Бромгексин 4 Берлин - Хеми Сироп, флакон, 1 шт, 60 мл, 4 мг, для приема внутрь, для детей

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Снижает вязкость мокроты;\nактивирует мерцательный эпителий, увеличивает объем мокроты и улучшает ее\nотхождение. Стимулирует выработку эндогенного сурфактанта, обеспечивающего\nстабильность альвеолярных клеток в процессе дыхания. Эффект проявляется через\n2-5 дней от начала лечения."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eФармакокинетика\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eВсасывание.\u003c/i\u003e После приема внутрь бромгексин быстро\nи практически полностью всасывается из желудочно-кишечного\nтракта. Период полуабсорбции составляет около 0,4 ч. Максимальная\nконцентрация в плазме крови после приема внутрь достигается через 1 ч."}},{"type":"paragraph","data":{"text":"\u003ci\u003eРаспределение.\u003c/i\u003e Объем распределения составляет приблизительно 7 л/кг\nмассы тела. Степень связывания с белками плазмы крови составляет 99%.\nБромгексин проникает через гематоэнцефалический барьер и плацентарный барьер.\nПроникает в грудное молоко и спинномозговую жидкость. Бромгексин не\nподвергается кумуляции."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетаболизм.\u003c/i\u003e 80% бромгексина подвергается эффекту \"первого\nпрохождения\" через печень с образованием биологически активных метаболитов.\nПри тяжелых заболеваниях печени отмечается снижение клиренса бромгексина."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВыведение.\u003c/i\u003e Бромгексин выводится из организма, главным образом, в\nвиде метаболитов. Полупериод достижения минимальной эффективной концентрации\nпосле достижения равновесия между процессами всасывания и выведения составляет\nприблизительно 1 ч. 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Применение препарата в период грудного\nвскармливания противопоказано."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Раствор для приема внутрь. 1 мерная ложка содержит 5 мл\nраствора."}},{"type":"paragraph","data":{"text":"Если не предписано иначе, то рекомендуется соблюдать\nнижеследующие дозы:"}},{"type":"paragraph","data":{"text":"\u003ci\u003eВзрослые и подростки старше 14 лет:\u003c/i\u003e 3 раза в день по 2-4 мерные ложки (24-48 мг\nбромгексина в сутки)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДети от 6 до 14 лет, а также\nпациенты с массой тела менее 50 кг:\u003c/i\u003e 3\nраза в день по 2 мерные ложки (24 мг бромгексина в сутки)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДети от 2 до 6 лет:\u003c/i\u003e 3 раза в день по 1 мерной ложке (12 мг бромгексина в\nсутки) - применяется по назначению врача."}},{"type":"paragraph","data":{"text":"При нарушении функции почек и/или\nтяжелых заболеваниях печени следует увеличить интервалы между приемами,\nлибо уменьшить дозу. По данному вопросу необходимо проконсультироваться с\nлечащим врачом."}},{"type":"paragraph","data":{"text":"Во время терапии препаратом Бромгексин 4 Берлин-Хеми\nрекомендуется употреблять достаточное количество жидкости."}},{"type":"paragraph","data":{"text":"Препарат Бромгексин 4 Берлин-Хеми не следует принимать более\n4-5 дней без консультации с лечащим врачом. Длительность применения\nустанавливается врачом в индивидуальном порядке и зависит от показаний и\nтечения заболевания."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Возможные побочные эффекты приведены ниже по нисходящей\nчастоте возникновения: \u003ci\u003eочень\nчасто (> 1/10), часто (> 1/100, > 1/10), нечасто (> 1/1000, > 1/100),\nредко (> 1/10000, < 1/1000), очень редко, включая отдельные сообщения\n(< 1/10000), частота не установлена (не может быть оценена исходя из\nимеющихся данных).\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны желудочно-кишечного\nтракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНечасто:\u003c/i\u003e тошнота, рвота, диарея, боль в животе;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eРедко:\u003c/i\u003e реакции гиперчувствительности;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eЧастота не установлена:\u003c/i\u003e анафилактические реакции, включая\nанафилактический шок, ангионевротический отек, кожный зуд."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны кожи и подкожных тканей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eРедко:\u003c/i\u003e кожная сыпь, крапивница;"}},{"type":"paragraph","data":{"text":"\u003ci\u003eЧастота не установлена:\u003c/i\u003e тяжелые кожные реакции, включая мультиформную эритему,\nсиндром Стивенса-Джонсона, токсический эпидермальный некролиз (синдром\nЛайелла), острый генерализованный экзантематозный пустулез (см. раздел \u003ci\u003e\"Особые указания\"\u003c/i\u003e)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОбщие нарушения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНечасто:\u003c/i\u003e лихорадка."}},{"type":"paragraph","data":{"text":"При всех формах аллергических реакций\n(гиперчувствительность, анафилаксия) или в случае появления любого поражения\nкожи и/или слизистых оболочек необходимо прекратить прием данного\nлекарственного препарата и немедленно проинформировать об этом лечащего врача."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Опасные для жизни симптомы передозировки, при применении\nпрепарата Бромгексин 4 Берлин-Хеми, неизвестны."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы:\u003c/i\u003e Опубликовано исследование случаев передозировки,\nсогласно которому в 4 из 25 случаев передозировки наблюдалась рвота. У трех\nдетей были отмечены такие явления, как рвота, а также оглушение сознания,\nатаксия, диплопия, метаболический ацидоз легкой степени тяжести и тахипноэ. У\nдетей симптомы не возникали при приеме бромгексина в дозе до 40 мг, даже при\nотсутствии лечения."}},{"type":"paragraph","data":{"text":"Доказательства хронической токсичности бромгексина у\nчеловека отсутствуют."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение:\u003c/i\u003e при выраженной передозировке показаны мониторинг\nкровообращения и, в случае необходимости, симптоматическое лечение. В связи с\nнизкой токсичностью бромгексина, как правило, нет необходимости в проведении\nинвазивных мероприятий, направленных на снижение его всасывания (принудительная\nрвота, промывание желудка) или на ускорение выведения. Кроме того, из-за\nособенностей фармакокинетики (высокий объем распределения, медленные процессы\nперераспределения и высокая степень связывания с белками), эффективного\nудаления бромгексина из организма путем диализа или форсированного диуреза не\nследует ожидать."}},{"type":"paragraph","data":{"text":"Поскольку у детей с 2-х лет даже после приема больших доз\nбромгексина ожидаются только легкие симптомы, при дозе бромгексина гидрохлорида\nдо 80 мг (например, 100 мл препарата Бромгексин 4 Берлин-Хеми) детоксикацию\nможно не проводить. У детей более младшего возраста соответствующий предел дозы\nсоставляет 60 мг бромгексина гидрохлорида (6 мг/кг массы тела)."}},{"type":"paragraph","data":{"text":"При передозировке возможно также развитие побочных эффектов,\nвызванных вспомогательными веществами."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Бромгексин 4 Берлин-Хеми можно назначать одновременно с другими\nпрепаратами, применяемыми при лечении бронхолегочных заболеваний."}},{"type":"paragraph","data":{"text":"Бромгексин не назначают одновременно с противокашлевыми\nсредствами (в том числе содержащими кодеин), т.к. из-за подавления рефлекса\nзатрудняется эвакуация разжиженной мокроты, что может привести к скоплению\nсекрета в дыхательных путях."}},{"type":"paragraph","data":{"text":"Бромгексин 4 Берлин-Хеми способствует проникновению\nантибиотиков (эритромицин, цефалексин, окситетрациклин, ампициллин,\nамоксициллин) в бронхиальный секрет в первые 4-5 дней противомикробной терапии.\nКлиническая значимость данного возможного взаимодействия не доказана."}},{"type":"paragraph","data":{"text":"При одновременном применении с препаратами, оказывающими\nраздражающее действие на желудочно-кишечный тракт (например, некоторые\nнестероидные противовоспалительные препараты), возможно усиление раздражающего\nдействия последних на слизистую оболочку желудка."}}]},{"id":9,"name":"Особые указания","slug":"","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В случаях нарушения моторики бронхов или при значительном\nобъеме выделяемой мокроты (например, при редком синдроме первичной дискинезии\nресничек) применение препарата Бромгексин 4 Берлин-Хеми требует осторожности в\nсвязи с повышенным риском обструкции дыхательных путей."}},{"type":"paragraph","data":{"text":"При нарушении функции почек\nи при тяжелых заболеваниях печени препарат Бромгексин 4\nБерлин-Хеми следует применять с особой осторожностью\n(например, рекомендуется уменьшить дозу или увеличить интервалы между\nприемами). При тяжелой почечной недостаточности необходимо учитывать\nвозможность кумуляции образующихся в печени метаболитов."}},{"type":"paragraph","data":{"text":"Рекомендуется мониторинг функции печени, особенно при\nдлительном лечении."}},{"type":"paragraph","data":{"text":"Имеются данные о возникновении в очень редких случаях\nтяжелых кожных реакций (таких как мультиформная эритема, синдром\nСтивенса-Джонсона, токсический эпидермальный некролиз, острый генерализованный\nэкзантематозный пустулез) на фоне приема бромгексина."}},{"type":"paragraph","data":{"text":"При появлении аллергических реакций и/или признаков\nпрогрессирующей кожной сыпи (иногда в сочетании с возникновением пузырей и\nпоражением слизистых оболочек) следует немедленно прекратить\nприменение препарата и обратиться к врачу."}},{"type":"paragraph","data":{"text":"Применение препарата Бромгексин 4 Берлин-Хеми у детей в\nвозрасте старше 2-х лет возможно только под контролем врача."}},{"type":"paragraph","data":{"text":"Пропиленгликоль, входящий в состав препарата Бромгексин 4\nБерлин-Хеми, может вызывать у детей симптомы, сходные с симптомами,\nвозникающими после употребления алкоголя."}},{"type":"paragraph","data":{"text":"Указание для больных сахарным диабетом: в 5 мл раствора (1\nмерная ложка) содержится 2 г сорбитола (эквивалентно 0,5 г фруктозы), что\nсоответствует 0,17 хлебным единицам."}},{"type":"paragraph","data":{"text":"Сорбитол может оказывать незначительный слабительный эффект."}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"При приеме в рекомендованных дозах препарат Бромгексин 4\nБерлин-Хеми не оказывает влияния на скорость психомоторных реакций."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для приема внутрь 4 мг/5 мл."}},{"type":"paragraph","data":{"text":"По 60 или 100 мл раствора во флаконы темного стекла с\nзавинчивающейся пластмассовой или алюминиевой пробкой с уплотнительной\nпрокладкой."}},{"type":"paragraph","data":{"text":"По 1 флакону в комплекте с мерной ложкой вместе с\nинструкцией по применению помещают в картонную пачку."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 25 оС."}},{"type":"paragraph","data":{"text":"Лекарственное средство хранить в недоступном для детей\nместе!"}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"3 месяца - после первого вскрытия флакона."}},{"type":"paragraph","data":{"text":"Не использовать после истечения срока годности, указанного\nна упаковке."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают без рецепта."}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Берлин-Хеми АГ"}},{"type":"paragraph","data":{"text":"Глиникер Вег, 125"}},{"type":"paragraph","data":{"text":"12489 Берлин, Германия"}}]},{"id":22,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ООО \"Берлин-Хеми/А. Менарини\", Россия"}},{"type":"paragraph","data":{"text":"123112, г. Москва, Пресненская набережная, дом 10, БЦ\n\"Башня на набережной\", Блок , тел. (495) 785-01-00, факс (495)\n785-01-01."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"ФармакодинамикаБромгексин оказывает муколитическое (секретолитическое) и отхаркивающее (секретомоторное) действие. Снижает вязкость мокроты; активирует мерцательный эпителий, увеличивает объем мокроты и улучшает ее отхождение. Стимулирует выработку эндогенного сурфактанта, обеспечивающего стабильность альвеолярных клеток в процессе дыхания. Эффект проявляется через 2-5 дней от начала лечения.ФармакокинетикаВсасывание.После приема внутрь бромгексин быстро и практически полностью всасывается из желудочно-кишечного тракта. Период полуабсорбции составляет около 0,4 ч. Максимальная концентрация в плазме крови после приема внутрь достигается через 1 ч.Распределение.Объем распределения составляет приблизительно 7 л/кг массы тела. Степень связывания с белками плазмы крови составляет 99%. Бромгексин проникает через гематоэнцефалический барьер и плацентарный барьер. Проникает в грудное молоко и спинномозговую жидкость. Бромгексин не подвергается кумуляции.Метаболизм.80% бромгексина подвергается эффекту \"первого прохождения\" через печень с образованием биологически активных метаболитов. При тяжелых заболеваниях печени отмечается снижение клиренса бромгексина.Выведение.Бромгексин выводится из организма, главным образом, в виде метаболитов. Полупериод достижения минимальной эффективной концентрации после достижения равновесия между процессами всасывания и выведения составляет приблизительно 1 ч. Конечный период полувыведения составляет около 16 ч за счет обратного распределения небольших количеств бромгексина из тканей. Выводится преимущественно почками в виде метаболитов, образующихся в печени. В связи с высокой степенью связывания с белками плазмы крови и высоким объемом распределения, а также медленным перераспределением из тканей в кровь, значительного выведения бромгексина с помощью диализа или форсированного диуреза ожидать не следует. При тяжелой почечной недостаточности не может быть исключено увеличение периода полувыведения метаболитов бромгексина. 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