Pharmacological properties
Pharmacodynamics. Carbocysteine affects the gel phase of respiratory tract mucus: by breaking disulfide bridges of glycoproteins, it causes liquefaction of excessively viscous bronchial secretion, which promotes sputum excretion.
The mucoregulatory effect of carbocysteine is associated with the activation of sialic transferase, an enzyme of the goblet cells of the bronchial mucosa. Carbocysteine normalizes the quantitative ratio of acidic and neutral sialomucins of the bronchial secretion, restores its viscosity and elasticity. Activates the activity of the ciliated epithelium and improves mucociliary clearance. Promotes the regeneration of the respiratory tract mucosa, normalizes its structure, reduces goblet cell hyperplasia and, as a result, reduces mucus production. Restores the secretion of immunologically active IgA (specific protection) and the number of sulfhydryl groups of mucus components (nonspecific protection). Has an anti-inflammatory effect due to the kinin-inhibiting activity of sialomucins, which leads to a decrease in edema and bronchial obstruction.
Pharmacokinetics. When taken orally, carbocysteine is rapidly absorbed. C max of the active substance in the blood plasma is reached after 2 hours. Bioavailability is low - 10% of the administered dose (due to intensive metabolism in the gastrointestinal tract and the effect of first passage through the liver). Carbocysteine and its metabolites are excreted mainly by the kidneys. T ½ is ≈2 hours.
Indication
Treatment of symptoms of disorders of bronchial secretion and sputum discharge, especially in acute bronchopulmonary diseases, such as acute bronchitis; in exacerbations of chronic diseases of the respiratory system.
Application
It is used internally. Mucolic is recommended for use in the treatment of children under the age of 15.
For accurate dosing of syrup, a graduated measuring spoon is included.
1 measuring spoon, filled to the 5 ml mark, contains 100 mg of carbocysteine.
Children aged 2-5 years: 200 mg (10 ml) of carbocisteine per day in 2 doses, i.e. 1 measuring spoon filled to the second division, corresponding to 5 ml, 2 times a day.
Children aged 5-15 years: 300 mg (15 ml) of carbocysteine per day in 3 doses, i.e. 1 measuring spoon filled to the second division, corresponding to 5 ml, 3 times a day.
The maximum single dose for children is 100 mg (5 ml) of carbocysteine.
The duration of treatment should not exceed 8-10 days.
The duration of use of carbocysteine in children should be as short as possible, no more than 5 days.
Contraindication
Allergic reaction to any of the components of the drug in history (especially to methyl parahydroxybenzoate or other salts of parahydroxybenzoate);
gastric and duodenal ulcer during the exacerbation period;
I trimester of pregnancy, due to insufficient data on teratogenic and embryotoxic effects.
Side effects
Very rarely, digestive disorders, nausea, vomiting, stomach pain are possible. Due to the presence of Parahydroxybenzoate in the composition, allergic reactions may occur in isolated cases, including angioedema, itching and skin rash (possibly delayed). In case of side effects, it is recommended to reduce the dose or discontinue the drug.
Special instructions
Productive cough is a fundamental mechanism of protection of the bronchopulmonary system and as such should not be suppressed. The combination of drugs that modify bronchial secretion with cough suppressants and/or substances that reduce secretion (atropine group) is irrational.
The use of mucolytic agents can lead to impaired bronchial patency in infants. In children of the first year of life, the ability to clear the respiratory tract of secretions is limited due to age-related anatomical and physiological characteristics. Any mucolytic agents should not be used in infants.
Treatment should be reviewed if there is no effect or if symptoms of the disease worsen.
The drug contains sucrose, so patients with hereditary glucose intolerance, glucose-galactose malabsorption or sucrose-isomaltase insufficiency should avoid taking the drug.
Careful medical supervision is necessary in the case of purulent sputum discharge and high body temperature.
The drug should be used with caution in the treatment of patients with a history of gastric or duodenal ulcer.
It should be noted that 5 ml of 2% syrup contains 3.5 g of sucrose.
The medicine contains methyl parahydroxybenzoate, as well as the dye sunset yellow FCF (E110), which may cause an allergic reaction (delayed in time).
Use during pregnancy and breastfeeding. During pregnancy (II and III trimesters) and breastfeeding, the drug is used after a careful assessment of the benefit to the woman / risk to the fetus (child), which is determined by the doctor. There is no data on the penetration of carbocysteine in breast milk.
Children. The drug can be prescribed to children from the age of 2. Treatment of children should be carried out under the supervision of a doctor.
The ability to influence the reaction speed when driving vehicles or working with other mechanisms. Does not affect.
Interactions
During the treatment period, other antitussives and agents that increase bronchial secretion should not be used. Increases the effectiveness of glucocorticoid (mutually) and antibacterial therapy.
Overdose
Treatment is symptomatic.
Storage conditions
In the original packaging at a temperature not exceeding 25 °C.
