Ambroxol is a drug that is recognized for having the ability to break down phlegm, used in the treatment of respiratory diseases associated with viscous or excessive mucus. Recently, a hypothesis suggested that it could have a potential role in the treatment of Paget’s disease of bone, parkinsonism, and other common diseases of aging that involve autophagy dysfunction. It is the active ingredient in Mucosolvan, Mucobrox, Mucol, Lasolvan, Mucoangin, Surbronc, Ambolar, and Lysopain. Here are all the details.

What is Ambroxol?

Ambroxol is a clinically proven systemically active mucolytic agent. When administered, the onset of oral action occurs after approximately 30 minutes. The breakdown of acidic mucopolysaccharide fibers makes sputum thinner and less viscous, and therefore it is more easily removed by coughing. Although the sputum volume eventually decreases.

Ambroxol is a secretolytic agent (expectorant) that was developed by Boehringer-Ingelheim in the late 1960s and 1970s and marketed in 1978. It is used to treat bronchopulmonary diseases by removing mucus from the lungs. It is marketed under various trade names, often as an active ingredient in cough syrups.

Earlier this year, Daniel H. Geschwind and his colleagues at UCLA discovered exciting new potential for ambroxol. They were looking for a way to allow the body to regenerate the nerve cells of the central nervous system in a way similar to the way that cells of the peripheral nervous system (PNS) grow spontaneously.

The researchers identified a genetic network used by the PNS to initiate self-repair. They then combined the expression patterns of the genes in the network with a database of bioactive molecules that trigger the same patterns.

Ambroxol came out! When the drug was fed to mice with optic nerve injuries, some neuronal growth occurred. The authors believe that this finding “provides a functional genomic basis for understanding neuronal repair and proof of the power of such approaches to address complex problems in nervous system biology.”

Ambroxol – mechanisms of action

Ambroxol is a mucolytic agent. Excess nitric oxide (NO) is associated with inflammation and some other disturbances in airway function. NO increases the activation of soluble guanylate cyclase and the accumulation of cGMP. Ambroxol has been shown to inhibit the NO-dependent activation of soluble guanylate cyclase. It is also possible that inhibition of the NO-dependent activation of soluble guanylate cyclase may suppress excessive mucus secretion, thereby decreasing the viscosity of phlegm and improving mucociliary transport of bronchial secretions.

Ambroxol indications

All forms of tracheobronchitis, emphysema with pneumoconiosis bronchitis, chronic inflammatory lung conditions, bronchiectasis, bronchitis with bronchospasm asthma. During acute exacerbations of bronchitis, it should be administered with the appropriate antibiotic.

Ambroxol contraindications

There are no absolute contraindications, but relative caution should be observed in patients with gastric ulceration.

Ambroxol Side Effects

Gastrointestinal side effects can occasionally occur, but these are generally mild.

Precautions

It is advisable to avoid use during the first trimester of pregnancy.

Ambroxol dosage

  • Adults: daily dose of 30 mg (one Ambroxol tablet) to 120 mg (4 Ambroxol tablets) taken in 2 to 3 divided doses
  • Children up to 2 years: half a tablespoon of Ambroxol syrup twice a day
  • Children 2 to 5 years: half a tablespoon 3 times a day
  • Children over 5 years: one teaspoon of Ambroxol syrup 2-3 times a day.

Storage

Store at a temperature that does not exceed 30 degrees Celsius. Keep all medicines out of the reach of children.

How to supply it

Box of 10, 1000 tablets.
Syrup – bottles of 60 ml, 120 ml.

Ambroxol – trade name

It is commercially available under the names Dinobroxol®, Motosol®, Mucibron®, Mucosan®, Naxpa®. The substance acts on the mucous membranes, restoring the physiological mechanisms of elimination of the respiratory tract, which include the elimination of phlegm, stimulation of mucus production and stimulation of the synthesis and release of surfactant, type II pneumocytes.

The surfactant reduces the adherence of mucus to the bronchial wall, by improving its transport and by providing protection against infections and irritants. Ambroxol is often given as an active ingredient in cough syrup.

Ambroxol – what is it for

Ambroxol is indicated as “secretolytic therapy in bronchopulmonary diseases associated with abnormal mucus secretion and impaired mucus transport. It promotes mucus clearance, facilitates expectoration and relieves productive cough, allowing patients to breathe freely and deeply. “

Its first marketing authorization was in 1978. Ambroxol is available in the form of syrup, tablets, lozenges, sachets of dry powder, solution for inhalation, drops and ampoules, as well as effervescent tablets.

Ambroxol also provides pain relief in acute sore throat. Pain in a sore throat is the hallmark of acute pharyngitis. A sore throat is usually caused by a viral infection. The infection is self-limited and the patient recovers normally after a few days. What bothers the patient the most is the continuous pain in the throat maximized when the patient is swallowing. The main goal of treatment is therefore to reduce pain. The main property of Ambroxol to treat a sore throat is the local anesthetic effect.

Ambroxol inhibits neuronal Na + channels. This property led to the development of a lozenge containing 20 mg of ambroxol. Many state-of-the-art clinical studies have demonstrated the efficacy of Ambroxol in relieving pain in acute sore throat, with a rapid onset of action, with an effect lasting at least three hours. Ambroxol is also anti-inflammatory, reducing redness in a sore throat.

Ambroxol has recently been shown to increase the activity of the lysosomal enzyme glucocerebrosidase. Because of this, it can be a useful therapeutic agent for both Gaucher disease and Parkinson’s disease.

Ambroxol was also recently shown to trigger lysosome exocytosis by releasing calcium from acidic cellular calcium stores. This occurs by diffusion of Ambroxol in lysosomes and neutralization of lysosomal pH. This mechanism is most likely responsible for the mucolytic effects of the drug, but may also explain the activity reported in Gauchers and Parkinson’s disease.

Expectorants and mucolytic agents

Pharmacology and toxicology

Expectorants and mucolytic agents enhance or facilitate the clearance of mucus in the respiratory tract. Ambroxol is a metabolite of bromhexine and has been used in the prevention of neonatal breathing difficulties.

Carbocysteine ​​is a mucus regulator rather than a mucolytic agent. Guaifenesin and guaiac stimulate the clearance of viscous mucus through stimulation of the gastropulmonary vagal reflex, but have no effect on mucus thickness.

Recommendation on the use of Androxol

N-acetylcysteine, ambroxol, and bromhexine are the first choice for mucolytics during pregnancy, if fluid therapy (oral) and other non-medical treatments are not effective. Mucolytics containing iodine are contraindicated, especially after the first trimester. Short-term inadvertent use of other expectorants and mucolytics does not require any intervention.

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Dr. Samantha Robson ( CRN: 0510146-5) is a nutritionist and website content reviewer related to her area of ​​expertise. With a postgraduate degree in Nutrition from The University of Arizona, she is a specialist in Sports Nutrition from Oxford University and is also a member of the International Society of Sports Nutrition.

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