Solmux/Solmux Broncho

Solmux/Solmux Broncho

carbocisteine

Manufacturer:

United Pharma

Distributor:

JDS
Full Prescribing Info
Contents
Solmux: Carbocisteine.
Solmux Broncho: Salbutamol, carbocisteine.
Description
Solmux Broncho: Each capsule or 5 mL (1 teaspoonful) of adult suspension contains salbutamol 2 mg and carbocisteine 500 mg.
Each 5 mL (1 teaspoonful) of paediatric suspension contains salbutamol 1 mg and carbocisteine 125 mg.
Action
Mucolytic.
Carbocisteine normalizes the viscosity (thickness) of secretions in the airways and facilitates the expectoration of phlegm as well as ease up breathing and thus relieve tight cough.
Pharmacology: Solmux: Carbocisteine is a derivative of an amino acid, acetylcysteine, in which the sulfhydryl group is blocked by carboxylic acid residue. It is known to disrupt the disulfide bonds which cross-link the peptide chains of mucin (this network confers of bronchial secretion their viscosity). Carbocisteine is also claimed to modify the metabolism of mucus-secreting (goblet) cells by the activation of sialyltransferase and inhibition of neuraminidase to produce more of the less viscous glycopeptides while decreasing the output of more viscous components (neutral glycopeptide and weakly acidic mucin).
Solmux Broncho: Salbutamol: Salbutamol has been widely used and is currently well established in the management of reversible obstructive airway disease, which encompasses a wide spectrum of diseases whose clinical features overlap as in "chronic bronchitis with asthmatic features". In studies of asthmatic patients given oral doses of salbutamol, rapid and significant improvement in FEV was observed compared with placebo.
In equivalent doses producing bronchodilation, salbutamol causes less side effects and more prolonged bronchial relaxation than do other drugs. Compared with terbutaline, salbutamol produces a greater degree of bronchodilation during the 1st hr. Salbutamol is a saligenin (not a catecholamine) derivative and is therefore not deactivated by catechol-O-methyltransferase in tissues nor by sulfatization in the bowel. This accounts for its oral efficacy and long duration of action.
Carbocisteine: A study which examined sputum viscosity and elasticity showed that in most patients, reduction in both was observed (2 cases had decreased viscosity with increased elasticity and 1 had an increase in both). In an earlier study, carbocisteine was also demonstrated to increase FEV, suggesting a possible complementary role to salbutamol.
Versus placebo in chronic bronchitis plus emphysema: Carbocisteine improved mucus quality by increasing sialinic acid (p<0.01) while decreasing the viscosity factor fucose (p<0.01).
Versus placebo and bromhexine in severe COPD: Carbocisteine increased volume of sputum up to 4 days with decreased viscosity versus bromhexine or placebo. Carbocisteine and bromhexine produced neuraminic acid versus placebo.
Pharmacokinetics: Solmux: Carbocisteine is rapidly and well absorbed after oral administration. Following intake of carbocisteine 1.5 g, peak serum concentrations of 13-16 mg/L were reached in 1-2 hrs. Plasma half-life was 1.5-2 hrs. Carbocisteine penetrates well into lung tissues and respiratory mucus, suggesting local action. It undergoes acetylation, decarboxylation and sulfoxidation. Majority of the drug is excreted unchanged in the urine.
Indications/Uses
Solmux: For the relief of all types of cough including those associated with excessive and tenacious bronchial secretions as in acute and chronic bronchitis, asthma, bronchiectasis and emphysema. Also indicated for cough-induced sinusitis and otitis media.
Solmux Broncho: For the relief of tight cough with thick phlegm accompanying airway disorders eg, acute and chronic bronchitis, bronchial asthma and bronchiectasis.
Dosage/Direction for Use
Solmux: Capsule: Adults and Children >12 years: 1 cap 3 times daily.
Forte Adult Suspension: Adults and Children >12 years: 5 mL (1 tsp) every 6 hrs.
Paediatric Suspension: Adults: 12.5 mL (2 ½ tsp). Children 8-12 years: 7.5 mL (1½ tsp); 4-7 years: 5 mL (1 tsp); 1-3 years: 2.5 mL (½ tsp); <1 year: 0.5 mL (20 mg)/kg body weight/day in divided doses.
Solmux Broncho: Adults: 1-2 caps or 1-2 teaspoonful 3 or 4 times daily. Children 7-12 years: ½-1 teaspoonful 3 or 4 times daily; 2-6 years: As prescribed by the physician.
Overdosage
Solmux Broncho: Reported overdose with oral salbutamol in 40 patients who received between 5-240 mg produced no fatalities.
Special Precautions
Patients with a recent history of gastrointestinal bleeding since Solmux could worsen the symptoms.
Consult a doctor if the cough persists for >3 weeks or if it gets worse; if the cough is accompanied by recurring fever; an upset stomach or heartburn is experienced after taking Solmux and if new or unusual symptoms occur.
Use in pregnancy: Solmux should be used in the 1st trimester of pregnancy only if absolutely essential.
Use In Pregnancy & Lactation
Use in pregnancy: Solmux should be used in the 1st trimester of pregnancy only if absolutely essential.
Adverse Reactions
Solmux/Solmux Broncho is generally well tolerated. Reactions to carbocisteine are rare and include skin rashes, nausea, headaches, myalgia, dizziness and urinary incontinence. Gastrointestinal disturbance often occurs with acute overdosage.
Solmux Broncho: Adverse effects of salbutamol are dose-related and predictable. They include tremor, unsteadiness of hands, anxiety, muscle cramps, headache and palpitation. These actually disappear with regular use.
Drug Interactions
Concomitant administration with carbocisteine enhances the absorption of sodium amoxicillin. Pre-treatment with cimetidine severely impairs the urinary elimination of carbocisteine sulfoxides.
Solmux Broncho: Concomitant intake of diuretics may enhance the hypokalemia that occurs with large doses of salbutamol. The effects of Solmux Broncho are inhibited by β-blockers.
Storage
Solmux: Store at temperatures not exceeding 30°C.
Paediatric Suspension: Always keep container tightly closed.
ATC Classification
R05CB10 - combinations ; Belongs to the class of mucolytics. Used in the treatment of wet cough.
R05CB03 - carbocisteine ; Belongs to the class of mucolytics. Used in the treatment of wet cough.
R03DX - Other systemic drugs for obstructive airway diseases ; Used in the systemic treatment of obstructive airway diseases.
Presentation/Packing
Solmux: Cap 500 mg x 100's. Paed oral susp (grape flavour) 200 mg/5 mL x 30 mL, 60 mL. Forte adult oral susp 500 mg/5 mL x 60 mL.
Solmux Broncho: Cap 25 x 4's. Adult oral susp 60 mL. Paed oral susp 60 mL.
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