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Ammonium chloride, dextromethorphan, bromhexine and menthol is a combination with synergistic action used to treat cough, runny or stuffy nose, sneezing, itching, and watery eyes caused by allergies, the common cold, or the flu. Cough that is caused by smoking, asthma, or emphysema will not be treated by this syrup.
- Coughs and upper respiratory tract symptoms
- Nasal congestion
- Allergy or common cold
- Chronic obstructive pulmonary disease (COPD)
Ammonium Chloride is an inorganic compound. It works as Systemic acidifier. In liver ammonium chloride is converted into urea with the liberation of hydrogen ions (which lowers the pH) and chloride. Ammonium chloride can be used as an expectorant due to its irritative action on the bronchial mucosa. This effect causes the production of respiratory tract fluid which in order facilitates the effective cough.
Bromhexine is a mucolytic drug used in the treatment of respiratory disorders associated with viscid or excessive mucus. Bromhexine is intended to support the body's mechanisms for clearing mucus from the respiratory tract. It is secretolytic, increasing the production of serous mucus in the respiratory tract, which makes the phlegm thinner and less viscous. This contributes to a secretomotoric effect, allowing the cilia to more easily transport the phlegm out of the lungs. For this reason it is often added to cough syrups. It has been shown to increase the proportion of serous bronchial secretion, making it more easily expectorated. It is indicated as "secretolytic therapy in bronchopulmonary diseases associated with abnormal mucus secretion and impaired mucus transport".
Dextromethorphan suppresses medullary cough center and is an NMDA receptor antagonist (receptors, N-methyl-D-aspartate). It acts as a non-competitive channel blocker and is one of the widely used antitussives. It is also used to study the involvement of glutamate receptors in neurotoxicity. Dextromethorphan is categorized as an opioid drug that acts as antagonist to the NMDA glutamatergic receptor, it is an agonist to the opioid sigma 1 and sigma 2 receptors. It is also an alpha3/beta4 nicotinic receptor antagonist and targets the serotonin reuptake pump.
Menthol primarily activates the cold-sensitive TRPM8 receptors in the skin. Menthol, after topical application, causes a feeling of coolness due to stimulation of 'cold' receptors by inhibiting Ca++ currents of neuronal membranes. It may also yield analgesic properties via kappa-opioid receptor agonism.
Bromhexine is rapidly absorbed, with peak plasma levels being reached within 1 h. As it is lipophilic, it is rapidly redistributed, undergoes extensive hepatic metabolism. About 85 to 90% of a dose is excreted in the urine mainly as metabolites. It has a terminal elimination half-life of up to about 12 hours. Bromhexine crosses the blood brain barrier and small amounts cross the placenta.
Dextromethorphan is rapidly absorbed from GIT and is extensively metabolised to dextrorphan (active metabolite) in liver. The half-life is 3-6 hours.
Bromhexine is a mucolytic drug used in the treatment of respiratory disorders associated with viscid or excessive mucus. Bromhexine is intended to support the body's mechanisms for clearing mucus from the respiratory tract. It is secretolytic, increasing the production of serous mucus in the respiratory tract, which makes the phlegm thinner and less viscous. This contributes to a secretomotoric effect, allowing the cilia to more easily transport the phlegm out of the lungs. For this reason it is often added to cough syrups. It has been shown to increase the proportion of serous bronchial secretion, making it more easily expectorated. It is indicated as "secretolytic therapy in bronchopulmonary diseases associated with abnormal mucus secretion and impaired mucus transport".
Dextromethorphan suppresses medullary cough center and is an NMDA receptor antagonist (receptors, N-methyl-D-aspartate). It acts as a non-competitive channel blocker and is one of the widely used antitussives. It is also used to study the involvement of glutamate receptors in neurotoxicity. Dextromethorphan is categorized as an opioid drug that acts as antagonist to the NMDA glutamatergic receptor, it is an agonist to the opioid sigma 1 and sigma 2 receptors. It is also an alpha3/beta4 nicotinic receptor antagonist and targets the serotonin reuptake pump.
Menthol primarily activates the cold-sensitive TRPM8 receptors in the skin. Menthol, after topical application, causes a feeling of coolness due to stimulation of 'cold' receptors by inhibiting Ca++ currents of neuronal membranes. It may also yield analgesic properties via kappa-opioid receptor agonism.
Pharmacokinetics:
Ammonium Chloride is completely absorbed from GIT within 3-6 hours. It is metabolised in liver to form urea and the metabolites are excreted in urine.Bromhexine is rapidly absorbed, with peak plasma levels being reached within 1 h. As it is lipophilic, it is rapidly redistributed, undergoes extensive hepatic metabolism. About 85 to 90% of a dose is excreted in the urine mainly as metabolites. It has a terminal elimination half-life of up to about 12 hours. Bromhexine crosses the blood brain barrier and small amounts cross the placenta.
Dextromethorphan is rapidly absorbed from GIT and is extensively metabolised to dextrorphan (active metabolite) in liver. The half-life is 3-6 hours.
Common side effect of the product includes:
- Rash
- Fever
- Irregular breathing
- Bradycardia
- Progressive drowsiness
- Mental confusion
- Not be administered in patients with hypersensitive to sympathomimetic amines
- In patients with known idiosyncratic reaction to bromhexine hydrochloride
Following drugs may interact with the combination:
- Diuretics
- Zoledronic acid
- Empaglilozin.
- Isocarboxazid
- Phenelzine
- Rasagiline
- Selegiline
- Tranylcypromine.