Usage
This combination medication is primarily prescribed for the relief of symptoms associated with the common cold, flu, and other upper respiratory tract infections. These symptoms include cough (both dry and productive), nasal congestion, runny nose, sneezing, itchy or watery eyes, and throat irritation.
Pharmacological Classification:
This combination includes drugs from multiple classifications:
- Ambroxol: Mucolytic, expectorant
- Cetirizine: Antihistamine
- Dextromethorphan Hydrobromide: Cough suppressant (antitussive)
- Phenylephrine: Decongestant (sympathomimetic)
Mechanism of Action:
- Ambroxol: Reduces the viscosity of mucus by breaking down mucopolysaccharide fibers, making it easier to cough up.
- Cetirizine: Blocks the action of histamine, a chemical mediator responsible for allergic symptoms.
- Dextromethorphan Hydrobromide: Suppresses the cough reflex by acting on the cough center in the brain.
- Phenylephrine: Constricts blood vessels in the nasal passages, reducing swelling and congestion.
Alternate Names
This combination medication does not have a universally recognized international non-proprietary name (INN). It is often referred to by the names of its constituent drugs. A variety of brand names exist depending on the manufacturer and region. Some brand names identified in the sources include “DEXMIN-ACD,” “Tussin-DMR,” “Kaykof-Q,” “Coflez-DX,” “Allerhin D Plus,” “Altime CF,” “Alvetus DMR,” “Kozifed Plus,” “Weecof DMR,” “Cufsniff AD,” “Cetmet Tcf,” “Broncolite-AZ”, and “ZEFCOLIN.”
How It Works
Pharmacodynamics:
The combined effects of the individual components provide symptomatic relief from cold and flu symptoms. Ambroxol facilitates mucus clearance, cetirizine reduces allergic responses, dextromethorphan suppresses cough, and phenylephrine relieves nasal congestion.
Pharmacokinetics:
- Absorption: All four components are absorbed orally.
- Metabolism: Primarily hepatic metabolism, especially by CYP450 enzymes for cetirizine and dextromethorphan.
- Elimination: Mainly renal excretion.
Mode of Action:
- Ambroxol: Modifies the structure and transportability of mucus.
- Cetirizine: H1-receptor antagonist.
- Dextromethorphan: NMDA receptor antagonist, sigma-1 receptor agonist.
- Phenylephrine: Alpha-1 adrenergic receptor agonist.
Dosage
Standard Dosage
Children: Dosages for children should be determined by a physician based on age and weight. Several sources caution against using this combination in young children.
Special Cases:
- Elderly Patients/Patients with Renal/Hepatic Impairment: Dosage adjustments are usually required based on organ function. Medical advice is necessary.
- Patients with Comorbid Conditions: Pre-existing conditions like high blood pressure, heart disease, glaucoma, hyperthyroidism, asthma, COPD, and others may necessitate adjustments.
Clinical Use Cases
The sources primarily associate this combination with common cold and flu symptoms. It’s not typically adjusted for specific clinical settings like intubation, surgery, mechanical ventilation, or ICU use. Individual components might be used in such situations but not typically in this fixed combination.
Dosage Adjustments
Necessary modifications depend on individual patient factors. Consult a physician for guidance.
Side Effects
Common Side Effects
Nausea, vomiting, stomach upset, drowsiness, dizziness, dry mouth, headache, fatigue.
Rare but Serious Side Effects
Allergic reactions, difficulty breathing, palpitations, hallucinations.
Long-Term Effects
Information on long-term effects from prolonged use of this specific combination isn’t readily available.
Contraindications
Hypersensitivity to any component, concurrent use of MAO inhibitors, severe liver or kidney disease, certain heart conditions.
Drug Interactions
Antihistamines, antidepressants, opioid pain medications, MAO inhibitors, other cough suppressants, antihypertensives, sedatives, antifungals, antibiotics, alcohol.
Pregnancy and Breastfeeding
The safety profile during pregnancy and breastfeeding isn’t well-established. Consult a physician before use.
Drug Profile Summary
- Mechanism of Action: See “Mechanism of Action” section above.
- Side Effects: See “Side Effects” section above.
- Contraindications: Hypersensitivity, MAOI use, severe organ dysfunction.
- Drug Interactions: Multiple; see “Drug Interactions” section above.
- Pregnancy & Breastfeeding: Consult physician before use.
- Dosage: Varies; see “Dosage” section above.
- Monitoring Parameters: Respiratory rate, cough frequency, blood pressure, heart rate, allergy symptoms.
Popular Combinations
Not explicitly mentioned in sources for this specific combination, however many alternative combinations with similar therapeutic goals exist.
Precautions
See “Contraindications” and “Drug Interactions”. Exercise caution in patients with pre-existing conditions. Avoid alcohol. May impair driving abilities.
FAQs
Q1: What is the recommended dosage for Ambroxol + Cetirizine + Dextromethorphan Hydrobromide + Phenylephrine?
A: Dosage varies by patient and formulation. Consult prescribing information or a physician.
Q2: Can this combination be used in children?
A: Use with caution in children. Consult a pediatrician for appropriate dosage. Several sources caution against its use for very young children.
Q3: Can pregnant or breastfeeding women take this medicine?
A: Consult a doctor before use during pregnancy or lactation.
Q4: What are the potential drug interactions?
A: See “Drug Interactions” section. Inform your physician about all medications you are taking.
Q5: What are the common side effects?
A: See “Common Side Effects” section.
Q6: What should I do if I experience severe side effects?
A: Seek immediate medical attention.
Q7: Can I drive while taking this medication?
A: Use caution as it can cause drowsiness.
Q8: Are there any dietary restrictions while taking this medication?
A: Alcohol should be avoided. Adequate hydration is recommended.
Q9: How long should I take this medication?
A: Follow your doctor’s recommendations. It is generally for short-term use.
