Ambroxol: Main Uses, Indications And Adverse Reactions

Ambroxol owes its effectiveness to its ability to act intracellularly, promoting the synthesis and secretion of alveolar and bronchial surfactant.
Ambroxol: main uses, indications and adverse reactions

Ambroxol, administered as hydrochloride, is a drug that belongs to the family of mucolytic drugs. Therefore, it is used for the treatment of bronchial processes.

It is a metabolite of bromhexine, this being the prodrug. A prodrug is a drug that, by itself, has no therapeutic action. However, when administered and absorbed, it undergoes a series of chemical reactions and is transformed into another substance that has therapeutic effects.

Ambroxol comes in the form of a solution, syrup, pediatric drops or tablets. The recommendations for administering this drug are:

  • Adults:  between 60 and 90 mg/day in two or three doses.
  • Children over 5 years of age : 15 mg/5 ml is recommended, corresponding to a teaspoon, 2 or 3 times a day.
  • Children from 2 to 5 years : half a tablespoon of syrup 2 or 3 times a day.
  • Children under 2 years : half a teaspoon of syrup twice a day.

Therapeutic indications of ambroxol

woman drinking syrup

As we mentioned, this is the active metabolite of bromhexine. In its hydrochloride form, it has mucolytic effects. It is effective in bronchial processes that require the mobilization of phlegm to prevent the formation of thick mucus in the pulmonary alveoli.

Ambroxol can be given alone or in combination with other bronchodilator drugs to improve the effect on bronchial processes. For example, in combination with salbutamol, ambroxol increases its spasmolytic activity and has an effect on mucociliary activity, which increases sputum.

How does ambroxol exert its effect on the body?

This medicine acts on type II pneumocytes (alveolar cells). Causes a stimulation of surfactant production. Thanks to this, it is possible to reduce the viscosity and adhesiveness of mucus. In this way, the formed plug dissolves and secretion mobilization is facilitated.

In short, ambroxol  owes its effectiveness to its ability to act intracellularly, promoting the synthesis and secretion of alveolar and bronchial surfactant, which forms a film throughout the respiratory epithelium.

Furthermore, this drug  is able to increase the vibratory power of the cellular epithelium. In this way, the adhesiveness of the mucus is reduced and the sliding and transport of bronchial secretions to the outside is facilitated. Your goal is to avoid concurrent obstructions.

Pharmacokinetics: what happens to this drug in the body?

Ambroxol, as we have seen, is given orally. Once taken, the dose is rapidly absorbed from the intestine. When taken on an empty stomach, maximum plasma concentration is reached after 2.5 hours. Its bioavailability is 60%, which means that, when exercising the action, only 60% of the administered dose is available.

This medication  extensively binds to plasma proteins to distribute throughout the body. This fact is important because, if given together with another drug that is also highly bound to plasma proteins, ambroxol can be displaced and increase its free concentration in plasma. As a result, its effects would be intensified and a toxic picture could start.

Adverse Reactions of Ambroxol

drug poisoning

The most common adverse reactions triggered by the administration of ambroxol are gastrointestinal. However, they usually disappear when treatment is stopped. Some of the most common side effects are:

  • Diarrhea
  • Nausea
  • vomiting
  • Headaches

As this medicine can irritate the gastric mucosa,  it is not recommended to take it if you suffer from gastritis or peptic ulcer. Also, pregnant or nursing women should avoid it as it can cause vomiting.

Despite this, ambroxol is a very well tolerated drug. No serious symptoms have been reported due to ambroxol overdose. Symptoms most commonly seen after administration of high doses include:

  • Diarrhea
  • vomiting
  • gastrointestinal problems
  • Skin rashes
  • Fatigue

In the event of an overdose,  vomit-induced lavage of the digestive tract  and, if there are no contractions, administration of activated charcoal is recommended.

Conclusion

Ambroxol is an active metabolite of bromhexine used in the treatment of bronchial processes in which mucus secretion needs to be increased. It can be administered together with other drugs that promote its action, such as salbutamol.

However,  if you are taking other medications, consult your doctor or pharmacist to see if you can take ambroxol as they may interact and cause unwanted effects.

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