Usage
Acebrophylline + Doxofylline is prescribed for the symptomatic management of respiratory conditions like:
- Chronic Obstructive Pulmonary Disease (COPD): This combination helps manage symptoms like breathlessness, wheezing, and chronic cough, and improves lung function.
- Asthma: It is effective in controlling asthma symptoms, preventing asthma attacks, and improving overall respiratory function.
- Bronchitis: It alleviates symptoms of bronchitis, including coughing and difficulty in breathing.
- Bronchospasm: It is indicated for prophylaxis and symptomatic treatment of bronchospasm.
Pharmacological Classification: Bronchodilator, Mucolytic (Acebrophylline)
Mechanism of Action: Acebrophylline decreases the thickness and stickiness of lung secretions, making them easier to cough up. It also has anti-inflammatory and antioxidant properties that reduce airway inflammation. Doxofylline, a xanthine derivative, relaxes the bronchial tubes’ muscles, leading to bronchodilation and improved airflow. It does this by blocking phosphodiesterases, raising intracellular cyclic AMP levels, causing smooth muscle relaxation in the airways. Doxofylline has minimal activity on adenosine receptors, which contributes to a reduced side effect profile compared to other xanthines.
Alternate Names
While the generic name is Acebrophylline + Doxofylline, it is marketed under various brand names, including S PHYLLIN DX, Doxocar-AC and Spirodin-AB.
How It Works
Pharmacodynamics: Acebrophylline acts as a mucolytic agent, reducing the viscosity of mucus and facilitating its expulsion. It also possesses anti-inflammatory properties, further aiding in airway opening. Doxofylline, on the other hand, primarily acts as a bronchodilator by relaxing the smooth muscles in the airways.
Pharmacokinetics: Acebrophylline and doxofylline is administered orally. The exact mechanisms of absorption, distribution, metabolism, and excretion for the combination aren’t detailed in the provided sources, however it’s likely that the liver plays a significant role in metabolizing both components, and elimination is likely primarily renal. The effects of the combination are primarily localized to the respiratory system. Specific details regarding receptor binding or neurotransmitter modulation for this combination were not found in the sources.
Dosage
Dosage guidelines can vary depending on patient factors and local practices. Always refer to local guidelines and individual product information. The following is a general guide based on available information, primarily relevant to adult patients:
Standard Dosage
Adults:
The standard dosage commonly cited is one tablet of Acebrophylline 100mg + Doxofylline 400mg twice daily. It’s often recommended to take the medication after meals to minimize gastrointestinal discomfort.
Children:
Acebrophylline + Doxofylline is generally not recommended for children under 12 years of age. Safety and effectiveness in younger children have not been established. Some sources specifically advise against use in children under 6. When prescribed for children 12 years and older, dosage is usually adjusted based on weight or age, with lower doses than adult doses.
Special Cases:
- Elderly Patients: Dosage reduction may be necessary.
- Patients with Renal Impairment: Dosage reduction is likely required.
- Patients with Hepatic Dysfunction: Dosage adjustments are likely needed due to potential impaired metabolism.
- Patients with Comorbid Conditions: Caution and potential dosage adjustments are necessary for patients with cardiovascular diseases (hypertension, heart failure, arrhythmias), hyperthyroidism, peptic ulcer disease, seizure disorders, or concomitant infections.
Clinical Use Cases
Specific dosage recommendations for clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations were not found in the provided sources.
Dosage Adjustments
Dosage adjustments are necessary for patients with renal or hepatic impairment, and in patients with specific comorbid conditions as noted above. Dosage may also need to be adjusted in smokers.
Side Effects
Common Side Effects:
- Nausea and vomiting
- Abdominal discomfort/pain
- Headache
- Dizziness
- Irritability
- Insomnia
- Fast heart rate (palpitations)
- Stomach discomfort
- Drowsiness
- Skin rash or itching.
- Diarrhea
- Fast breathing
Rare but Serious Side Effects:
- Allergic reactions (rash, itching, swelling, severe dizziness, trouble breathing)
- Seizures
- Cardiovascular effects (changes in heart rate, palpitations)
- Hypotension
- Gastrointestinal bleeding
Long-Term Effects:
Information on potential long-term complications from prolonged use was not found in the provided sources.
Adverse Drug Reactions (ADR):
Clinically significant ADRs requiring immediate intervention can include severe allergic reactions, seizures, significant cardiovascular effects, and gastrointestinal bleeding.
Contraindications
- Hypersensitivity to acebrophylline, doxofylline, or other xanthine derivatives.
- Acute myocardial infarction
- Arrhythmia
- Hemodynamic instability.
Drug Interactions
Acebrophylline + Doxofylline can interact with various medications:
- Certain antibiotics (ciprofloxacin, erythromycin, clarithromycin)
- Corticosteroids (prednisone)
- Diuretics (furosemide)
- Beta-2 agonists (salbutamol)
- Monoamine oxidase inhibitors (selegiline)
- Water pills (furosemide)
- Medicines used to treat gout (allopurinol)
- Antacids (cimetidine)
- Antibiotics (amoxicillin, doxycycline, clindamycin, lincomycin)
- Drugs used to lower high blood pressure (diltiazem, verapamil, propranolol)
- Heart-related medicines (isoprenaline)
- Anthelmintics (thiabendazole)
- Oral contraceptives (ethinylestradiol)
- Central nervous system stimulant (ephedrine)
- Flu vaccine
- Anticonvulsants (phenytoin)
- Caffeine-containing foods and beverages
It’s important to inform the doctor about all medications being taken to avoid potential interactions.
Pregnancy and Breastfeeding
The safety of Acebrophylline + Doxofylline during pregnancy and lactation has not been established. It should be used during pregnancy only if clearly needed and under strict medical supervision. It’s generally not recommended during breastfeeding.
Drug Profile Summary
- Mechanism of Action: Bronchodilation (doxofylline), mucolytic and anti-inflammatory (acebrophylline).
- Side Effects: Nausea, vomiting, headache, dizziness, gastrointestinal discomfort, palpitations, insomnia. Rarely, allergic reactions, seizures.
- Contraindications: Hypersensitivity, acute MI, arrhythmia, hemodynamic instability.
- Drug Interactions: Interacts with certain antibiotics, corticosteroids, diuretics, beta-2 agonists, and others.
- Pregnancy & Breastfeeding: Use with caution during pregnancy if clearly needed; not recommended during breastfeeding.
- Dosage: Typically 100mg acebrophylline/400mg doxofylline twice daily in adults. Adjustments needed for various factors.
- Monitoring Parameters: Heart rate, blood pressure, respiratory rate, CNS effects.
Popular Combinations
While this medication itself is a combination product, further information on its combination with other drugs wasn’t available in the provided sources.
Precautions
- General Precautions: Screening for allergies, metabolic disorders, and organ dysfunction.
- Specific Populations: Caution in pregnant women, breastfeeding mothers, children, and the elderly.
- Lifestyle Considerations: Avoid alcohol; inform your doctor about smoking habits and diet.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Acebrophylline + Doxofylline?
A: The standard adult dosage is typically one tablet (100mg acebrophylline/400mg doxofylline) twice daily, taken after meals. Pediatric dosage needs individualized adjustment.
Q2: What are the common side effects?
A: Common side effects include nausea, vomiting, headache, dizziness, and gastrointestinal issues.
Q3: Is it safe to take during pregnancy or breastfeeding?
A: Its use during pregnancy and breastfeeding is generally discouraged unless the benefits clearly outweigh the risks. It is generally not recommended during breastfeeding.
Q4: What conditions does this medication treat?
A: It primarily treats COPD, asthma, bronchitis, and bronchospasm.
Q5: Are there any drug interactions I should be aware of?
A: Yes, it can interact with several drugs, including certain antibiotics, corticosteroids, and others. Provide a full medication history to your doctor.
Q6: What precautions should I take while on this medication?
A: Inform your physician about any pre-existing conditions and avoid alcohol. Monitor for changes in heart rate, respiratory rate, and any unusual symptoms.
Q7: Can this medication be used in children?
A: It is not recommended for children under 12. For older children, doses must be adjusted based on age and weight.
Q8: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember, unless it is almost time for the next dose. Do not double the dose to catch up.
Q9: How should this medication be stored?
A: Store at room temperature, away from direct light and moisture, and keep out of reach of children.
