Относится к группе муколитических средств, стимулирует пренатальное развитие легких (повышает синтез, секрецию сурфактанта и блокирует его распад). Обладает секретомоторным, секретолитическим и отхаркивающим действием. Амброксол является метаболитом бромгексина и дает более выраженный отхаркивающий эффект. Амброксол стимулирует серозные клетки желез слизистой оболочки бронхов, увеличивая содержание слизистого секрета, нормализует нарушенное соотношение серозного и слизистого компонентов мокроты, а также активизирует гидролизирующие ферменты. Активируя гидролизирующие ферменты и усиливая высвобождение лизосом из клеток Кларка, нормализует патологически измененное образование бронхиального секрета, что облегчает его выделение, ускоряет мукоцилиарный клиренс, уменьшает вязкость мокроты. Повышает двигательную активность ресничек мерцательного эпителия, увеличивает мукоцилиарный транспорт мокроты. Уменьшает бронхиальную гиперактивность, увеличивает секрецию IgA в бронхиальном секрете и оказывает антиоксидантное действие.
Показания к применению
Инфекционно-воспалительные заболевания бронхолегочной системы, сопровождающиеся образованием трудноотделяемой мокроты: острый бронхит, трахеит, хронический бронхит в стадии обострения, хроническая обструктивная болезнь легких, бронхиальная астма, бронхопневмония, муковисцидоз, бронхоэктатическая болезнь
Профилактика застойных явлений в бронхолегочной системе после больших операционных вмешательств, травм
Противопоказания
I триместр беременности
Повышенная чувствительность к препарату. С осторожностью: язвенная болезнь желудка и двенадцатиперстной кишки в стадии обострения
Применение при беременности и в период грудного вскармливания
При необходимости применения амброксола во II и III триместрах беременности следует оценить потенциальную пользу терапии для матери с возможным риском для плода. Противопоказан в I триместре беременности. При назначении в период лактации следует решить вопрос о прекращении грудного вскармливания.
Способ применения и дозы
Взрослым и детям старше 12 лет назначают по 30 мг (1 таб.) 2-3 раза/сут внутрь (в особо тяжелых случаях суточная доза может быть увеличена до 180 мг). Детям в возрасте 5-12 лет - по 15 мг (1/2 таб.) 2-3 раза/сут, в возрасте 2-5 лет - по 7.5 мг (1/4 таб.) 3 раза/сут, в возрасте до 2 лет - по 7.5 мг (1/4 таб.) 2 раза/сут. Препарат применяют во время или после еды, запивая небольшим количеством жидкости. Время лечения препаратом Амбросан определяется индивидуально, в зависимости от назначения и вида заболевания. Не рекомендуется применять препарат без врачебного контроля более чем 4-5 дней.
Побочное действие
Со стороны пищеварительной системы: редко при длительном применении в высоких дозах - гастралгия, тошнота, рвота. Аллергические реакции: возможна кожная сыпь, крапивница, ангионевротический отек. Редко: слабость, головная боль, диарея, сухость во рту и дыхательных путях, экзантемы, ринорея, запоры, дизурия.
Передозировка
Диапазон между терапевтической и токсической дозами препарата очень широкий, поэтому возможность его передозирования практически отсутствует. Симптомы: тошнота, рвота, диарея, диспепсия. Лечение: искусственная рвота, промывание желудка в первые 1-2 ч после приема препарата, прием жиросодержащих продуктов.
Особые указания
Не следует комбинировать Амбросан с противокашлевыми средствами, затрудняющими выведение мокроты. При нарушении бронхиальной моторики и повышенном количестве секрета (например, при злокачественном цилиарном синдроме), амброксол следует назначать с осторожностью, ввиду возможности накопления секрета. При почечной недостаточности, выраженной печеночной недостаточности амброксол следует применять с осторожностью (т.е. с более длительным промежутком времени между отдельными приемами или в меньших дозах).
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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