Clinical medicine profile
Ambroxol hydrochloride + Terbutaline sulphate + Guaiphenesin)
Beta-2 adrenergic agonist (bronchodilator)
- Route
- INHALATION / ORAL / NEB / IV (rare)
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Allergy to any of the components of the formulation, pre-existing ischaemic heart disease or those patients with significant risk factors for ischaemic heart disease, and
- gastric ulceration.
Precautions
- Paradoxical bronchospasm.
- Hypokalaemia with high dose/nebs especially with steroids/diuretics/xanthines.
- CV disease: tachycardia/arrhythmia risk.
- Thyrotoxicosis caution.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Adults: 10-20 mL TID. Children (6-12 years). 10 mL TID. Children (under 6 years). 5-10 mL TID
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Low for inhaled; monitor electrolytes if continuous nebs.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Low clinical concern for inhaled therapy.
Use, effects & interactions
Indications
- Relief of cough associated with bronchitis, bronchial asthma, emphysema and other bronchopulmonary disorders where bronchospasm, mucous plugging, and problems of expectoration co-exist.
- Clinical selection for Ambroxol hydrochloride + Terbutaline sulphate + Guaiphenesin) should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Beta-2 adrenergic agonist (bronchodilator).
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- [From component Terbutaline sulphate] Tachycardia, skeletal muscle cramp, palpitation, headaches, severe emotional disturbances, resistance after prolonged use, acidosis, GI disturbances, hypokaleamia, sweat
Drug interactions
Open multi-drug checker ↗- Fixed-dose/multi-ingredient product.
- Clinical details partially inherited from component monographs: Terbutaline sulphate.
- Confirm combination SmPC for exact dosing.
Mechanism & disposition
Combination product.
Read complete mechanism
Combination product. Component mechanism (Terbutaline sulphate): It stimulates Beta-agonist in the lungs to relax bronchial smooth muscle, thereby relieving bronchospasm. This action may result from increased production of cAMP and ensuing reduction in intracellular calcium concentration caused by activation of the enzyme adenylate cyclase that catalyzes the conversion ATP to cAMP. Increased cAMP concentrations, in addition to relaxing bronchial smooth muscle, inhibit release of mediators of immediate hypersensitivity from cells, especially from mast cells.
Minutes (SABA)
3–6 h SABA; 12 h LABA
INHALATION / ORAL / NEB / IV (rare)
causes tremor/tachycardia. Hepatic
of many agents. [Terbutaline sulphate] Inhaled route maximises lung delivery and reduces systemic effects. Systemic
Pregnancy, lactation & diet
[Ambroxol] Inhaled salbutamol widely used; uncontrolled asthma risk > drug risk. [Terbutaline sulphate] Inhaled salbutamol widely used; uncontrolled asthma risk > drug risk.
Inhaled therapy generally compatible.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.