is it used?

Ambrohexal is prescribed for the treatment of respiratory diseases, which are accompanied by a prolonged cough and poor sputum discharge. During the inhalation procedure, the active component of the drug acts directly on the affected area. Thanks to the high temperature of the steam, viruses and bacteria do not multiply. This means that two methods are used simultaneously to destroy them: chemical and thermal. Sputum is released in a shorter time, and the effect of the drug leads to the death of pathogenic microorganisms.

The solution has been successfully used:

in the presence of acute diseases of the respiratory system that are chronic;
for the treatment of acute bronchitis;
with pneumonia;
with bronchial asthma, which is accompanied by difficulty removing sputum;
with cystic fibrosis;
for pulmonary tuberculosis;
with obstructive pulmonary disease;
in the presence of bronchiectasis.

The duration of the course can be reduced by starting treatment immediately after the first symptoms of the disease appear.

Indications for use

Due to the antitussive and mucolytic effect of the main active ingredient, Ambrohexal is widely used in pediatrics. Doctors prescribe this drug for acute and chronic forms of diseases:

acute, obstructive, chronic bronchitis;
pneumonia;
laryngitis, tracheitis;
cystic fibrosis;
pulmonary tuberculosis;
bronchial asthma;
rhinitis.

The listed diseases require immediate treatment and relief of the child’s condition. It is necessary to reduce cough and improve sputum separation, stimulate the movement of mucus along the bronchopulmonary tract. Mucolytics are used for this purpose. For adult patients, the appointment is carried out by a therapist, for children - by a pediatrician.

Contraindications

Inhalation therapy using Ambrohexal can be started only after familiarization with the contraindications of the medicinal solution. The drug is contraindicated in the following cases:

For dry cough, including due to allergies.
Patients should use the drug with caution if they have a weakened cough reflex, since in this case mucus accumulates.
During the treatment period, you should not do breathing exercises.
If you have bronchial asthma, your cough may worsen.
It is not recommended to perform the inhalation procedure before going to bed.
If kidney and liver function are impaired, use of the drug is recommended only under the supervision of a doctor, reducing the dose or increasing the interval between inhalations.
Use Ambrohexal with extreme caution if you have poor tolerance to fructose; be sure to consult your doctor.
Pregnant women who are in the first trimester should not take the drug.
Ambrohexal should be used very carefully and under medical supervision by pregnant women in the second and third trimesters, as well as during the lactation period.

Release form, composition and pharmacological properties

The active ingredient of the drug (AI) is ambroxol hydrochloride. The therapeutic effect is based on the ability of the substance to break intermolecular bonds in sputum, while simultaneously enhancing the hydrolysis of secretions, that is, activating enzymes that, when interacting with water, dilute the mucus. This reduces the viscosity of the secretions, increases their water content, and makes the sputum more liquid and easier to cough up. The medicine is effective for oral administration and inhalation. The drug contains excipients, the composition of which depends on the dosage form.

Ambrohexal for children is available in the following dosage forms:

Syrup of two concentrations of the active substance (3 or 6 mg of active ingredient in 1 ml of medicine). Excipients provide a sweet raspberry taste and pleasant appearance. The composition includes benzoic acid, sorbitol, glycerol, sodium disulfite, hydroxide and cyclamate, citric acid monohydrate, flavoring, water. Available in dark colored bottles of 100 ml. The package includes a measuring spoon.
Solution for inhalation and oral administration. 1 ml of medicine includes 7.5 mg of DV and additional components - methyl parahydroxybenzoate, propyl parahydroxybenzoate, sodium disulfite and hydroxide, citric acid monohydrate, water. Colorless liquid in 50 ml bottles equipped with a dropper.
Long-acting capsules. One capsule contains 75 mg of active ingredients and auxiliary ingredients - microcrystalline cellulose, eudragit RL30D and RS30D, triethyl citrate, magnesium stearate, titanium dioxide, red dye iron oxide. The capsules are covered with a gelatin shell, packed in a blister of 10 pieces.
White tablets, packed in blister packs of 10 pieces. Each tablet contains 30 mg DV and lactose monohydrate, calcium hydrogen phosphate dihydrate, corn starch, sodium carboxymethyl starch, magnesium stearate, silicon dioxide.

List of side effects

As a result of inhalations with ambrohexal and saline, the patient may experience adverse reactions. The most common side effects from using the drug include:

Attacks of nausea;
Taste sensations change;
The sensitivity of tissues in the oral cavity and pharynx decreases;

Not so often, but you can see:

Allergic manifestations;
Disturbances in the digestive system;
The appearance of dryness on the mucous membranes.

Side effects and overdose

Ambrohexal should be taken by children and adults as prescribed by a doctor in strict accordance with the dosage. Side effects are observed in children with hypersensitivity to the active substance or auxiliary components. The following reactions are possible:

allergies (urticaria, skin rashes);
anaphylactic shock (rare);
angioedema of the skin and mucous membranes;
digestive disorders (nausea, vomiting, diarrhea, dyspepsia);
dry mouth and throat;
change in taste sensations.

With a multiple overdose of the drug, disorders of the gastrointestinal tract are very rarely possible: nausea, vomiting, diarrhea, dyspepsia. If there are signs of an overdose, you should artificially induce vomiting in the child and rinse the stomach, then call a doctor. Eat foods high in fat.

Instructions for use

Before starting inhalation therapy, you need to make sure that the cough is not a consequence of an allergic reaction. Ambrohexal is prescribed only if the disease is of viral origin. If the cough is a consequence of an allergy, then treatment with Ambrohexal is not effective.

How to dilute - dosage

According to the instructions for use attached to the drug, Ambrohexal must be diluted with physiological solution, observing the following proportions:

For a child under 2 years of age - dilute 20 drops of the drug (1 ml) in 40 drops of saline;
For a child aged 2 to 6 years – dilute 40 drops of the drug (2 ml) in 80 drops of saline solution;
For a child over 6 years of age and older, dilute 60 drops of Ambrohexal (3 ml) in 80 drops of saline solution.

In the instructions for the inhaler, you can sometimes read information that when carrying out the procedure in the nebulizer, the amount of liquid should be at least 8 milliliters. Otherwise, the quality of inhalation therapy decreases. To get 8 milliliters of solution, you should dilute 60 drops of the drug in 100 drops of saline solution.

Attention! The dosage of Ambrohexal for inhalation procedures should only be calculated by the attending physician. It is unacceptable to self-medicate to avoid negative consequences.

How to do inhalations in a nebulizer

It is necessary to carry out inhalation therapy using a nebulizer, adhering to the following rules:

Before starting the procedure, you need to prepare a healing solution. It is necessary to pour the medicine mixed with saline solution in the appropriate proportion into the inhaler container.
The inhalation procedure is allowed only an hour after eating.
When inhaling the drug, breathing should be even and deep.
During the procedure you cannot talk, read books or watch TV.
To avoid coughing attacks during therapy, it is not allowed to take medications with mucolytic effects before inhalation.
It is not recommended to leave the house for an hour after the end of inhalation.

Attention! Before inhalation, it is recommended to bring the prepared solution to body temperature, warming it up slightly.

Compound

Ambroxol hydrochloride is the main active component of the drug. The active substance thins thick mucus and promotes its rapid evacuation. Along with this, Ambrohexal does not enhance the production of mucous secretion. The active substance quickly penetrates the circulatory system and reaches the bronchi and lungs.

To impart a certain smell, taste and consistency, the composition of the medicinal product also includes auxiliary components:

sorbitol;
water;
starch;
lemon acid;
povidone;
gelatin;
flavorings.

The drug is well absorbed by the body. After about half an hour, it begins to act and maintains its therapeutic effect for six to twelve hours.

Duration of treatment and its features

The duration of inhalation therapy with Ambrohexal can be determined exclusively by the attending physician. The course of treatment lasts no more than 5 days. If the patient’s condition worsens or after this time no improvement is visible, you should seek medical advice.

For children

One of the main advantages of Ambrohexal is the ability to treat cough in babies, starting from birth. According to the instructions for use, Ambrohexal for inhalation is used no more than 1-2 times a day. The duration of one session cannot exceed 3 minutes.

Adult patients

It is recommended for an adult to do inhalation therapy 1-2 times a day. The duration of one procedure is no more than 5 minutes.

Attention! How long the course of treatment should last should be determined only by the attending physician.

Ambrohexal for oral administration

The drug is taken after meals. It can be dissolved in any liquid, including milk. 1 ml of medication contains 7.5 mg of active substance. To accurately determine the dosage, you should know that 1 ml equals 20 drops. The duration of therapy is determined by the doctor. The average course of therapy is 5 days. The dosage is selected individually. Depends on the severity of the disease, diagnosis, and age of the patient.

Age	Amount of drug in ml	Reception mode
Adults, children over 12 years old	4	2-3 times
Children 5-12 years old	2	2-3
Children 2-5 years old	1	3
Children under 2 years old	1	2

Ambrohexal drops for inhalation and internal administration are not prescribed for individual intolerance. It manifests itself as an allergic rash on the skin, deterioration in health. The dosage should not be exceeded to avoid side effects.

Reviews and prices in pharmacies

Patients who have tried Ambrohexal for inhalation therapy respond positively to the drug. It is successfully used in the treatment of diseases of the respiratory system in children. Ambrohexal is an effective mucolytic agent that helps cure dry cough within a week. The drug practically does not cause adverse reactions, in addition to hypersensitivity in the patient to some of its components.

Ambrohexal attracts patients due to its cost. The price of one bottle with a capacity of 50 ml does not exceed 110 rubles.

Compatibility with other drugs

Patients taking other drugs in parallel should inform their doctor. There is no data on the drug incompatibility of Ambrohexal with specific substances. It is not advisable to take ambroxol preparations with antitussives. This provokes stagnation of sputum with the development of respiratory failure. The activity of some antimicrobial agents (amoxicillin, erythromycin, cefuroxime) in combination with ambrohexal is enhanced.

The use of ambrohexal is permitted along with the treatment of chronic pathologies. In people with bronchial asthma, ambroxol can be combined with glucocorticoids and bronchodilators. For pathologies of the heart and blood vessels, ambrohexal is used together with diuretics, cardiac glycosides, and antihypertensives.

Dosage forms

The solid form is round tablets with a notch on one of the surfaces and gelatin capsules with white or pinkish powder inside.

In the liquid state, it is produced in the form of a viscous, transparent, yellowish-tinged syrup for oral use or in the form of a transparent, colorless solution “Ambrohexal” for inhalation and oral administration (the latter is packaged in glass dropper bottles). The package comes with a measuring cup that allows you to correctly measure the required amount of the medicine.

Technique for administering Ambroxol for inhalation

Inhalations are carried out in any position. After refilling the nebulizer, turn it on and put on the mask. Breathing during the procedure should be calm and even, relaxed. Its duration is 7-10 minutes, until the liquid is consumed, the maximum number of sessions per day is two, best in the morning and evening. If your breaths make you feel dizzy, you need to stop, come to your senses, and then continue. After inhalation, the device is disassembled into its components and each part is thoroughly washed under hot water without the use of brushes or other similar devices. Periodically, at least once a week, it needs to be sterilized.

Ambroxol syrup and solution for inhalation, dosage

An ambroxol solution for inhalation is suitable for the procedure; under no circumstances should syrup be poured into the nebulizer. Under pressure, the device converts the liquid fraction into tiny aerosol particles. A single dosage for children over 5 years of age and adults is 3-5 ml, in drops it is 40-60, before this age - 2 ml. First, saline solution is poured into the container in the same ratio as the medicine, warmed to room temperature. After inhaling ambroxol, its maximum concentration in the body is observed after half an hour, after which the person begins to feel its effect. The duration of such therapy on average can be 4-5 days, depending on the clinical picture and test results.

Ambroxol for inhalation during pregnancy

During pregnancy, women are prohibited from inhaling ambroxol, especially in the first trimester, because its active ingredient ambroxol hydrochloride can provoke various disorders in the formation of organs such as kidneys and liver in the unborn child. In the second and third trimester, it is not so dangerous, but still undesirable, unless the risk to the life of the mother and baby will force you to ignore lesser threats. Inhalations are also not used when feeding a newborn for the same reason.

Price of medicine

The cost of one 100 ml bottle of syrup for children is 100–150 rubles.

The price of one package of tablets, the quantity of which is 20 pieces, ranges from 80 to 120 rubles.

And for a solution with a volume of 50 ml you will need to pay from 150 to 200 rubles per bottle.

Now it is clear why the medicine “Ambrohexal” is needed, instructions, reviews about it, as well as the procedure for using the drug - all this is described in the article. This medication is available in different forms: syrup, tablets, and a solution for inhalation. This drug has both positive and negative sides, but there is no need to give up on it or, conversely, take it in unlimited quantities. You must first go for an examination and consultation with a doctor so that he can make an accurate diagnosis, and then, according to his instructions, go to the pharmacy for the medicine “Ambrohexal”.

Important recommendations regarding inhalation

Before inhaling the Ambrohexal solution for children, the instructions for which are quite detailed and understandable, you need to make sure that the cause of the cough is not an allergy, but rather viruses or bacteria.

Inhalation of this drug during a cold is quite effective, since the vapors of the substance interact with the site of inflammation and the location of pathogens.

Such an event helps warm up the bronchi, and this creates a critical environment for bacteria and viruses, and in this case they are doomed to death on both sides. In the first case, heat treatment takes place, and in the second, the vapors of the substances affect the tissues and help the phlegm to move away, and also reduces the likelihood of further spread of harmful microorganisms.

At the time of inhalation, it is necessary to monitor the temperature of the solution - it should not burn the throat and bronchi, however, you should not use cold solution.

It is also important to organize this procedure at a time so that there is no need to go outside and breathe cold air. And the optimal solution temperature is 36.6 degrees

Useful video

Watch this video about the indications for use of the drug Ambrohexal:

Review Reviews

Most users give a positive assessment to the drug based on ambroxol. Reviews of Ambrohexal note the following advantages:

high efficiency;
fast action;
affordable price;
variety of dosage forms;
Possibility to purchase without a prescription.

As for opinions on the use of the drug Ambrohexal for the treatment of children, reviews here also note the possibility of carrying out therapy even in infants. However, there are some disadvantages:

no effect;
deterioration of the condition (may be due to non-compliance with the requirement for what cough to take Ambrohexal for);
the occurrence of an allergic reaction;
addiction to the drug;
restrictions on use for pregnant and lactating women, etc.

Pharmacodynamics and pharmacokinetics

The active ingredient, ambroxol, belongs to the group of benzylamines. Restores the normal balance between the serous and mucous components of the bronchial secretion, by increasing the secretion of the mucous membrane and directly affects the active cells in the bronchial glands. The substance stimulates the activity of special villi of the respiratory tract, thereby facilitating its movement through the bronchi.

In a period of time from half an hour to three hours, when taking tablets orally, the drug reaches its maximum concentration in the lungs. About 90% of the substance binds to blood proteins. Most of the drug is excreted by the kidneys 6-11 hours after administration as a glucuronide (or unchanged), the rest is metabolized in the liver tissue.

Similar means

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

Ambroxol is a remedy for diluting difficult sputum, has the same indications as Ambrohexal, in the form of syrup is also suitable for the treatment of children under 2 years of age (but only under medical supervision). Approximate price: 100 rubles (per 100 ml bottle).
Ambrobene is a safe and effective medication prescribed for both dry and wet coughs. Available in different forms, syrup is suitable for children, its approximate price (per 100 ml) is 130 rubles.
Lazolvan is a medicine that softens cough, as well as thins sputum and facilitates its elimination. In syrup form (100 ml) it costs about 200 rubles.

An analogue of Ambrohexal is Lazolvan.

There are drugs on pharmacy shelves that have an effect similar to Ambrohexal, but have a different composition:

Ascoril is a medicine based on salbutamol, bromhexine and guaifenesin. The product relaxes the muscles of the bronchi, improves their permeability, 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.
ACC is a drug with the active ingredient acetylcysteine. There are several forms of release - syrup, granules for making syrup and effervescent tablets. 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, makes it easier to expectorate and has an anti-inflammatory effect. The average price of syrup (100 ml) is 260 rubles.
Bromhexine is a drug based on bromhexine that effectively thins mucus and facilitates its removal, and also has a mild antitussive effect. The average cost of medicine in the form of syrup (100 ml) is 135 rubles.
Erespal is a medicine with the active ingredient fenispiride hydrochloride. It has anti-inflammatory, antispasmodic and antihistamine effects. 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 your child any of the Ambrohexal analogues. Each medicine has its own characteristics; only a doctor can select adequate therapy. Self-medication can have serious consequences.

Angelina

2014-11-03 01:36

Joset syrup helps a lot with dry coughs. Acts quickly and effectively. By evening, the dry cough disappeared. By the way, unlike many analogues, it can be used from 0 years. So now I recommend it to everyone I know.

Zoya

2014-11-28 21:35

If we talk separately about Ambrohexal syrup, then it is a really good expectorant. And if we talk about the treatment of coughs in general, you won’t be cured quickly with Ambrohexal alone. Here I also prefer Joset. The active ingredients in this syrup are selected so that they affect all components of the cough, literally on the first day. It's just more convenient.

Sasha

2014-12-19 14:34

I would never have believed that there was a 100% cough remedy until I tried Joset. In our family, coughing is normal, and the reasons are different for everyone. So Joset solved this problem. A complex drug that works on the first day and helps us all with both dry and wet coughs.

Galya

2015-01-28 00:30

Sasha, this combination of components just suited you very well. I personally don’t use Joset because I can’t stand menthol. But my husband is successfully treated with it, and with any cough it helps him well and quickly. All that remains is to be jealous :)

Lena

2015-02-21 23:40

Yes, indeed, combination drugs are not a panacea for coughs, because they are not suitable for everyone. The pediatrician prescribed Joset for the children. The eldest tolerated it well, the cough became mild in the evening. And the youngest’s head began to spin (although she may have been imagining things). In any case, I started giving my youngest a monocomponent syrup, bought Lazolvan, and now I think I could have gotten by with Ambrohexal.

Mary Read

2016-08-26 10:52

Hello. My son is 2 years old and when I gave him this syrup he immediately vomited. And he vomited for 5 hours. Then he started having diarrhea. Horror. But what happened to my 13-year-old daughter, I am generally silent. I gave it to her, so far everything is fine, by night she started burping and so on until the morning. Her stomach hurt. They took my children to the hospital for rinsing. NEVER HEAR NEVER BUY THIS DRUG (poison)

Ella

2016-11-27 19:23

Never buy this Ambrohexal! Children 3 and 4 years old are vomiting non-stop, it’s been a day since I stopped giving it and the vomiting doesn’t stop! They can’t even eat, but once you’ve eaten, you vomit right away, bitches, not pharmacists!

pharmachologic effect

Pharmacodynamics.

Ambroxol is a benzylamine metabolite of bromhexine. It differs from bromhexine in the absence of a methyl group and the presence of a hydroxyl group in the para-trans position of the cyclohexyl ring. It has secretomotor, secretolytic and expectorant effects.

After oral administration, the effect occurs within 30 minutes and lasts for 6-12 hours (depending on the dose taken). Preclinical studies have shown that ambroxol stimulates the serous cells of the glands of the bronchial mucosa. By activating ciliated epithelial cells and reducing the viscosity of sputum, ambroxol improves mucociliary transport. Ambroxol activates the formation of surfactant, having a direct effect on type 2 alveolar pneumocytes and Clara cells of the small airways.

Studies on cell cultures and in vivo studies on animals have shown that ambroxol stimulates the formation and secretion of a substance (surfactant) active on the surface of the alveoli and bronchi of the embryo and adult.

Also, preclinical studies have proven the antioxidant effect of ambroxol. Ambroxol, when used together with antibiotics (amoxicillin, cefuroxime, erythromycin, doxycycline), increases their concentration in sputum and bronchial secretions.

Pharmacokinetics.

When taken orally, ambroxol is almost completely absorbed from the gastrointestinal tract. The maximum concentration is reached 1-3 hours after oral administration. Due to first-pass metabolism, the absolute bioavailability of ambroxol after oral administration is reduced by approximately 1/3. The resulting metabolites (such as dibromoanthranilic acid, glucuronides) are eliminated in the kidneys. Plasma protein binding is about 85% (80-90%). The plasma half-life ranges from 7 to 12 hours. The total half-life of ambroxol and its metabolites is approximately 22 hours.

It is excreted primarily by the kidneys in the form of metabolites - 90%, less than 10% is excreted unchanged.

Given the high binding to plasma proteins, large volume of distribution and slow redistribution from tissues to blood, significant elimination of ambroxol does not occur during dialysis or forced diuresis.

In patients with severe liver disease, the clearance of ambroxol is reduced by 20-40%. In patients with severe renal impairment, the half-life of ambroxol metabolites increases.

Ambroxol penetrates into the cerebrospinal fluid and through the placental barrier, and is also excreted into breast milk.

Storage of medication

The tablet form can be stored for five years from the date of manufacture. This should be a place protected from sunlight, inaccessible to children, with a temperature not exceeding +25 degrees Celsius.

The syrup is stored under similar conditions with the only difference being that its shelf life is two years from the date of release.

The medicine in the form of a solution is also stored in a dark place, inaccessible to children, at a temperature not exceeding +25 degrees Celsius. It is suitable for use for four years.