Flavamed

Flavamed is a mucus thinning and expectorant drug.

The medicine liquefies viscous bronchial secretions and facilitates their discharge – improving the processes of mucociliary clearance (movement of mucus, which occurs with the help of ciliated cells). At the same time, the medicine improves the parameters of external respiratory processes, acting as an expectorant (helps to excrete sputum), as well as a mucolytic (liquefying effect). [ 1 ]

The drug also increases the volume of surfactant. [ 2 ]

Indications Flavamed

It is used in cases of chronic or active forms of respiratory diseases, in which the presence of viscous, difficult to remove sputum is observed:

• bronchiectatic pathology or bronchitis;
• tracheitis, sinusitis, pharyngitis or laryngitis;
• pneumonia;
• runny nose;
• pulmonary cystic fibrosis;
• BA;
• RDS syndrome;
• prevention or treatment of postoperative complications in the lung area;
• during preparation for bronchoscopy.

Release form

The medicinal substance is released in the form of tablets with a volume of 30 mg.

It is also sold as an oral solution, in 60 or 100 ml bottles; inside the pack there is 1 such bottle and a measuring spoon.

Pharmacodynamics

The active ingredient of the drug is ambroxol hydrochloride. It enhances the excretory activity of the glands of the respiratory tract. Ambroxol potentiates the excretion of pulmonary surfactant, directly affecting the type 2 pneumocytes inside the alveoli and the Clara cells inside the bronchioles; in addition, it has a stimulating effect on ciliary activity. As a result, mucus secretion increases and mucociliary clearance improves.

With the activation of fluid secretion processes and an increase in mucociliary clearance, mucus excretion is facilitated and cough is weakened. [ 3 ]

The medicinal effect develops within half an hour from the moment of taking the drug and lasts for 6-12 hours (depending on the portion size).

Ambroxol hydrochloride has an anti-inflammatory effect in vitro. In vitro testing has shown that the component significantly reduces blood cytokine release, as well as tissue synthesis of poly- and mononuclear cells.

The use of the substance increases the levels of antibiotics (cefuroxime and amoxicillin with erythromycin) in sputum and bronchopulmonary secretions.

Pharmacokinetics

Suction.

The absorption of the drug is quite complete and occurs at a high speed; the process has a linear dependence when used in the drug range. Plasma Cmax values are noted after 1-3 hours from the moment of application.

Distribution processes.

The component is sharply and quickly distributed from the blood into the tissues; high values are noted in the lungs. The distribution volume index after oral administration is 552 l. In the blood plasma in the medicinal range, about 90% of the drug is synthesized with blood protein.

Metabolic processes and excretion.

About 30% of the dose after oral administration is excreted by presystemic metabolism. Ambroxol is involved in intrahepatic metabolism via glucuronidation and cleavage within dibromanthranilic acid (about 10% of the dose). Clinical testing with liver microsomes revealed that the above process occurs via CYP3A4.

Over a 3-day period, approximately 6% of the dose is excreted unchanged; another 26% of the dose is excreted in the urine in the form of conjugates.

The plasma half-life is within 7-12 hours. Total clearance values are approximately 660 ml per minute. Renal clearance values are approximately 83% of the total values.

Dosing and administration

Using tablets.

The tablets should be taken orally, after meals. The dosage is 30 mg, 2-3 times a day. In case of exacerbation of the chronic form of pathology, the portion can be increased to 60 mg, 2 times a day.

The dosage for children is selected taking into account weight – 1.2-1.6 mg/kg per day (in 3 doses).

The duration of taking the medication is not limited, but long-term treatment should be carried out exclusively under the supervision of a doctor. Without prior medical consultation, Flavamed can be used for a maximum of 4-5 days.

Application of the solution.

Children under 2 years of age.

0.5 measuring spoon of oral liquid (2.5 ml), 2 times a day - corresponds to 15 mg of ambroxol per day.

Age within 2-5 years.

0.5 measuring spoon of the medicine 3 times a day – equals 22.5 mg of medicine per day.

Age category 6-12 years.

1 measuring spoon (5 ml) of the medicine, 2-3 times a day – corresponds to 30-45 mg of the drug per day.

Children over 12 years old and adults.

2 measuring spoons of the drug (10 ml), 3 times a day - corresponds to 90 mg of the substance per day (this scheme is used in the first 2-3 days). Then the medicine is taken in the same dosage, but 2 times a day - corresponds to 60 mg of ambroxol per day.

If necessary, the adult dosage can be increased to 20 ml of medication twice a day (equivalent to a daily dose of 0.12 g of ambroxol hydrochloride).

The solution can be used without reference to food intake. It is prohibited to use Flavamed for more than 4-5 days without consulting a doctor.

• Application for children

The medication in tablet form cannot be used by persons under 6 years of age.

Use Flavamed during pregnancy

Active molecules can cross the placenta, but animal tests have not shown any negative effects on embryonic/fetal development, pregnancy, or labor. The drug should be used with extreme caution in pregnant women.

Ambroxol hydrochloride is excreted in breast milk. Flavamed should not be prescribed during breastfeeding, although no negative effects are expected.

Contraindications

Main contraindications:

• severe renal/hepatic dysfunction;
• hypersensitivity to the components of the drug.

The medicine should be used with caution in people with ulcers or erosions in the gastrointestinal tract, and also when using antitussive medications.

Side effects Flavamed

Side effects include:

• digestive disorders: constipation, nausea, xerostomia, diarrhea, heartburn and gastralgia;
• allergy symptoms: Quincke's edema, epidermal rash, urticaria, itching and anaphylactic symptoms (including shock);
• others: headaches and weakness.

Overdose

Signs of overdose: bowel disturbances (diarrhea or constipation), nausea and other manifestations of dyspepsia.

It is necessary to perform gastric lavage or induce vomiting during the first few hours after using the drug; in addition, symptomatic procedures are carried out.

Interactions with other drugs

When using the drug together with cough suppressants, excessive accumulation of mucus is possible due to suppression of the cough reflex. For this reason, such a combination can only be used after a doctor has assessed all possible risks and benefits.

Storage conditions

Flavamed should be stored in a place closed to small children. Temperature values are in the range of 15-25°C.

Shelf life

Flavamed can be used for a period of 2 years from the date of manufacture of the drug.

Analogues

The drug's analogues are Ambroxol, Lazolvan, Ambrobene with Abrol and Bronchoval.