Uses

Combination mucolytic and bronchodilator used for the management of productive cough associated with acute and chronic respiratory conditions such as bronchitis, asthma, and COPD. Ambroxol and guaifenesin facilitate mucus clearance while theophylline provides bronchospasm relief.

Do not use if

Contraindicated in patients with hypersensitivity to any component. Theophylline is contraindicated in active peptic ulcer disease and seizure disorders unless adequately controlled. Use with caution in patients with cardiac arrhythmias.

Side effects

Ambroxol may cause nausea and gastrointestinal upset. Guaifenesin may cause nausea and drowsiness. Theophylline has a narrow therapeutic index; toxicity manifests as nausea, vomiting, tachycardia, tremor, insomnia, and at high levels seizures and arrhythmias.

Warnings

Monitor theophylline serum levels to avoid toxicity; therapeutic range is 10–20 mcg/mL. Multiple drug interactions with theophylline (e.g., fluoroquinolones, macrolides, cimetidine) can raise serum levels. Reduce dose in elderly patients and those with hepatic impairment.

How it works

Ambroxol stimulates surfactant production and reduces mucus viscosity. Guaifenesin is an expectorant that increases respiratory tract secretions to facilitate expectoration. Theophylline inhibits phosphodiesterase, increasing intracellular cAMP leading to smooth muscle relaxation and bronchodilation; it also has mild anti-inflammatory and diaphragm stimulant effects.

Storage

Store at room temperature, below 30°C, away from moisture and direct sunlight. Keep out of reach of children.