Usage
Acebrophylline is prescribed for the prevention and treatment of symptoms associated with respiratory conditions like:
- Asthma: A chronic condition characterized by airway narrowing, swelling, and mucus production, leading to breathing difficulties.
- Chronic Obstructive Pulmonary Disease (COPD): A group of lung diseases, including emphysema and chronic bronchitis, that block airflow to the lungs.
- Acute and Chronic Bronchitis: Inflammation of the bronchial tubes.
- Sinusitis: Inflammation of the sinuses.
Pharmacological Classification: Acebrophylline is classified as a bronchodilator and mucolytic.
Mechanism of Action: Acebrophylline combines theophylline-7-acetate and ambroxol. Theophylline-7-acetate relaxes the smooth muscles of the airways, while ambroxol thins and loosens mucus. This dual action widens the airways and facilitates easier breathing and mucus clearance.
Alternate Names
Acebrophylline is also known as Acefylline piperazine. Brand names include Acibro, Acefylline, Brophyle, Mucophyllin, Ab-Resp, Aphyren, and others.
How It Works
Pharmacodynamics: Acebrophylline exerts its effects through a combination of bronchodilation and mucolytic action. Bronchodilation occurs via inhibition of phosphodiesterases, leading to increased cyclic adenosine monophosphate (cAMP) levels, which relaxes bronchial smooth muscles. Mucolytic action is achieved by breaking down disulfide bonds in mucus, reducing its viscosity. Acebrophylline also exhibits anti-inflammatory properties by inhibiting the production of leukotrienes and tumor necrosis factor.
Pharmacokinetics: Acebrophylline is administered orally and is absorbed in the gastrointestinal tract. Peak plasma concentrations are reached within 1-2 hours. The drug is metabolized in the liver and excreted primarily through the kidneys. The plasma half-life ranges from 4 to 9 hours.
Mode of Action: At the cellular level, Acebrophylline inhibits phosphodiesterases, increases cAMP, and relaxes bronchial smooth muscles. It also breaks down disulfide bonds in mucus, reducing viscosity and promoting clearance. Additionally, it inhibits the production of inflammatory mediators like leukotrienes and tumor necrosis factor.
Elimination Pathways: Primarily renal excretion, with some hepatic metabolism.
Dosage
Standard Dosage
Adults:
100 mg twice daily.
Children:
Dosage varies depending on age and formulation (syrup). Consult a physician for pediatric dosing.
Special Cases:
- Elderly Patients: Dosage adjustment may be necessary.
- Patients with Renal Impairment: Dose reduction may be required.
- Patients with Hepatic Dysfunction: Dosage adjustment may be necessary.
- Patients with Comorbid Conditions: Exercise caution and adjust dose as needed.
Clinical Use Cases
Dosage recommendations for specific clinical settings should be determined by a physician based on the patient’s condition and response to therapy.
Dosage Adjustments: Dosage modifications are based on renal and hepatic function, other medical conditions, and concomitant medications.
Side Effects
Common Side Effects:
Nausea, vomiting, diarrhea, stomach discomfort, heartburn, dizziness, headache, skin rash, drowsiness.
Rare but Serious Side Effects:
Allergic reactions (rash, itching, difficulty breathing), gastrointestinal bleeding, changes in blood pressure, increased heart rate, unusual tiredness and weakness, numbness of the hands, sleeplessness, fever with chills.
Long-Term Effects:
Data on long-term effects are limited. Monitor for potential chronic complications with prolonged use.
Adverse Drug Reactions (ADR):
Severe allergic reactions, bronchospasm, liver damage, kidney damage.
Contraindications
Hypersensitivity to acebrophylline, theophylline, ambroxol or other xanthine derivatives; low blood pressure; acute myocardial infarction; hemodynamic instability; arrhythmias; severe liver or kidney disease; pregnancy; breastfeeding.
Drug Interactions
Acebrophylline may interact with several medications, including:
- Quinolones (ciprofloxacin)
- Cimetidine
- Erythromycin, other macrolides
- Oxytetracycline, other tetracyclines
- Lincomycin
- Cephalexin
- Barbiturates (phenytoin)
- Furosemide
- Corticosteroids
- Oral contraceptives
- Alcohol
Consult a physician or pharmacist for a comprehensive list of potential drug interactions.
Pregnancy and Breastfeeding
Acebrophylline is contraindicated in pregnancy and breastfeeding.
Drug Profile Summary
- Mechanism of Action: Bronchodilator and mucolytic. Inhibits phosphodiesterases, increases cAMP, relaxes bronchial smooth muscles, breaks down mucus, and has anti-inflammatory properties.
- Side Effects: Nausea, vomiting, diarrhea, dizziness, headache, rash.
- Contraindications: Hypersensitivity, hypotension, heart conditions, liver/kidney disease, pregnancy, breastfeeding.
- Drug Interactions: Quinolones, cimetidine, macrolides, barbiturates, furosemide, and others.
- Pregnancy & Breastfeeding: Contraindicated.
- Dosage: Adults: 100 mg twice daily. Pediatric dosage varies.
- Monitoring Parameters: Respiratory function, potassium levels.
Popular Combinations
Acebrophylline is sometimes combined with acetylcysteine for enhanced mucolytic effects.
Precautions
Caution should be exercised in patients with heart conditions, seizures, gastrointestinal disorders, hepatic or renal impairment. Adjust dosage as needed. Avoid alcohol consumption during treatment. Pre-screening for allergies and organ dysfunction is recommended.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Acebrophylline?
A: The standard adult dose is 100mg twice daily. Pediatric doses vary based on age and require a physician’s recommendation.
Q2: Can I take Acebrophylline during pregnancy?
A: No, Acebrophylline is contraindicated during pregnancy.
Q3: Can I take Acebrophylline while breastfeeding?
A: No, Acebrophylline is contraindicated while breastfeeding.
Q4: What are the common side effects of Acebrophylline?
A: Common side effects include nausea, vomiting, diarrhea, stomach discomfort, dizziness, and headache.
Q5: Does Acebrophylline interact with other medications?
A: Yes, Acebrophylline can interact with other medications, such as quinolones, cimetidine, macrolides, and theophylline. Consult with your physician or pharmacist for a comprehensive list of potential drug interactions.
Q6: Can patients with liver or kidney disease take Acebrophylline?
A: Acebrophylline should be used with caution in patients with liver or kidney disease, and dosage adjustments may be necessary.
Q7: What should I do if I miss a dose of Acebrophylline?
A: Take the missed dose as soon as you remember, unless it is almost time for your next dose. Do not double the dose.
Q8: How does Acebrophylline differ from theophylline?
A: Acebrophylline combines theophylline-7-acetate with ambroxol. This combination provides both bronchodilation and mucolytic action, whereas theophylline primarily acts as a bronchodilator. Acebrophylline may offer improved mucus clearance compared to theophylline alone.
Q9: Are there any precautions for elderly patients taking Acebrophylline?
A: Yes, elderly patients may require dosage adjustments due to age-related changes in drug metabolism and clearance. Careful monitoring is recommended.
