Components:
Treatment option:
Medically reviewed by Kovalenko Svetlana Olegovna, PharmD. Last updated on 31.03.2022
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A-Phyl
Ambroxol
Acute and chronic bronchitis, bronchial asthma (with difficult sputum discharge), bronchiectatic disease.
Acute and chronic respiratory diseases with the release of viscous sputum:
acute and chronic bronchitis
pneumonia
chronic obstructive pulmonary disease
bronchial asthma with difficulty in expectorating sputum
bronchiectatic disease.
Respiratory tract diseases accompanied by the release of viscous sputum: acute and chronic bronchitis, pneumonia, chronic obstructive pulmonary diseases (including bronchial asthma with difficulty in expelling sputum), bronchiectatic disease.
Bronchitis (acute, chronic, asthmatic)
Inside, after eating. Adults and children over 12 years of age - in the first 2-3 days-1 tablet (30 mg) 3 times / day
Solution: дозируют с помощью прилагаемого мерного стаканчика. Взрослым в первые 2–3 дня — по 4 мл 3 раза; затем — по 4 мл 2 раза или по 2 мл 3 раза/сутки. Детям до 2 лет — по 1 мл 2 раза, от 2 до 5 лет — по 1 мл 3 раза, от 5 до 12 лет — по 2 мл 2–3 раза.
Conducting inhalations (using an inhaler). Взрослым и детям старше 5 лет — по 1–2 ингаляции по 2–3 мл в день; детям до 5 лет — по 1–2 ингаляции по 2 мл в день.
Syrup: взрослым — по 10 мл 3 раза/сутки 2–3 дня, затем — по 10 мл 2 раза или по 5 мл 3 раза/сутки; детям до 2 лет — по 2,5 мл 2 раза в день, от 2 до 5 лет — по 2,5 мл 3 раза в день, от 5 до 12 лет — по 5 мл 2–3 раза в день.
Inside, regardless of the meal. Oral administration (1 ml = 25 drops).
Adults and children over 12 years: 4 ml (=100 drops) 3 times a day: children from 6 to 12 years: 2 ml (=50 drops) 2-3 times a day
Inhaled.
Adults and children over 6 years of age: 1-2 inhalations of 2-3 ml of solution per day®, an inhalation solution, can be used using any modern inhalation equipment (except steam inhalers). To achieve maximum hydration during inhalation, the drug is mixed with 0.9% sodium chloride solution in a ratio of 1:1. Since inhaling deep breaths can cause coughing during inhalation therapy, inhalation should be performed in normal breathing mode. Before inhalation, it is usually recommended to warm up the inhalation solution to body temperature. Patients with bronchial asthma are recommended to inhale after taking bronchodilators, in order to avoid non-specific irritation of the respiratory tract and their spasm
If the symptoms of the disease persist for 4-5 days from the start of taking the drug, it is recommended to consult a doctor.
Inside, after eating, after dissolving the tablet in a glass of water.
Effervescent pills: взрослым — по 30 мг 3 раза в сутки, при необходимости дозу увеличивают до 60 мг 2 раза в сутки.
Syrup: взрослым и детям старше 12 лет в первые 2–3 дня — по 10 мл (2 мерные ложки) 3 раза в сутки, затем — по 10 мл 2 раза в сутки, детям от 6 до 12 лет — по 5 мл (1 мерная ложка) 2–3 раза в сутки, детям от 2 до 6 лет — по 2,5 мл 3 раза в сутки, детям от 1 до 2 лет — по 2,5 мл 2 раза в сутки.
Taking the drug for more than 4-5 days — only under the supervision of a doctor.
Inside. Tablets (after meals) for adults-1 tab. 3 times a day, with long-term therapy-1 tab. 2 times a day.
Drops (во время еды) разбавляют чаем, фруктовым соком, молоком, водой. Взрослым — вначале по 4 мл 3 раза в сутки, при длительной терапии — по 2 мл 3 раза в сутки, детям до 2 лет — по 1 мл 2 раза в сутки, 2–5 лет — по 1 мл 3 раза в сутки, старше 5 лет — по 2 мл 2–3 раза в сутки.
Hypersensitivity, peptic ulcer of the stomach and duodenum, convulsions of any etiology.
Nausea, vomiting, epigastric pain (with prolonged use), allergic reactions: skin rash, urticaria, angioedema.
Specific symptoms of overdose in humans are not described. There have been reports of accidental overdose and / or medical error, resulting in symptoms of known side effects of the drug A-Phyl®: nausea, dyspepsia, vomiting, diarrhea, abdominal pain.
Treatment: индукция рвоты, промывание желудка в первые 1–2 ч после приема препарата; симптоматическая терапия.
Studies have shown that ambroxol is the active ingredient of A-Phyl® - increases the secretion in the respiratory tract. It enhances the production of pulmonary surfactant and stimulates ciliary activity. These effects lead to increased mucus flow and transport (mucociliary clearance). Increased mucociliary clearance improves sputum discharge and relieves cough. In patients with COPD, long-term therapy with A-Phyl® (for at least 2 months) resulted in a significant reduction in the number of exacerbations. There was a significant decrease in the duration of exacerbations and the number of days of antibiotic therapy.
The effect occurs 30 minutes after administration and lasts 6-12 hours.
Increasing the content of mucosal secretions, changes the disturbed ratio of serous and mucosal components of sputum, increases the release of lysosomes (from Clark cells), leading to a decrease in the viscosity of sputum
All immediate-release ambroxol dosage forms are characterized by rapid and almost complete absorption with a linear dose dependence in the therapeutic concentration range. Cmax when taken orally is reached after 1-2. 5 hours.
Vd-552 l. In the therapeutic range of concentrations, binding to plasma proteins is approximately 90%.
The transition of ambroxol from the blood to the tissues with oral administration is rapid. The highest concentrations of the active component of the drug are observed in the lungs.
Approximately 30% of the oral dose is exposed to the effect of primary passage through the liver. Studies on human liver microsomes have shown that the CYP3A4 isoenzyme is the predominant isoform responsible for the metabolism of ambroxol to dibromantranilic acid. The remaining part of ambroxol is metabolized in the liver, mainly by glucuronidation and partial cleavage to dibromantranilic acid (approximately 10% of the administered dose), as well as a small amount of additional metabolites.
Terminal T1/2 of ambroxol is 10 h. The total clearance is in the range of 660 ml / min, the renal clearance accounts for approximately 8% of the total clearance. Using a radioactive label, it was estimated that after taking a single dose of the drug for the next 5 days, about 83% of the dose is excreted in the urine. There was no clinically significant effect of age and gender on the pharmacokinetics of ambroxol, so there is no reason to select a dosage based on these signs.
- Secretolytics and stimulants of motor function of the respiratory tract
Increases the penetration of amoxicillin, cefuroxime, erythromycin and doxycycline into the bronchial secretions. Simultaneous use with antitussive agents leads to difficulty in the discharge of sputum. It is compatible with drugs that inhibit labor activity.
