27.11.2020

Mucolytic drug “Lasolvan” and its analogues

In 1979, the firm Boehringer Ingelheim has produced an expectorant drug that represents the first original Ambroxol. In Russia, the drug was entered in the register under the trade name Mucosolvan.

Mucosolvan is a mucolytic agent. Action of mucolytics based on the fact that they alter the chemical and physical properties of sputum. It leads to its liquefaction.
Mucosolvan productive combines properties of phlegm, to facilitate its excretion from the lungs and additional anti-inflammatory and antioxidant effects.

Pharmacological action

The studies have shown that Ambroxol is an active ingredient of Mucosolvan – increases secretion in the respiratory tract. It enhances pulmonary surfactant production and stimulates ciliary activity. These effects lead to increased flow and transport of mucus (mucociliary clearance). Enhancing mucociliary clearance improves expectoration and eases cough.

In patients with chronic obstructive pulmonary disease long-term treatment with Mucosolvan for at least two months led to a significant decrease in the number of exacerbations. There was a significant reduction in the duration of exacerbations and the number of days of antibiotic therapy.

Dosage forms

Dosage forms Mucosolvan:

  • tablets;
  • syrup;
  • pastilles;
  • long-acting capsules Mucosolvan Max;
  • solution for inhalation and ingestion.

Diverse dosage forms can be conveniently dosed based on the patient’s age. The drug is widely used in pediatric practice.

Composition

The main active ingredient of Mucosolvan – Ambroxol. The excipients depends on the form of the medicine.

Pills

Ambroxol hydrochloride 30 mg; lactose monohydrate, corn starch dried, silicon dioxide colloidal, magnesium stearate.

Syrup

Ambroxol hydrochloride 15 mg (in 5 ml); benzoic acid, giallos (hydroxyethyl cellulose), Acesulfame potassium, sorbitol liquid (rekristallizatsiya), glycerol, flavor wild berry PHL-132195, 201629 vanilla flavoring, purified water.
Has a smell of wild berries.

Pastilles

Ambroxol hydrochloride 15 mg; acacia gum, sorbitol, Karion 83 [sorbitol, mannitol, hydrogenated hydrolysed starch], peppermint leaf oil, eucalyptus promovideo leaf oil, sodium saccharin, liquid paraffin (purified mixture of liquid saturated hydrocarbons), purified water.
Has a smell of peppermint.

Solution for inhalation and ingestion

Ambroxol hydrochloride 7.5 mg; citric acid monohydrate, sodium hydrogen phosphate dihydrate, sodium chloride, benzalkonium chloride, purified water.

Capsules of the prolonged action

Ambroxol hydrochloride 75 mg; crospovidone, Carnauba wax, stearyl alcohol, magnesium stearate.
The composition of the capsule shell: gelatin, purified water, titanium dioxide (E171), dye iron oxide red (E172), dye iron oxide yellow (E172). Ink composition: shellac, titanium dioxide.

Testimony

The use of Mucosolvan is recommended in acute and chronic diseases of the respiratory tract with the production of viscous sputum:

  • acute bronchitis, chronic bronchitis;
  • pneumonia;
  • chronic obstructive pulmonary disease;
  • bronchial asthma with obstruction of sputum discharge;
  • bronchiectasis.

Mucosolvan refers to the enzymatic mukolitiki, which is used when sputum is present in sufficient quantity.

Contraindications

Hypersensitivity to Ambroxol or other components of the drug, pregnancy up to 14 weeks, the period of breastfeeding.
To apply caution in patients with renal and/or hepatic insufficiency.
When passing pre-clinical trials of Ambroxol is not detected negative effect on the ability to conceive a fetus.

Use in pregnancy and lactation

Ambroxol crosses the placenta. Make the rest in the first trimester of pregnancy is not recommended. After the 14th week of pregnancy and before delivery the use of drugs may prescribed with caution.
Mucosolvan may be excreted in breast milk. During lactation use of the drug is not recommended.

Method of application and dosing

Reception of Mucosolvan do not depend on food intake.
Pills inside, squeezed water, and 1 thing three times a day. You can enhance the therapeutic effect of taking 2 tablets twice a day if needed.
The syrup is administered orally:

  • children under 2 years 2.5 ml twice a day;
  • from 2 to 6 years: 2.5 ml three times a day;
  • from 6 to 12 years: 5 ml two to three times a day;
  • adults and children from 12 years: 10 ml three times a day.

Resolves lozenge slowly in the mouth in 2 pieces three times a day children from 12 years and adults. If necessary, enhance the therapeutic effect apply 2 lozenges 4 times per day. At the age of 6 to 12 years: 1 lozenge 2 to 3 times a day.

Long-acting capsules take 1 capsule once a day. The capsules do not open and do not chew. Swallow them whole, drinking plenty of fluid. We should not attach importance to “balance” capsules, which are sometimes present in the stool.
The oral solution can be diluted with any liquid. We recommend the following technique:

  • children under 2 years: 1 ml (about 25 drops) 2 times a day;
  • patients with 2 to 6 years: 1 ml 3 times a day;
  • patients with 6 to 12 years 2 ml 2 – 3 times a day;
  • from 12 years and adults: 4 ml 3 times a day.

Inhalation children 6 years and adults – 1 – 2 treatments at 2 – 3 ml per day; for patients 6 years 1 – 2 treatments at 2 ml per day.
To ensure the necessary moisture when inhaled the medication is diluted with a solution of sodium chloride 0.9% in a ratio of 1:1. Inhalations are performed in normal breathing.

To avoid spasm of the Airways of patients with asthma, the procedure must take place after receiving bronchodilators.
If within 4 to 5 days from initiation of Mucosolvan there is no improvement you must consult a doctor.

Side effects

From the digestive tract:

  • nausea, decreased sensitivity in the mouth – often;
  • indigestion, vomiting, diarrhea, dry mouth, abdominal pain rarely;
  • dryness in the throat is rare.

Allergic reactions: itching, skin rash, hypersensitivity, urticaria, anaphylaxis, including anaphylactic shock, angioneurotic edema is rare.
Disorders of the nervous system: impairment of taste perception (dysgeusia).

Overdose

Specific symptoms of overdose are not described. There have been cases of overdose, medical mistakes with signs listed in the summary of symptoms side effects of the drug Mucosolvan: nausea, indigestion, vomiting, diarrhea, abdominal pain.
Therapy: the provocation of the gag reflex, gastric lavage in the first two hours after taking Mucosolvan, treatment of manifested symptoms.

Control therapy cautions

It should not be combined with medications for cough, difficult expectoration of sputum.
There are few reports about the acute toxic-allergic lesions of the skin (Stevens – Johnson syndrome), toxic epidermal necrolysis. The start of these difficult lesions coincided with Ambroxol. This is due to severe underlying pathology, concomitant treatment.

Patients observed the following symptoms development of the disease in the early phase: fever, sore throat, body pain, rhinitis, cough. There is a probability of incorrect assignment of cold medicine in the treatment of symptoms. If you find new damage to the skin and mucous membranes, it is necessary to interrupt the treatment amboroxol and urgently seek medical help.
In renal failure the rest is assigned by a doctor.

Interaction with other drugs

There is no information on clinically significant adverse manifestations at simultaneous reception with other drugs.
Mucosolvan increases the penetration in bronchial secretion of amoxicillin, cefuroxime, erythromycin.
Mucosolvan is sold without a prescription. Original drug is manufactured in Germany. Manufacturer – Boehringer Ingelheim International GmbH.

Analogues Of Mucosolvan

The active ingredient of Mucosolvan is Ambroxol hydrochloride. Analogues of Mucosolvan much. It’s all preparations containing Ambroxol – medication with brand names:

  • Ambrobene, Germany;
  • Ambrosan, Czech Republic;
  • Medavant, Cyprus.
  • Ambrogeksal, Germany;
  • Delegen, Poland;
  • Helical, Hungary.

Bromhexine hydrochloride is also the equivalent of Mucosolvan. Substance ingestion is converted to its active metabolite Ambroxol. Drugs Bromhexine, which are the analogues of the Rest manufactured under the following trade names:

  • Flemoxin, Cyprus.
  • Pageskin Rivo, Switzerland;
  • Bronchosan, Slovakia;
  • Colvin, India;
  • Flexamin, Poland;
  • Bromhexine-4, Bromhexine-8, Germany;
  • Sedex, India;
  • Bromhexine produced in Germany, Latvia, USA, Denmark, Russia, India and other countries.

Ambroxol and Bromhexine are introduced inhalation, orally, subcutaneously, intramuscularly, intravenously. They are readily soluble in lipids, rapidly and almost completely absorbed from the gut. But the partial loss of the active drug occurs before it enters the systemic circulation. This is especially true for Bromhexine. Therefore, the amount of drug reaching its place of action in the body, Ambroxol is 70 – 80%, and Bromhexine – only 20%.
Mucolytics are most effective antitussive drugs. Mucosolvan and its analogues are well liquefy the bronchial secretion by changing the structure of mucus, but not substantially increase it.

In addition Bromhexine and Ambroxol by enzymatic mukolitiki also include acetylcysteine, carbocisteine. Conventionally, they can also be attributed to analogues of Mucosolvan.

Acetylcysteine

NAC breaks disulfide bonds of acid mucopolysaccharides mucus, thins mucus. The drug greatly increases the amount of sputum, so in some cases it is necessary to use suction in order to prevent “flooding” of the lungs. Acetylcysteine has anti-inflammatory, detoxifying, antioxidant action, promotes the production of glutathione.
Indications: heavy sputum production when tracheitis, bronchitis, bronchiolitis, bronchiectasis, pneumonia; cystic fibrosis, emphysema, lung abscess, laryngotracheitis, bronchial asthma, interstitial lung disease, purulent and catarrhal otitis media, sinusitis (including sinus infection), lung atelectasis (due to mucous plugging, bronchial tube), removal of airway viscous secretion after surgery and for conditions after injury; as an antidote for poisoning by paracetamol.
Contraindications: hypersensitivity, aggravation of gastric ulcer and duodenal ulcer.
Used mostly in the form of inhalation through the trachea by slow intravenous injection of solution. Acetylcysteine can be administered orally as it is rapidly and well absorbed not only from the respiratory tract, but also from the gastrointestinal tract.
The acetylcysteine drugs have trade names Acetylcysteine, NAC, Mokobane, Mukomist, Fluimucil, Alsomuch.

Carbocisteine

Carbocisteine reduces the viscosity and increases the elasticity of the secret. The drug promotes regeneration mucous membranes normalizes its structure, stimulates the activity of ciliated epithelium, restores the secretion of immunologically active immunoglobulin IgA (specific protection), improves elimination sinobronchial secret.
Indications: acute and chronic diseases of bronchi, lungs, ENT organs, accompanied by the formation of a viscous, difficult to spit sputum (tracheitis, bronchitis, tracheobronchitis, bronchial asthma, bronchiectasis) and mucus (inflammation of the middle ear cavity, nose and paranasal sinus – rhinitis, sinusitis, otitis media); preparing the patient for bronchoscopy or bronhografii.
Contraindications: gastric ulcer and duodenal ulcer in the acute stage, chronic glomerulonephritis in the acute phase, cystitis; hypersensitivity; pregnancy, children up to age 15 years.
Preparations carbocisteine have the following trade names: Libeksin, syrup Inspiron, Fluifort.
When taking mucolytics desirable to consume more than the usual amount of fluid to facilitate sputum discharge – fruit drinks, fruit drinks, weak tea.

For rational therapy of cough it is necessary to establish its cause and determine how to address them. The main directions of treatment of cough in children include improvement of the drainage function of bronchi, the restoration of adequate mucociliary clearance, anti-inflammatory and, if necessary, broncholytic therapy. To determine the treatment for a productive cough needs a doctor.

Table 1 lists the prices of Mucosolvan in various dosage forms, the prices of analogues of the drug.
Table 1

International nonproprietary name The trade name of the drug Price Release form Manufacturer
Ambroxol Mucosolvan 170 RUB. Tablets 30 mg, 20 pieces Germany
279 RUB. Tablets 30 mg, 50 pieces
385 RUB. Solution for inhalation 0,0075/ml, 100 ml
269 RUB. Syrup 0,03/5ml, 100 ml
210 RUB. Syrup 0,015/5ml, 100 ml
158 RUB. Lozenges 15 mg, 20 pieces
Mucosolvan Max 210 RUB. Capsules 75 mg, 10 pieces
Ambroxol Ambrobene 146 RUB. Tablets 30 mg, 20 pieces Germany
Travis 110 RUB. Pills 30 ml, 20 pieces Germany
Helical 98 RUB. Tablets 30 mg, 20 pieces Hungary
Bromhexine Bromhexine 23 RUB. Tablets 8mg, 50 pieces Belarus
Bromhexine 17 RUB. Tablets 8 mg, 50 pieces Russia
Bronchosan 206 RUB. Drops, bottle 25 ml Slovakia

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