Ambroxol

Ambroxol

Systematic (IUPAC) name
trans-4-(2-Amino-3,5-dibrombenzylamino)-cyclohexanol
Clinical data
AHFS/Drugs.com	International Drug Names
Pregnancy cat.	?
Legal status	?
Identifiers
CAS number	18683-91-5 Y
ATC code	R05CB06
PubChem	CID 2132
ChemSpider	10276826 Y
UNII	200168S0CL Y
KEGG	D07442 Y
ChEMBL	CHEMBL153479 Y
Chemical data
Formula	C13H18Br2N2O
Mol. mass	378.10
SMILES	eMolecules & PubChem
InChI InChI=1S/C13H18Br2N2O/c14-9-5-8(13(16)12(15)6-9)7-17-10-1-3-11(18)4-2-10/h5-6,10-11,17-18H,1-4,7,16H2/t10-,11- Y Key:JBDGDEWWOUBZPM-XYPYZODXSA-N Y
Y(what is this?)  (verify)

Ambroxol hydrochloride tablets in Japan

Ambroxol is a secretolytic agent used in the treatment of respiratory diseases associated with viscid or excessive mucus. It is the active ingredient of Mucosolvan, Mucobrox, Lasolvan, Mucoangin, Surbronc and Lysopain. The substance is a mucoactive drug with several properties including secretolytic and secretomotoric actions that restore the physiological clearance mechanisms of the respiratory tract, which play an important role in the body’s natural defence mechanisms. It stimulates synthesis and release of surfactant by type II pneumocytes. Surfactants acts as an anti-glue factor by reducing the adhesion of mucus to the bronchial wall, in improving its transport and in providing protection against infection and irritating agents.^[1]

Ambroxol is indicated as "secretolytic therapy in bronchopulmonary diseases associated with abnormal mucus secretion and impaired mucus transport. It promotes mucus clearance, facilitates expectoration and eases productive cough, allowing patients to breathe freely and deeply".^[2] There are many different formulations developed since the first marketing authorisation in 1978. Ambroxol is available as syrup, tablets, pastilles, dry powder sachets, inhalation solution, drops and ampules as well as effervescent tablets.

Ambroxol also provides pain relief in acute sore throat. Pain in sore throat is the hallmark of acute pharyngitis.^[3] Sore throat is usually caused by a viral infection. The infection is self limited and the patient recovers normally after a few days. What is most bothering for the patient is the continuous pain in the throat maximized when the patient is swallowing. The main goal of treatment is thus to reduce pain. The main property of Ambroxol for treating sore throat is the local anaesthetic effect, described first in the late 1970s,^[4][5] but explained and confirmed in more recent work.

Ambroxol is a very potent inhibitor of the neuronal Na+ channels.^[6] This property led to the development of a lozenge containing 20 mg of ambroxol. Many state-of-the-art clinical studies^[7] have demonstrated the efficacy of Ambroxol in relieving pain in acute sore throat, with a fast onset of action and a long duration of effect of at least 3 hours. Additional anti-inflammatory properties of Ambroxol are of clinical relevance since treatment lead to a marked reduction of redness of the patient’s sore throat.

References

1. ^ Sanderson RJ et al. Morphological and physical basis for lung surfactant action. Respir Phys 1976; 27: 379-392.; Kido H et al. Secretory leukoprotease inhibitor and pulmonary surfactant serve as principal defenses against influenza A virus infection in the airway and chemical agents up-regulating their levels may have therapeutic potential. Biol Chem 2004; 385: 1029-1034)
2. ^ (Malerba and Ragnoli. Ambroxol in the 21st century: pharmacological and clinical update. Expert Opin Drug Metab Toxicol 2008; 4(8): 1119-1129)
3. ^ (de Mey et al. Efficacy and safety of ambroxol lozenges in the treatment of acute uncomplicated sore throat. Arzneimittelforschung 2008; 58(11): 557 - 568)
4. ^ (Pueschmann S et al. Pharmacological study on the bromhexine-metabolite ambroxol. Pharmakologische Untersuchungen des Bromhexin-Metaboliten Ambroxol. Arzneimittelforschung 1978; 28: 889 – 898.
5. ^ Klier KF and Papendick U. The local anaesthetic effect of eye drops containing NA 872. Die lokalanaesthetische Wirkung von NA-872-haltigen Augentropfen. Med Monatsschr. 1977; 31: 575 – 578)
6. ^ (Weiser T. Comparison of the effects of four Na+ channel analgesics on TTX-resistant Na+ currents in rat sensory neurons and recombinant Nav1.2 channels. Neurosci Lett. 2006; 395: 179 – 184)
7. ^ (de Mey et al. Efficacy and safety of ambroxol lozenges in the treatment of acute uncomplicated sore throat. Arzneimittelforschung 2008; 58(11): 557 – 568)