Mucolytic and expectorant drug

Active ingredient

Ambroxol hydrochloride (ambroxol)

Release form, composition and packaging

◊ Solution for oral administration and inhalation transparent, colorless or slightly brownish.

Excipients: citric acid monohydrate - 2 mg, sodium hydrogen phosphate dihydrate - 4.35 mg, - 6.22 mg, benzalkonium chloride - 225 mcg, purified water - 989.705 mg.

100 ml - amber glass bottles (1) with a polyethylene dropper and a polypropylene screw cap with first opening control, complete with a measuring cup - cardboard packs.

Pharmacological action

Studies have shown that the active ingredient of the drug Lazolvan increases secretion in the respiratory tract. Strengthens products pulmonary surfactant and stimulates ciliary activity. These effects lead to increased mucus flow and transport (mucociliary clearance). Increasing mucociliary clearance improves sputum discharge and relieves cough.

In patients with COPD long-term therapy Lazolvan (for at least 2 months) led to a significant reduction in the number of exacerbations. There was a significant decrease in the duration of exacerbations and the number of days of antibiotic therapy.

Pharmacokinetics

Suction

For everyone dosage forms immediate release of ambroxol is characterized by rapid and almost complete absorption from linear dependence from dose in the therapeutic concentration range. Cmax when taken orally is achieved within 1-2.5 hours.

Distribution

V d is 552 l. In the therapeutic concentration range, protein binding is approximately 90%. The transition of ambroxol from the blood to tissues when administered orally occurs quickly. Highest concentrations active component of the drug are observed in the lungs.

Metabolism

Approximately 30% of the dose taken orally undergoes a first-pass effect through the liver. Studies on human liver microsomes have shown that CYP3A4 is the predominant isoform responsible for the metabolism of ambroxol to dibromoantranilic acid. The remainder of ambroxol is metabolized in the liver, mainly by glucuronidation and by partial breakdown to dibromoantranilic acid (approximately 10% of the administered dose), as well as a small number of additional metabolites.

Removal

The terminal half-life of ambroxol is about 10 hours. The total clearance is within 660 ml/min, renal clearance accounts for approximately 8% of the total clearance. Using the radioactive tracer injection method, it was estimated that after taking a single dose of the drug, about 83% of the dose taken is excreted in the urine over the next 5 days.

Pharmacokinetics special groups patients

No clinically significant effect of age and gender on the pharmacokinetics of ambroxol was found, so there is no basis for selecting the dose based on these characteristics.

Indications

Spicy and chronic diseases respiratory tract accompanied by the release of viscous sputum and impaired mucociliary clearance:

- spicy and chronic bronchitis;

- pneumonia;

- difficulty with sputum discharge;

- bronchiectasis.

Contraindications

— increased sensitivity to ambroxol or other components of the drug;

— I trimester of pregnancy;

- period of lactation (breastfeeding).

With caution Lazolvan should be used during pregnancy (II and III trimesters), with renal and/or liver failure.

Dosage

Oral administration (1 ml = 25 drops).

Drops can be diluted in water, tea, juice or milk. The solution can be used regardless of meals.

Adults and children over 12 years old- 4 ml (100 drops) 3 times/day; children aged 6 to 12 years- 2 ml (50 drops) 2-3 times/day; children aged 2 to 6 years- 1 ml (25 drops) 3 times/day; children under 2 years of age- 1 ml (25 drops) 2 times/day.

Inhalations

Adults and children over 6 years old- 1-2 inhalations of 2-3 ml of solution/day.

Children under 6 years of age- 1-2 inhalations of 2 ml solution/day.

Lazolvan solution for inhalation can be used using any modern equipment for inhalations (except steam inhalers). To achieve optimal hydration during inhalation, the drug is mixed with 0.9% sodium chloride solution in a 1:1 ratio. Since during inhalation therapy a deep breath can provoke a cough, inhalations should be carried out in normal breathing mode. Before inhalation, it is usually recommended to warm the inhalation solution to body temperature. Patients with bronchial asthma It is recommended to carry out inhalation after taking bronchodilators, in order to avoid nonspecific irritation of the respiratory tract and their spasm.

If symptoms of the disease persist within 4-5 days from the start of using the drug, it is recommended to consult a doctor.

Side effects

From the outside digestive system: often (1-10%) – dysgeusia (violation taste sensations), nausea, decreased sensitivity in the mouth or throat; uncommon (0.1-1%) - dyspepsia, vomiting, diarrhea, abdominal pain, dry mouth; rarely (0.01-0.1%) – dry throat.

For the skin and subcutaneous tissues: rarely (0.01-0.1%) – rash, itching*.

Allergic reactions: rarely (0.01-0.1%) – urticaria; anaphylactic reactions (including anaphylactic shock)*, angioedema*, hypersensitivity*.

* data adverse reactions were observed at widespread use drug; with a 95% probability, the frequency of these adverse reactions is uncommon (0.1%-1%), but possibly lower; the exact frequency is difficult to estimate, because they were not noted during the clinical trials.

Overdose

Specific symptoms of overdose in humans have not been described.

There have been reports of accidental overdose and/or medical error, as a result of which we observed symptoms famous side effects drug Lazolvan: nausea, dyspepsia, vomiting, diarrhea, abdominal pain.

Treatment: provocation of vomiting, gastric lavage in the first 1-2 hours after taking the drug, symptomatic therapy.

Drug interactions

About clinically significant, unwanted interactions with others medicines not reported.

Ambroxol increases penetration into bronchial secretion amoxicillin, cefuroxime, erythromycin.

Special instructions

Should not be used in combination with antitussives that impede the removal of sputum.

The solution contains a preservative, which, when inhaled, may cause bronchospasm in sensitive patients with increased respiratory tract reactivity.

Lazolvan solution for oral administration and inhalation is not recommended to be mixed with cromoglicic acid and alkaline solutions. An increase in the pH value of the solution above 6.3 may cause precipitation of ambroxol hydrochloride or the appearance of opalescence.

Patients on a diet with reduced content sodium, it is necessary to take into account that Lazolvan solution for oral administration and inhalation contains 42.8 mg of sodium in the recommended daily dose(12 ml) for adults and children over 12 years old.

There are isolated reports of severe lesions skin (Stevens-Johnson syndrome and toxic epidermal necrolysis), which coincided with the use of expectorants such as ambroxol hydrochloride. In most cases, they are explained by the severity of the underlying disease and/or concomitant therapy. Patients with Stevens-Johnson syndrome or toxic epidermal necrolysis may present in the early phase with fever, body pain, rhinitis, cough, etc. With symptomatic treatment, erroneous prescription is possible cold remedies. If new lesions of the skin and mucous membranes develop, the patient should stop treatment with ambroxol and immediately seek medical advice. medical care.

If renal function is impaired, Lazolvan should be used only on the recommendation of a doctor.

Impact on ability to manage vehicles and mechanisms

There were no cases of the drug influencing the ability to drive vehicles and machinery. Studies on the effect of the drug on the ability to drive vehicles and engage in other potentially dangerous species activities requiring increased concentration attention and speed of psychomotor reactions were not carried out.

Pregnancy and lactation

Ambroxol penetrates the placental barrier. Preclinical studies have not revealed direct or indirect adverse effects on pregnancy, embryonic/fetal, postnatal development and labor.

Extensive clinical experience I found no evidence of using ambroxol after the 28th week of pregnancy negative influence drug for the fetus. However, the usual precautions should be taken when using the drug during pregnancy. It is especially not recommended to take Lazolvan in the first trimester of pregnancy. In the second and third trimesters of pregnancy, the use of the drug is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.

No clinically significant effect of age on the pharmacokinetics of ambroxol was found, so there is no basis for selecting the dose based on these characteristics.

Conditions for dispensing from pharmacies

The drug is available without a prescription.

Storage conditions and periods

The drug should be stored in its original packaging out of the reach of children at a temperature not exceeding 25°C. Shelf life - 5 years.

L azolvan refers to effective solutions for nebulizer therapy of productive cough, thins viscous mucus and accelerates its removal from the lungs.

The drug is well tolerated and is prescribed in complex therapy respiratory diseases in adults and children.

Reviews about inhalations with Lazolvan are positive, most note the effect after the first procedures. The price for the solution in pharmacies is from 380 rubles.

For adults

For children

The dosage of Lazolvan for children and the duration of treatment should be prescribed by a pediatrician, but if there are no instructions, you can adhere to the standard values: the duration of one inhalation procedure is no more than 3-5 minutes. The course of treatment is 4-5 days.

If after treatment the child’s condition has improved, wheezing has disappeared, a dry cough has changed into a wet one, treatment can be stopped.

Rules for inhalation

To achieve the maximum therapeutic effect, it is important not only to observe the dose of the solution, the duration of treatment, but also the rules for inhalation:

• pour the medicine only into a clean nebulizer container;
• after each procedure, wash the container and mask well and prepare for the next procedure;
• inhalations with Lazolvan should be carried out 1 hour before meals;
• During the procedure, you need to sit upright, open your mouth and close your eyes;
• do not inhale at temperatures above 37.5 degrees;
• if there is medicine left in the container after inhalation, it must be poured out;
• for each new procedure, use only freshly prepared solution;
• During inhalation, you do not need to take deep breaths, this can cause a severe coughing attack;
• if inhalation of Lazolvan is carried out by patients with bronchial asthma, it is first necessary to inhale a drug with a bronchodilator effect (Berodual, Ventolin);
• the temperature of the solution should be equal to the temperature of the human body;
• it is prohibited to combine Lazolvan with drugs that suppress the cough center;
• It is not recommended to carry out procedures before bedtime to avoid excessive accumulation of mucus in the respiratory tract;
• For inhalation, use only a nebulizer, other devices are prohibited.

Compliance with all the rules will help strengthen therapeutic effect drug, minimize unwanted reactions body.

Possible side effects

Lazolvan solution is well tolerated by patients, but in some cases it can cause adverse reactions in the body. The following symptoms indicate intolerance to the drug:

• nausea;
• vomit;
• diarrhea;
• pain in the stomach;
• dizziness;
• allergic manifestations;
• dry throat.

Doctors are inclined to believe that the risk of the above symptoms increases if the recommended doses of the medication are not observed or if the patient has a history of contraindications to the prescription.

If the above symptoms develop, you should stop inhaling and seek help from a doctor who can adjust the dose or prescribe another medicine.

How can I replace Lazovan?

Lazolvan solution refers to effective drugs from the group of mucolytics, but if for some reason its use is not possible, another medicine with a similar mechanism of action and composition should be considered.

The list of inhaled muculolytics is varied, but before using them you should consult your doctor.

Ambrobene

A structural substitute for Lazolvan, which contains ambroxol hydrochloride.

The drug has a thinning effect, promotes the removal of sputum, and is often used in the treatment of bronchitis, tracheitis, and pneumonia.

Prescribed to children from 6 months, as well as pregnant women in the second and third trimester. During inhalations with Ambrobene, it also needs to be diluted with 9% sodium chloride in a 1:1 ratio. Treatment lasts up to 7 days.

Ambrohexal

A drug from the group of mucolytics, which has a pronounced thinning and expectorant property.

The basis of Ambrohexal is the same ambroxol. It is produced in the form of a solution for inhalation and provides quick relief discharge of sputum.

When administered by inhalation, the medicine is well concentrated in the lungs, which ensures maximum results.

The drug is not prescribed to children under 2 years of age. IN pure form the solution is not used, it must be diluted with 9% sodium chloride according to the instructions.

Acetylcysteine

The medicine is a mucolytic, but has a different composition. Often used in the treatment of diseases with increased viscosity bronchial secretion.

Available in several forms, but can be used for inhalation effervescent tablets or powder for preparing a solution.

The exact dose and frequency of procedures is calculated by the doctor individually for each patient.

Mucomist

A drug from the group of secretolytics and stimulants of motor function of the respiratory organs. It has a pronounced mucolytic, hepatoprotective and expectorant effect.

The active component of the medicine is acetylcysteine, which thins viscous mucus and promotes its rapid removal.

For inhalation, a solution is used, which is diluted in equal quantities with saline before use.

Bronchorus

A budget replacement for Lazolvan, which contains ambroxol. The principle of action of the drug is the same as that of the brand, but the cost is much cheaper. The medicine is available in syrup for inhalation or oral administration.

It has an expectorant, secretomotor and secretolytic effect, enhances the secretion of the bronchial glands, and facilitates the discharge of viscous mucus.

Inhalations with Bronchorus can be performed on children from birth. Before use, the medicine must be diluted with saline in a 1:1 ratio.

Berodual

Does not apply to structural analogues Lazolvan, but is widely used in the treatment of diseases respiratory system which are accompanied by spasm and bronchial obstruction. The composition contains two components: ipratropium bromide and fenoterol, which have an anticholinergic effect.

The use of the drug allows you to relax the smooth muscles of the bronchi, relieve spasms and attacks of suffocation. Berodual is often used in combination with Lazolvan.

During the treatment, inhalations are done with Berodual, and after 1 hour with Lazolvan. Berodual is widely used in pediatrics, but it is important to understand that both drugs have different composition and the mechanism of action, so one cannot be replaced by the other.

There are other drugs, but they are more often used for individual intolerance Lazolvan or lack of positive dynamics after treatment.

In conclusion

Lazolvan – harmless remedy, which in practice is often used by pediatricians, therapists and pulmonologists, but despite the safety of the medicine, it must be combined with other pharmaceutical drugs.

Only integrated approach to treatment will help to successfully cope with the disease, eliminate possible risk complications. When coughing with sputum that is difficult to separate, doctors recommend, in addition to inhalation procedures, drinking a lot of fluid, this will also help thin the viscous mucus.

Lazolvan for inhalation, the instructions for use of which describe its properties in detail, is a high-quality German product. The effect of use is felt within half an hour after the procedure, and lasts 10–12 hours.

Lazolvan (solution for oral administration and inhalation), the instructions for use of which recommend it for many diseases, is sold freely in pharmacies. You can treat yourself using it. However, if there is no improvement for 5 or more days, you should contact a specialist for recommendations.

Lazolvan for inhalation, instructions for use for which are contained in each package, is made using ambroxol. This main component has the following effects:

1. Secretory. Represents stimulation of contractions of the ciliated epithelium and peristalsis of the terminal branches bronchial tree. In parallel, the intensity of secretion of the bronchial glands increases and becomes thinner.
2. Leads to increased synthesis of pulmonary surfactant. This substance covers inner surface pulmonary alveoli. Its presence causes the absence of their adhesion. The substance is synthesized from blood components.
3. Increases ciliary activity. Under the influence of ambroxol, the cilia lining the epithelium begin to move more actively. This helps clear mucus.

Thus, Lazolvan for inhalation, the instructions for use of which contain the full mechanism of action, accelerates mucociliary clearance. The result of this process is the removal of active biological agents. The product is recommended for respiratory pathologies accompanied by the release of viscous sputum.

Instructions for use: inhalation with Lazolvan and saline solution

Pharmaceutical products, aromatic oils, and plant extracts are used for inhalation. The procedure is a special type of therapy based on inhalation medicinal substances. Popular remedies include Lazolvan, a solution for inhalation and oral administration.

Inhalations with Lazolvan are carried out according to the instructions for use in combination with saline solution in a nebulizer. For speedy recovery It is important to follow some recommendations.

Dosage for adults

To obtain a stable effect, it is necessary to do a course of procedures. The manufacturer stipulates in the instructions for use the following proportions for adults for inhalation with Lazolvan and saline:

• optimal - 3–4 milliliters;
• 2–4 procedures must be done per day;
• to achieve a therapeutic effect, combine with sodium chloride (0.9 percent concentration) in equal proportions.

Inhalations with Lazolvan and saline (the dosage for adults is calculated per day) are recommended to be done at a normal respiratory rate. The increased rhythm serves to intensify the cough.

Proportions for children

Lazolvan for inhalation for children (the instructions for use recommend it from the age of six) is used with sodium chloride at a concentration of 0.9 percent.

From the age of twelve, the dosage for children of inhalation with Lazolvan and saline increases to the amount required by an adult. Before this, the following proportions are recommended for children for inhalation with saline:

• daily amount medicine- 2 ml or less;
• assigned in equal proportions.

For inhalations in a nebulizer for children, the instructions for use recommend limiting the procedure to 5–7 minutes.

How to breed?

The components are mixed in equal quantities, but may vary as agreed with the doctor. In addition, it is important:

1. Inhalations with Lazolvan for children and adults are carried out with warm liquid. According to the instructions for use, the solution should have a temperature of 20–30 degrees. It is not advisable to use a microwave. The best option- water bath.
2. Instructions for use prohibit combination with antitussive therapy. Inhalation of Lazolvan in this case may lead to bronchospasm.
3. If kidney function is impaired, the amount of the drug should be reduced. In this case, how to dilute Lazolvan for inhalation should be checked with a doctor. Certain patients you will have to completely abandon such therapy.

How to do the procedure?

There are some rules to follow:

1. Use an inhaler. Inhalation of Lazolvan using a nebulizer is most preferable.
2. Instructions for use with Lazolvan for inhalation advise not to carry out the procedure if the thermometer shows more than 37–37.5 degrees. The procedure should be postponed until the temperature normalizes.
3. Inhalation and exhalation are carried out freely, rhythmically, calmly. Clothing or posture should not restrict breathing.
4. Before the procedure, the patient must wash their hands.
5. It is not recommended to eat, drink or smoke within an hour after the procedure.
6. After each procedure, it is worth sterilizing the inhaler.
7. Therapy is carried out every 3–6 hours, not more often.

How to inhale with Lazolvan depends on the type of inhaler. Before the procedure, it is important to read the manufacturer's instructions. For inhalation by adults in a nebulizer, the instructions for use of Lazolvan recommend a procedure duration of 7–15 minutes. Asthmatics should take a bronchodilator beforehand.

Can this be done without a nebulizer?

A nebulizer turns liquid into an aerosol without heating. This ensures that tiny drops of the drug reach hard-to-reach areas of the mucosa. The instructions for using Lazovlan for inhalation in a nebulizer recommend this particular method due to its undeniable advantages. In the absence of a device, it is possible to use other inhalers that eliminate heating of the steam.

Can it be used for dry cough?

A dry cough is not accompanied by the release of sputum and has a paroxysmal character. Inhalations with Lazolvan for dry cough relieve the symptom and help the discharge to go away faster.

The cough becomes wet, and with sputum the body gets rid of active biological components. Inhalations with Lazolvan and saline (dosage for children and adults are indicated above) can and should be used for such a phenomenon.

During pregnancy

It is worth familiarizing yourself with how to take Lazolvan (solution for oral administration and inhalation), what restrictions exist on its use. Reasons to be careful are pregnancy and lactation. Exactly:

1. For inhalations during pregnancy, the first 3 months are prohibited due to possible negative consequences for the growth and development of the fetus.
2. Inhalations with Lazolvan during pregnancy are subsequently carried out with extreme caution. There are no studies confirming its harmlessness to the embryo.

The dosage of Lazolvan for inhalation for women during breastfeeding can be changed by a specialist. If individual intolerance occurs in the baby or mother, treatment should be interrupted.

Which is better?

Available on pharmacy shelves large number analogues. For the right choice it is necessary to have an understanding of their advantages and disadvantages.

Ambrobene

Ambrobene is a product for oral consumption and use in a nebulizer, manufactured by a German company. At its core, the product is an analogue of Lazolvan for inhalation. Both have similar features:

1. Active ingredient. Both remedies are based on the effect of ambroxol.
2. Dosage. The amount of active ingredient is identical for both drugs.
3. Features of use. Ambrobene should be diluted similarly to the instructions on how to dilute Lazolvan with saline solution for inhalation. You must first heat the liquid to a warm state.

However, there are many differences, in particular:

• minor components are different, but this does not play a significant role for the patient;
• have different age restrictions(Ambrobene is prescribed from the age of 12, and from the age of 6);
• Abrobene leads to the development of a reflex cough and has a less mild effect;
• Ambrobene can serve as a provoking factor for the development of bronchospasm;
• Ambrobene tastes more bitter and unpleasant;
• Ambrobene costs half as much, but has more possible side effects.

When looking for information on which is better for inhalation - Lazolvan or Ambrobene, the scales tip towards the former. However, the doctor determines the treatment based on the patient’s parameters.

Experts often recommend Lazolvan and Berodual for inhalation. The second drug is manufactured in Germany. It is completely different in composition and effect produced. The product is recommended for:

• prevention of disease and mitigation of symptoms;
• treatment of chronic obstructive pulmonary disease;
• treatment (with/without emphysema).

Berodual relieves bronchospasm, has a positive effect on the functioning of the lungs, and relaxes their muscles. It is recommended in the presence of an allergic component, during treatment for pneumonia. It is incorrect to say which is better for inhalations, Berodual or Lazolvan. These are complementary, but not interchangeable medicines.

In case of complex paroxysmal cough (for example, false croup) resort to inhalation of Lazolvan with Berodual. The advantages of this combination include:

1. Lazolvan and Berodual for inhalation together have a double effect. In particular, Berodual expands the bronchi.
2. To facilitate coughing, Lazolvan and Berodual for inhalation can be prescribed (Lazolvan promotes the discharge of sputum).

Berodual is a powerful therapy for damage to the respiratory system. Inhalation through a nebulizer with Lazolvan (the dosage for adults and children is calculated exclusively by the doctor) together with Berodual has a significant healing effect even in difficult situations.

Lazolvan for inhalation – medicinal medicine, made in the form of a solution. Significant function drug – treatment and elimination of cough. During inhalation, the medicine immediately enters the bronchial mucosa. There they expand, and the expectorant effect increases.

Lazolvan solution for inhalation is a transparent, slightly brownish liquid. The medicine is available in 100 ml bottles using dark glass. The kit includes a dosing cup.

1 ml of solution contains:

• ambroxol;
• citric acid monohydrate;
• benzalkonium chloride;
• sodium hydrogen phosphate dihydrate;
• purified water;
• sodium chloride.

Features of Lazolvan

Reviews from people using medicinal solution, confirm that this is an excellent alternative to potions and intramuscular injections. Its reasonable price, compared to other medications, makes it an indispensable assistant in the treatment of cough.

Inhalation of the medicine ensures its complete penetration into each part of the respiratory tract. Due to this, the disease goes away much faster. By inhaling the drug with steam, spasms in smooth muscles are eliminated. Removal of phlegm from the lungs occurs faster.

Inhalation of the drug is prescribed for any bronchopulmonary disease. The spraying process can quite worthy replace the use of Lazolvan solution internally. There may be situations in which Lazolvan solution for oral administration and inhalation are combined.

Indications for use:

• acute bronchitis;
• pneumonia;
• chronic lung disease;
• asthma.

Contraindications:

• children under 4 years old;
• allergic reaction to ambroxol;
• pregnancy;
• breastfeeding;
• frequent nosebleeds;
• elevated temperature -37.5.

Side effects:

• heartburn;
• headache;
• nausea.

Creation of an inhalation solution

Lazolvan solution in its pure form is not used for inhalation. It must be diluted and heated in warm water up to a temperature of 37 ° C.

Before using a medicinal solution, you need to know how to dilute it. To obtain maximum hydration, the drug must be mixed with a 0.9% sodium chloride solution. The ratio of mixing ingredients is 1:1.

The required dose for effective treatment is 2 ml. The duration of the procedure is no more than 10 minutes.

Lazolvan in solution according to the instructions is prohibited from being combined with other solutions whose pH is greater than 6.3. Also, the addition of cromoglycic acid can lead to some complications.

To prepare a medicinal solution, you must follow the rules:

• use a solution of 0.9% sodium chloride as a solvent;
• the use of distilled water and running water is undesirable;
• The container in which the saline solution is diluted must be sterile. This also applies to the mask. After each procedure, it is necessary to treat with a disinfectant solution;
• To prevent coughing during inhalation, do not take deep breaths. It is better to relax and breathe calmly;
• use only warm inhalation solution.

According to the instructions, it is recommended to prepare Lazolvan for inhalation as follows:

1. The product must be diluted with saline solution in a ratio of 1 to 1.
2. The diluted solution is heated to required temperature. Such conditions do not allow causing irritation in the respiratory tract.

The solution remaining after the procedure in the nebulizer for reuse not suitable.

In order to inhale Lazolvan, the following instructions for use are used:

1. Before the procedure, you must wash your hands thoroughly with soap to avoid germs.
2. A nebulizer, a device that sprays medicine, is being prepared. According to the instructions, the 2 parts of the device must be connected to each other.
3. Pour into a measuring cup medicinal substance. First of all, the required dosage of saline solution is poured in, then the medicine.
4. Through a special tube, the medicinal solution enters the respiratory system.
5. Adults use a mouthpiece during the procedure.
6. After the saline solution is placed in the inhaler, you must begin to breathe, inhaling the vapors.
7. Take a shallow breath through your mouth and hold your breath for 4 seconds. Exhales through the nose.

According to the instructions, Lazolvan in solution for inhalation is contraindicated for use at night. This is due to the stimulation of liquefaction and removal of sputum. As a result, a severe cough may occur.

Reviews from patients confirm this fact. Procedures should be performed during the daytime.

Caring for your inhalation device

At the end of the procedure, all parts of the nebulizer must be rinsed hot water. The use of brushes or other devices is not advisable. Ordinary soap solution does its job perfectly

The device must be sterilized within a week. For this, a special thermal disinfector is used, or you can boil it in hot water for 10 minutes.

Inhalation for children

The treatment process is the same for adults and children. Only the dosage and proportions are slightly different. Spraying of the medicinal solution is allowed for a child who has reached the age of four.

Lazolvan is prescribed to a child under six years of age in a dosage of no more than 2 ml. per day. Perform no more than two procedures per day.

Inhalation with Lazolvan for children over 6 years old is allowed to be done in a dose of 3 ml.

Parents, whose reviews can be found on specialized websites, strongly recommend inhalation for children through a nebulizer. This device converts a drug solution into an aerosol, sending it into the respiratory tract. Thanks to this device inhalation therapies can be carried out in comfortable conditions Houses. This is what is most often used during serious illnesses respiratory system. Lazolvan is considered a popular and effective medicine administered to a child’s body by inhalation.

Inhalation treatment method

The most asked question is “how to inhale Lazolvan for a child?”

Method of use of the medicinal solution:

In order not to provoke a cough, the child should be in a calm and not excited state. In the form of a game, tell what the inhaler is and how the process itself goes. Invite him to try this drug. It is important that the baby does not create sudden movements, thereby not harming himself.

Important for every parent to know

If a child has bronchial asthma, it is better to take bronchodilators first. Combining inhalation with such a medicine increases the concentration antimicrobials in lung tissues.

Before resorting to inhalation, it is necessary to show the child to a doctor and undergo tests. If the doctor approves of this method of treatment, he will advise you on how to do inhalations with Lazolvan; why do they need to be done; explain the subtleties and nuances of use.

An important factor is the choice of inhaler. In this case, the use of steam inhalers is undesirable.

To find out if your child has hypersensitivity to this drug, first you need to offer to take it internally, for example, in the form of syrup. If after taking the medicine there are no side effects or allergy symptoms have not appeared, the use of the solution is permitted.

Procedure deadlines

The second most important question is “how many days can you do inhalations with Lazolvan?”

To rid your child of a cough, treatment is necessary for 5 days. If the course of treatment does not help, you should not continue inhalations. It is necessary to show the child to the doctor.

According to Lazolvan's instructions, these actions must be performed twice a day. The duration of the procedure depends on the age of the child. It is contraindicated for children to breathe through a nebulizer for more than 5 minutes. Older children can easily withstand 7 to 10 minutes.

Composition of the drug

active ingredient: ambroxol hydrochloride;

1 tablet contains ambroxol hydrochloride 30 mg

excipients: lactose monohydrate, corn starch, silicon dioxide, colloidal magnesium stearate.

Dosage form

Pills.

Round, white or slightly yellowish color tablets, flat on both sides, with beveled edges on one side of the tablet - a notch and marking “67 °” on both sides of the notch, on the other side of the tablet a brand name is extruded.

Manufacturer's name and location. Boehringer Ingelheim Ellas A.E., Greece / Boehringer Ingelheim Ellas A.E., Greece. 5th km Paiania-Markopoulo, Koropi Attiki 19400, Greece / 5th km Paiania-Markopoulo, Koropi Attiki 19400, Greece.

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Pharmacological group

Medicines used for coughs and colds. Mucolytic agents.

ATC code R05C B06.

It has been preclinically proven that the active ingredient of Lazolvan tablets, ambroxol hydrochloride, increases the secretion of the glands of the respiratory tract. Ambroxol enhances the secretion of pulmonary surfactant by direct action on type II pneumocytes in the alveoli and Clara cells in the bronchioles, and also stimulates ciliary activity, thereby facilitating the secretion of mucus and its elimination (mucociliary clearance). Improvement in mucociliary function has been proven during clinical and pharmacological studies.

Activation of fluid secretion and increased mucociliary clearance facilitate the removal of mucus and relieve cough.

The local anesthetic effect of ambroxol hydrochloride was observed in a rabbit eye model, which may be explained by the sodium channel blocking properties. Research in vitro showed that ambroxol hydrochloride blocks neuronal sodium channels; binding was reversible and concentration dependent.

Ambroxol hydrochloride has demonstrated anti-inflammatory in vitro. Thus, ambroxol hydrochloride significantly reduces the release of cytokine from mononuclear and polymorphonuclear cells of blood and tissues.

As a result clinical trials involving patients with pharyngitis, a significant reduction in pain and redness in the throat when using the drug was proven.

Thanks to pharmacological property Ambroxol rapidly relieved pain in the treatment of diseases of the upper respiratory tract, observed during studies of the clinical effectiveness of inhaled forms of ambroxol.

The use of ambroxol hydrochloride increases the concentration of antibiotics (amoxicillin, cefuroxime, erythromycin and doxycycline) in bronchopulmonary secretions and sputum.

Absorption. Absorption of ambroxol hydrochloride from oral forms immediate release is rapid and complete, with a linear dose dependence over the therapeutic range. The maximum level in blood plasma is reached after 1-2.5 hours when taking oral dosage forms of immediate release and on average 6.5 hours when using dosage forms of slow release.

Distribution. When taken orally, the distribution of ambroxol hydrochloride from the blood to the tissues is rapid and pronounced, with high concentration active substance in the lungs. The expected volume of distribution after oral administration is 552 L. In blood plasma in the therapeutic dose range, approximately 90% of the drug is protein bound.

Metabolism and excretion. Approximately 30% of the dose after oral administration is eliminated by first-pass metabolism. Ambroxol hydrochloride is metabolized in the liver by glucuronidation and breakdown into dibromoantranilic acid (approximately 10% of the dose). Studies on human liver microsomes have shown that CYP3A4 is responsible for the metabolism of ambroxol hydrochloride to dibromoantranilic acid.

After 3 days of administration, about 6% of the dose is excreted in the urine unchanged, about 26% of the dose is excreted in conjugated form.

The plasma half-life is approximately 10:00. The total clearance is approximately 660 ml/min. Renal clearance is approximately 8% of the total. After 5 days, approximately 83% of the total dose is excreted in the urine.

Pharmacokinetics in special groups of patients. In patients with impaired liver function, the excretion of ambroxol hydrochloride is reduced, resulting in 1.3-2 times higher plasma levels. Since the therapeutic range of ambroxol hydrochloride is quite wide, there is no need to change the dosage.

Age and gender do not have a clinically significant effect on the pharmacokinetics of ambroxol hydrochloride, so any dose adjustment is not required.

Indications.

Secretolytic therapy for acute and chronic bronchopulmonary diseases associated with impaired bronchial secretion and weakened mucus movement.

Contraindications.

Lazolvan should not be used in patients with hypersensitivity to ambroxol hydrochloride or other components of the drug.

Lazolvan, 30 mg tablets, is not intended for use in children under 6 years of age due to dosage. For children under 6 years of age, it is recommended to use Lazolvan, syrup 15 mg / 5 ml, or Lazolvan, solution for inhalation and oral administration, 15 mg / 2 ml.

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Proper safety precautions for use

There have been only a few reports of GI skin lesions: Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's syndrome) associated with the use of expectorants such as ambroxol hydrochloride. They could mainly be explained by the severity of the underlying disease in patients and the simultaneous use of another drug.

Also on initial stage Stevens-Johnson syndrome or Lyell's syndrome patients may have nonspecific, flu-like symptoms such as fever, aches, rhinitis, cough and sore throat. It is wrong with such nonspecific, similar signs onset of flu symptoms can be applied symptomatic treatment cough and cold medications. Therefore, if new lesions of the skin or mucous membranes appear, you should immediately seek medical help and stop treatment with ambroxol hydrochloride.

Lazolvan tablets contain 684 mg of lactose in the maximum recommended daily dose (120 mg).

Patients with rare hereditary conditions of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption should not take this drug.

Since ambroxol can increase mucus secretion, the drug Lazolvan, tablets, should be used with caution in cases of impaired bronchial motility and increased mucus secretion (for example, with such rare disease as primary ciliary dyskinesia).

Patients with impaired renal function or severe liver failure should take Lazolvan tablets only after consulting a doctor. When using ambroxol, like any active substance, which is metabolized in the liver and then excreted by the kidneys, there is an accumulation of metabolites formed in the liver in patients with severe renal failure.

Use during pregnancy or breastfeeding

Pregnancy. Ambroxol hydrochloride penetrates the placental barrier. Animal studies have shown no direct or indirect harmful effects on pregnancy, embryonic/fetal development, childbirth or postnatal development.

As a result of clinical studies of the use of the drug after the 28th week of pregnancy, no harmful influence for the fruit.

However, you need to follow the usual precautions regarding taking medications during pregnancy. In particular, it is not recommended to use Lazolvan tablets in the first trimester of pregnancy.

Breastfeeding. Ambroxol hydrochloride penetrates into breast milk. Lazolvan tablets are not recommended for use during breastfeeding.

Fertility. Preclinical studies do not indicate direct or indirect harmful effects on fertility.

The ability to influence the reaction rate when driving vehicles or other mechanisms

There is no data on the effect on reaction speed when operating vehicles or other mechanisms. No relevant studies have been conducted.

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Children.

For use in children over 6 years of age who cannot tolerate syrup or solution for inhalation and oral administration.

Method of administration and dose.

children aged 6 to 12 years as a rule, the dose is 1/2 tablet 2-3 times a day (equivalent to 30-45 mg ambroxol hydrochloride / day);

adults and children over 12 years old the usual dose is 1 tablet 3 times daily for the first 2-3 days (equivalent to 90 mg ambroxol hydrochloride/day). Continue treatment with 1 tablet 2 times a day (equivalent to 60 mg ambroxol hydrochloride / day).

If necessary, the therapeutic effect for adults and children over 12 years of age can be enhanced by taking 2 tablets 2 times a day (equivalent to 120 mg ambroxol hydrochloride / day).

The tablets should be swallowed whole with plenty of liquid (such as water, tea or fruit juice) after meals.

In general, there are no restrictions on the duration of use, but long-term therapy should be carried out under supervision.

Lazolvan tablets should not be used for longer than 4-5 days without consulting a doctor.

Overdose

To date, there are no reports of human overdoses. Symptoms known from rare reports of overdose and/or cases of drug misuse correspond to those known side effects Lazolvan in recommended doses and requires symptomatic treatment.