Carbocisteine

Oral
As a mucolytic
Adult: As adjunctive therapy in respiratory tract disorders characterised by excessive, viscous mucus secretions (including COPD): Initially, 2,250 mg daily in divided doses, may be decreased to 1,500 mg daily in divided doses when a satisfactory response is obtained.
Child: 2-5 years Usual dose: 62.5-125 mg 4 times daily or 200 mg daily in 2 divided doses; 6-12 years Usual dose: 100 mg or 250 mg tid. Dosage recommendations may vary among individual products and between countries (refer to detailed product guidelines).

Should be taken with food.

Active peptic or duodenal ulcer. Children <2 years.

Patient with history of gastroduodenal ulcers, chronic bronchial asthma, respiratory failure. Patients taking concomitant medicines known to cause gastrointestinal bleeding. Not recommended to be concomitantly used with antitussives and/or medicines that dry up bronchial secretions. Children (≥2 years) and elderly. Pregnancy and lactation.

Significant: Gastrointestinal bleeding. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, epigastric discomfort. Immune system disorders: Anaphylactic reactions, fixed drug eruption. Skin and subcutaneous tissue disorders: Rash. Rarely, bullous dermatitis (e.g. Stevens-Johnson syndrome, erythema multiforme).

Symptoms: Gastrointestinal disturbances such as gastralgia, nausea, and vomiting. Management: Supportive treatment. May perform gastric lavage, then closely observe the patient.

Carbocisteine is a mucolytic agent. The mucoregulatory mechanism of carbocisteine is not completely understood. It has been shown to reduce goblet cell hyperplasia, therefore plays a role in the management of disorders characterised by abnormal mucus.
Absorption: Rapidly and well absorbed from the gastrointestinal tract. Bioavailability: <10%. Time to peak plasma concentration: Approx 2 hours (range: 1-3 hours).
Distribution: Penetrates into the lung tissue and respiratory mucus. Volume of distribution: Approx 60-105 L.
Metabolism: Metabolised via acetylation, decarboxylation, and sulfoxidation.
Excretion: Via urine (as unchanged drug and metabolites). Elimination half-life: 1.87 hours (range: 1.4-2.5 hours).

Oral: Syrup/oral solution: Store below 25°C. Tab/cap: Store below 30°C.

Cough & Cold Preparations

R05CB03 - carbocisteine ; Belongs to the class of mucolytics. Used in the treatment of wet cough.