Carbocisteine


Generic Medicine Info
Indications and Dosage
Oral
Mucolytic
Adult: As adjunctive therapy in respiratory tract disorders characterised by excessive, viscous mucus secretions (including COPD): Initially, 2,250 mg daily in divided doses, may be decreased to 1,500 mg daily in divided doses when a satisfactory response is obtained.
Child: 2-5 years Usual dose: 62.5-125 mg 4 times daily or 200 mg daily in 2 divided doses; 6-12 years Usual dose: 100 mg or 250 mg tid. Dosage recommendations may vary among individual products and between countries (refer to detailed product guidelines).
Administration
Should be taken with food.
Contraindications
Active peptic or duodenal ulcer. Children <2 years.
Special Precautions
Patient with history of gastroduodenal ulcers, chronic bronchial asthma, respiratory failure. Patients taking concomitant medicines known to cause gastrointestinal bleeding. Not recommended to be concomitantly used with antitussives and/or medicines that dry up bronchial secretions. Children (≥2 years) and elderly. Pregnancy and lactation.
Adverse Reactions
Significant: Gastrointestinal bleeding.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, epigastric discomfort.
Immune system disorders: Anaphylactic reactions, fixed drug eruption.
Skin and subcutaneous tissue disorders: Rash. Rarely, bullous dermatitis (e.g. Stevens-Johnson syndrome, erythema multiforme).
Overdosage
Symptoms: Gastrointestinal disturbances such as gastralgia, nausea, and vomiting. Management: Supportive treatment. May perform gastric lavage, then closely observe the patient.
Action
Description: Carbocisteine is a mucolytic agent. The mucoregulatory mechanism of carbocisteine is not completely understood. It has been shown to reduce goblet cell hyperplasia, therefore plays a role in the management of disorders characterised by abnormal mucus.
Pharmacokinetics:
Absorption: Rapidly and well absorbed from the gastrointestinal tract. Bioavailability: <10%. Time to peak plasma concentration: Approx 2 hours (range: 1-3 hours).
Distribution: Penetrates into the lung tissue and respiratory mucus. Volume of distribution: Approx 60-105 L.
Metabolism: Metabolised via acetylation, decarboxylation, and sulfoxidation.
Excretion: Via urine (as unchanged drug and metabolites). Elimination half-life: 1.87 hours (range: 1.4-2.5 hours).
Chemical Structure

Chemical Structure Image
Carbocisteine

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 193653, Carbocysteine. https://pubchem.ncbi.nlm.nih.gov/compound/Carbocysteine. Accessed Mar. 29, 2022.

Storage
Syrup/oral solution: Store below 25°C. Tab/cap: Store below 30°C.
MIMS Class
Cough & Cold Preparations
ATC Classification
R05CB03 - carbocisteine ; Belongs to the class of mucolytics. Used in the treatment of wet cough.
References
Anon. Carbocisteine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 01/03/2022.

Buckingham R (ed). Carbocisteine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/03/2022.

Carbocisteine 250 mg/5 mL Oral Solution (ROMA Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk. Accessed 16/03/2022.

Carbocisteine 375 mg Capsule Hard (Manx Healthcare Ltd). MHRA. https://products.mhra.gov.uk. Accessed 01/03/2022.

Joint Formulary Committee. Carbocisteine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/03/2022.

Mucodyne 250 mg/5 mL Syrup; Paediatric Syrup (Aventis Pharma Limited). MHRA. https://products.mhra.gov.uk. Accessed 01/03/2022.

Pabron Cough Kids Syrup (Xepa-Soul Pattinson [M] Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/03/2022.

Pabron Cough Tablet (Xepa-Soul Pattinson [M] Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 01/03/2022.

Rhinathiol Adult Syrup (Sanofi-Aventis Singapore Pte Ltd). MIMS Singapore. http://www.mims.com/singapore. Accessed 01/03/2022.

Rhinathiol Children Syrup (Sanofi-Aventis Singapore Pte Ltd). MIMS Singapore. http://www.mims.com/singapore. Accessed 01/03/2022.

Disclaimer: This information is independently developed by MIMS based on Carbocisteine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2022 MIMS. All rights reserved. Powered by MIMS.com
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