Pharmacodynamics. Stoptussin is a combined preparation with antitussive, mucolytic and expectorant effects. Butamirate citrate refers to a non-opioid antitussive agent of peripheral action, exhibits a local enesthetic effect on nerve endings that transmit ascending signals from the respiratory tract. Unlike opioid antitussives, it does not cause a central inhibitory effect, does not depress the respiratory center, and does not cause addiction.
The antitussive effect of citrate butamirate is complemented by the expectorant effect of guaifenesin.
Guaifenesin reveals secretolytic (by directly enhancing the secretion of the bronchial glands and stimulating the elimination of acidic glycoproteins from acinar cells) and secretomotor properties (reduces the viscosity of sputum and facilitates the evacuation of mucus and its coughing).
Pharmacokinetics. Butamirate citrate is rapidly and completely absorbed, 98% binds to blood plasma proteins. As a result of metabolism, two metabolites are formed, which have an antitussive effect, and more than 90% of them are excreted by the kidneys; only a small part is excreted in the feces. Biological T½ is about 6 hours.
Guaifenesin after oral administration is rapidly and easily absorbed in the gastrointestinal tract. A small part of it binds to plasma proteins. Excreted by the kidneys, mainly in the form of metabolites, infrequently - unchanged. Biological T1 / 2 - 1 h.
Dry, irritating, paroxysmal cough of various origins; the preparation in the form of solution and syrup can be used to eliminate cough in the pre- and postoperative period.
Stopussin drops: body weight 7 kg - 8 drops every 6-8 hours (3-4 times a day); 7-12 kg - 9 drops every 6-8 hours (3-4 times); 13–20 kg - 14 drops every 8 hours (3 times); 21-30 kg - 14 drops every 6-8 hours (3-4 times); 31-40 kg - 16 drops every 6-8 hours (3-4 times); 41-50 kg - 25 drops every 8 hours (3 times); 51–70 kg - 30 drops every 8 hours (3 times); from 71 kg - 40 drops every 8 hours (3 times a day). The preparation is recommended to be taken after meals. The appropriate number of drops are diluted in 100 ml of liquid (water, tea or fruit juice). For children who are unable to drink 100 ml of fluid, you can reduce the amount of fluid to ensure that the correct dose is taken.
The maximum daily dose of guaifenesin for children aged 6 months to 2 years is 300 mg (102 drops), for children aged 2-6 years - 600 mg (204 drops), 6-12 years old - 1200 mg / day, for adults and children over the age of 12 years - 2400 mg / day.
Do not take the preparation for more than 7 days without consulting a doctor.
Hypersensitivity to the components of the preparation, myasthenia gravis.
If the recommended dosage is adhered to, patients tolerate the preparation well. side effects usually disappear after dose reduction.
Metabolic disorders: lack of appetite.
From the nervous system: headache, drowsiness.
From the respiratory system: shortness of breath.
Hearing impairment and vestibular disorders: dizziness.
From the gastrointestinal tract: discomfort, nausea, stomach pain, vomiting, diarrhea. If you experience stomach discomfort or other unusual effects, you should stop using the preparation and consult your doctor.
On the part of the skin and subcutaneous tissue: allergic reactions, including anaphylactic shock, angioedema, rash, pruritus, urticaria, exanthema.
From the urinary system: urolithiasis.
When using the preparation, you must refrain from drinking alcoholic beverages. the preparation is not used in patients with:
The preparation is used with caution in asthma, tuberculosis, pneumococcosis.
If the cough persists or worsens, treatment should be reviewed.
The syrup contains liquid maltitol. Patients who have an established rare hereditary fructose intolerance should not take this preparation.
During pregnancy and breastfeeding. There have been no controlled studies involving pregnant women in humans or animals.
An increase in the incidence of inguinal hernia in newborns has been reported with the use of guaifenesin in the first trimester of pregnancy. Therefore, the preparation is contraindicated in the first trimester of pregnancy.
The use of the preparation in the II, III trimester of pregnancy or during lactation is possible if, in the opinion of the doctor, the expected positive effect for the mother outweighs the potential risk for the fetus / child.
It is not known whether butamirate citrate or guaifenesin passes into breast milk.
Taking into account safety, it is necessary to carefully weigh the benefits and risks of using the preparation during breastfeeding. The use of the preparation during breastfeeding is possible if, in the opinion of the doctor, the expected positive effect for the mother outweighs the potential risk for the child.
Children. From 6 months according to indications
The ability to influence the reaction rate when driving or working with other mechanisms. In rare cases, Stoptussin causes drowsiness, which may have some effect on the ability to drive vehicles or operate machinery. Therefore, you should be careful when driving vehicles or performing other work requiring attention (for example, when operating machinery).
Since butamirate suppresses the cough reflex, the simultaneous use of expectorants should be avoided, because this can lead to stagnation of mucus in the airways, which increases the risk of bronchospasm and respiratory tract infection.
Lithium and magnesium enhance the effect of guaifenesin.
Guaifenesin enhances the analgesic effect of paracetamol and acetylsalicylic acid, and also enhances the effect of alcohol and other preparations that depress the function of the central nervous system. Centrally acting muscle relaxants can increase the severity of the side effects of guaifenesin, especially muscle weakness.
Impact on laboratory test results
Guaifenesin can cause false positive results in diagnostic tests that detect 5-hydroxyindoleacetic acid (photometric method using nitrosonaphthol as a reagent) and vanillyl mandelic acid in urine. Therefore, treatment with Stoptussin must be discontinued 48 hours before urine collection for this analysis.
In case of an overdose, signs of the toxic effect of guaifenesin predominate - drowsiness, muscle weakness, nausea, vomiting, diarrhea, dizziness, arterial hypotension. X-ray negative urolithiasis is possible. there is no specific antidote.
Treatment: gastric lavage, intake of activated charcoal, symptomatic therapy aimed at maintaining the function of the cardiovascular and respiratory system, kidneys and electrolyte balance.
In original packaging at temperatures up to 25 ° c. Do not cool or freeze drops! after opening the bottle, store the syrup for no more than 4 weeks.
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