Ambroxol 1

Ambroxol
Ambroxol

Systematic (IUPAC) name

trans-4-(2-Amino-3,5-dibrombenzylamino)-cyclohexanol
Identifiers

CAS number [1]

18683-91-5

ATC code [2]

R05 CB06

PubChem [3]
CID 2132

ChemSpider [4]
10276826

Chemical data

Formula C13H18Br2N2O

Mol. mass 378.10

SMILES [5]
eMolecules & PubChem
[6]

Therapeutic considerations

Pregnancy cat. ?

Legal status

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, Lasolvan or Mucoangin. 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 [7] .
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 [8] . There are many different formulations developed since the
first marketing authorisation in 1978. A major product is the syrup with two concentrations of the substance, 30
mg/ml and 15 mg/ml, which can be given in adults and children from the age of 1 year on and even from infant in
the latter concentration. Other formulations are tablets containing 30 mg or 60 mg, and a pastille to be sucked with
15 mg ambroxol. There is also a sustained release form with 75 mg to be given once a day. Ambroxol is also
available as dry powder sachets, inhalation solution, drops and ampoules as well as effervescent tablets.
Ambroxol also provides pain relief in acute sore throat. Pain in sore throat is the hallmark of acute pharyngitis. [9]
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
Ambroxol 2

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 [10] [11] , but explained and confirmed in more
recent work.
Ambroxol is a very potent inhibitor of the neuronal Na+ channels [12] . This property led to the development of a
lozenge containing 20 mg of ambroxol. Many state-of-the-art clinical studies [13] 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] http:/ / www. nlm. nih. gov/ cgi/ mesh/ 2009/ MB_cgi?term=18683-91-5& rn=1
[2] http:/ / www. whocc. no/ atc_ddd_index/ ?code=R05CB06
[3] http:/ / pubchem. ncbi. nlm. nih. gov/ summary/ summary. cgi?cid=2132
[4] http:/ / www. chemspider. com/ Chemical-Structure. 10276826
[5] http:/ / www. emolecules. com/ cgi-bin/ search?t=ex&
q=O%5BC%40H%5D2CC%5BC%40H%5D%28NCc1cc%28Br%29cc%28Br%29c1N%29CC2
[6] http:/ / pubchem. ncbi. nlm. nih. gov/ search/
?smarts=O%5BC%40H%5D2CC%5BC%40H%5D%28NCc1cc%28Br%29cc%28Br%29c1N%29CC2
[7] 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)
[8] (Malerba and Ragnoli. Ambroxol in the 21st century: pharmacological and clinical update. Expert Opin Drug Metab Toxicol 2008; 4(8):
1119-1129)
[9] (de Mey et al. Efficacy and safety of ambroxol lozenges in the treatment of acute uncomplicated sore throat. Arzneimittelforschung 2008;
58(11): 557 - 568)
[10] (Pueschmann S et al. Pharmacological study on the bromhexine-metabolite ambroxol. Pharmakologische Untersuchungen des
Bromhexin-Metaboliten Ambroxol. Arzneimittelforschung 1978; 28: 889 – 898.
[11] 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)
[12] (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)
[13] (de Mey et al. Efficacy and safety of ambroxol lozenges in the treatment of acute uncomplicated sore throat. Arzneimittelforschung 2008;
58(11): 557 – 568)

Ambroxol hydrochloride tablets in

Japan
Article Sources and Contributors 3

Article Sources and Contributors

Ambroxol  Source: http://en.wikipedia.org/w/index.php?oldid=377484252  Contributors: Anassagora, Beetstra, Chempedia, Chrisbos, DENker, Extransit, Gor n bein, Jangraboy1985,
Jorgenumata, Jü, Kay.fluhr, LMB, Luci Sandor, Naturevet, Nishantkumarnishu, Schneelocke, Sgpsaros, Vantey, ‫طبلا يلع نسح‬, 9 anonymous edits

Image Sources, Licenses and Contributors

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User:Vantey

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