Cough mixtures for adults and children: list of names, reviews

Many liquid medicines taken orally for coughs are cough mixtures - solutions of various ingredients, including pharmacological substances, extracts, alcohol tinctures of medicinal plants, etc.

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When are cough mixtures indicated?

The main indications for the use of liquid drugs of this pharmacological group are: symptomatic therapy of cough in acute respiratory infections and acute respiratory viral infections; laryngitis, tracheitis and laryngotracheitis; bronchitis, tracheobronchitis, pneumonia, bronchial asthma and obstructive respiratory diseases of an allergic and inflammatory nature.

Ready-made and pharmacy cough mixtures: release forms and composition

Without going into pharmaceutical nuances, most consumers believe that cough mixtures also include such liquid forms of medicines as diluted alcohol extracts from various parts of plants (elixirs) and plant extracts with a high sugar content (syrups). Therefore - may pharmacists forgive us - this review will also consider some of these medicines.

As a rule, a solution of medicinal substances in purified water – a liquid cough mixture – contains ethanol. Ethyl alcohol in cough mixtures is a multifunctional auxiliary component: a solvent (dispersion medium), a stabilizer of the homogeneity of other ingredients, and, along with benzoic and tartaric acids, a preservative necessary to maintain the microbiological purity of solutions.

The composition of cough mixture with herbal extracts includes sugar syrup, which makes it more pleasant to taste. At the same time, cough mixture without sugar may contain its substitute (sorbitol or fructose), and for a thicker consistency and increased adsorption, hydroxyethyl ether of cellulose is added to the solution. Such products are most suitable for diabetics.

Dry cough mixtures are also produced, for example: the combined remedy Vicks Active Symptomax; powdered cough mixture for children Bronhomishka (consisting of powdered sugar, soda, dry extracts of marshmallow root, plantain leaves and raspberry, anise oil and ascorbic acid); children's mixture Arida (with dry extract of marshmallow roots and licorice, sodium bicarbonate, anise oil and ammonium chloride). How to dilute cough mixture for children, and in what dosage to use it, is indicated in the instructions attached to them.

Cough mixture for adults is also available in powder form - dry cough mixture with thermopsis (dry extract of the herb Thermopsis lanceolata) and the same components as the previous remedy. Thermopsis alkaloids, on the one hand, increase the production of mucus in the bronchi, and on the other, acting on the respiratory center of the brain, promote its expectoration. It should also be noted that at the reflex level, ammonia solution stimulates the respiratory center, and the ether of anise oil anethole is a fairly strong antiseptic.

Cough mixture in sachets: granulated Chinese cough mixture Baishiqingzhe, which contains about a dozen herbal components used in traditional Eastern medicine; Thai cough mixture Takabb Anti-cough.

But the mixture with antibiotics for cough is not produced, possibly due to the peculiarities of antimicrobial therapy of cough. More details - in the publication Antibiotics for cough

Pharmacy cough mixtures, which are prepared in the pharmacy individually, according to a doctor's prescription (i.e. extemporaneously), are currently undeservedly forgotten. And when, for example, an anise mixture is prescribed, it can be prepared in the pharmacy - on the basis of a decoction of marshmallow root with the addition of ammonia-anise drops - a time-tested expectorant with a reflex action, which can be used for children from the age of two. You will find more information in the material - Cough drops

List of cough mixture names

To choose the most effective cough mixtures, first of all, you should consider the nature of the cough.

The list of names of cough mixtures should be divided into: mixtures with bronchodilator action - for dry (unproductive) cough and, accordingly, mixtures for wet (wet or productive) cough.

Mixtures for dry cough and cough in asthma:

• cough mixture Sinekod (syrup, which has other trade names - Omnitus, Panatus, Sinkodin), can be used for laryngitis and whooping cough in children;
• Clenbuterol (syrup);
• Erespal (Eladon, Inspiron, Siresp);
• Rengalin.

By the way, Sinekod and Clenbuterol are often used as cough mixtures for smokers. For more details, see – Smoker's Cough

Cough mixtures with codeine are represented by the drug Kofeks.

In turn, a mixture for wet cough is used for better removal of bronchial mucous secretion formed during inflammation of the respiratory tract (which consists of mucins or glycoproteins). Thus, to treat cough with phlegm, expectorants are needed - expectorant cough mixtures, depending on pharmacodynamics, conventionally divided into mucolytic and mucokinetic. The former make viscous phlegm more liquid, and then it is easier to cough up; the latter contribute to the optimization of mucociliary clearance - cleaning the respiratory tract from mucus by supporting the functions of the ciliary (ciliated) epithelium of the respiratory organs.

Expectorants and mucus thinning liquids include:

• Ascoril (Kashnol), Sinetos, Prothiazine expectorant;
• Ambrobene (Ambroxol, Bronchoval, Lazolvan, Flavamed, Halixol and other trade names) with ambroxol hydrochloride;
• cough mixture Fluditec with carbocisteine (synonyms - Mucosol, Broncatar, Fluvik, etc.);
• Phlegamine mixture containing bromhexine;
• ammonia-anise cough mixture (with anise oil, aqueous ammonia solution and licorice root extract); this is a cough mixture from childhood - Breast Elixir. Naked licorice (Glycyrrhiza glabra) or licorice contains in its roots a pharmacologically valuable set of flavonoids, coumarins and glycosides; the most pronounced mucokinetic is the glycoside glycyrrhizin, and the anti-inflammatory effect is exerted by the flavonoid glabridin.

Herbal expectorant cough mixtures such as:

• Althea syrup or marshmallow - another cough mixture from childhood with an extract of the root of Althaea officinalis;
• cough mixture with thyme or thyme - Pertussin and Pectosol;
• Herbion is a syrup of three types: with an extract of ivy leaves, plantain leaves and primrose root;
• Prospan (syrup containing ivy leaf extract);
• multi-component homeopathic cough syrup Stodal;
• The Chinese cough mixture Nin Jiom Pei Pa Koa, in addition to licorice root, contains ginger root, thin-leaved polygonum and pinellia, an aqueous extract of trichosanthes cucumerina seeds, coltsfoot leaves (Tussilago farfara) and wolfiporia extensa, as well as menthol and honey.

The elixir Bronchicum raises some doubts, since one version of this product (manufactured by A. Nattermann & Cie. GmbH, Germany) contains extracts of thyme herb and primrose roots, while the second version (allegedly manufactured by Klosterfrau Vertriebsgesellschaft), in addition to these, contains plants used only in homeopathy (in particular, Grindelia robusta and the bark of the Aspidosperma quebracho-blanco tree).

Cough mixture for children

Almost every cough mixture for children has some age restrictions. So, if a child is under six years old, any cough mixtures with codeine are prohibited. According to the instructions, Ascoril is also not prescribed to children under six years old (although guaifenesin, which is part of this drug, is prohibited for children under two years old, and bromhexine - up to three years). Sinekod syrup and Rengalin mixture are contraindicated for children under three years of age, and Pectosol - for children under one year.

The mixture Flegamine with bromhexine is acceptable for use in the treatment of cough in children under two years of age. You can also inhale the cough mixture Bromhexine (no more than five drops per procedure). For more information, see – Inhalations for bronchitis

Only after two years of age can children be given 2% Fluditec syrup, Herbion and Stodal syrups, as well as children's dry cough mixture.

Cough mixtures approved by pediatricians for infants under 1 year: Althea, Pertussin, Ambrobene (Ambroxol, Lazolvan) and Prospan. The instructions for Erespal and Clenbuterol syrup (which are used only for dry coughs) indicate that the dose for infants should be determined by body weight. More useful information on treating cough in infants - Cough in an infant

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Pharmacodynamics

The mechanism of action of the drug Ascoril recommended for chronic bronchitis is provided by its bromhexine (benzylamine, which liquefies bronchial mucus by destroying its glycoproteins) and guaifenesin, which not only makes sputum more liquid (in the same way as bromhexine), but also irritates the cilia of the ciliary epithelium, stimulating the bronchial mucociliary system. And the selective β2-adrenergic agonist salbutamol helps to expand the lumen of the bronchi when they are inflamed.

The mucolytic effect of Flegamine is the result of the action of bromhexine, enhanced by menthol and eucalyptus oil, which cause a reflex expectoration of sputum.

Ambroxol in the drug Ambrobene (Lazolvan) acts similarly to bromhexine, since it is a product of its biotransformation. Ambroxol has a normalizing effect on the production of bronchial secretions with an increase in the proportion of hydrophilic mucins (which make sputum less thick) and the functioning of the mucociliary system of the bronchi as a whole.

Fluditec cough mixture contains carbocysteine (RS-carboxymethyl), which also destroys the structure of glycoproteins in the secretion secreted by the bronchi, making it less viscous. It also increases the functional activity of the ciliated epithelium lining the bronchi.

Marshmallow with an extract of the root of Althaea officinalis, rich in hydrophilic mucous polysaccharides and flavonoids, on the one hand, increases the volume of sputum when coughing, and on the other, liquefies it. At the same time, bronchial motility reflexively increases, and sputum is removed more easily.

Pertussin contains thyme extract and potassium bromide. Such a spice in cough mixture as thyme (Thymus serpyllum) is used due to the presence of thymol in its essential oil - a monoterpene phenol, which not only increases the activity of the cilia of the ciliary epithelium of the bronchi, but also relieves their spasm. And potassium bromide acts resorptively, increasing the production of bronchial secretions and liquefying them.

In addition to thyme extract, the expectorant cough mixture Pectosol contains extracts from elecampane root, Icelandic cetraria, hyssop herb and medicinal soapwort. The result of the synergistic action of triterpene acids, alkaloids, flavonoid glycosides and phenolic compounds included in these medicinal plants is the pronounced mucolytic, mucokinetic and anti-inflammatory effect of Pectosol.

The pharmacological action of Herbion syrups is also due to the biological activity of substances contained in extracts of medicinal plants: plantain (Plantago major), primrose (Primula veris) and ivy (Hedera helix). Ivy leaf extract (containing saponins and glycosides) is the main active component of the mucolytic agent Prospan.

And the pharmacodynamics of the homeopathic remedy Stodal is determined by a dozen ingredients, including plants such as common pasqueflower, curly dock

White bryony, Lobaria pulmonaria.

The action of the cough mixture Sinekod (Omnitus), which contains the phenylbutyric acid derivative butamirate as an active substance, is aimed at suppressing the cough center located in the medulla oblongata (without affecting the respiratory center located there).

The antihistamine drug Erespal contains fenspiride, an antagonist of histamine H1 receptors, which reduces swelling of the bronchi and relieves spasms by widening their lumens. In addition, Erespal reduces the production of inflammation mediators released by mast cells into the blood for allergic coughs.

The pharmacodynamics of Clenbuterol is based on the ability of its active substance – clenbuterol monohydrochloride (a derivative of benzenemethanol) – to selectively stimulate β2-adrenaline receptors, which leads to relaxation of the bronchial muscles and a decrease in the intensity of coughing.

Suppression of dry cough with Rengalin cough mixture occurs due to the effect of antibodies contained in it on B1 bradykinin receptors, H1 histamine receptors and opioid receptors of the brain. As a result of a cascade of biochemical processes, the excitability of the cough center decreases and the cough reflex is suppressed.

Cofex contains codeine phosphate, which acts on the opioid receptors of the cough center, as well as the antihistamine chlorpheniramine, which blocks histamine receptors, like the above-mentioned fenspiride.

Pharmacokinetics

The instructions for herbal cough mixtures do not describe their pharmacokinetics.

Preparations containing ambroxol – Ambrobene, Lazolvan, etc. – have a high level of absorption, and binding to plasma proteins is almost 80%. Biotransformation of the drug occurs in the liver, and metabolites are excreted in the urine.

After oral administration of Fluditec mixture, the highest concentration of carbocysteine in the blood is observed on average after 2.5 hours, and in the bronchial mucosa its amount provides therapeutic activity for eight hours. Carbocysteine is broken down in the gastrointestinal tract (with a half-life of slightly more than three hours); its products are excreted through the kidneys within three days.

Sinekod is absorbed in the stomach and enters the blood, binding 98% to plasma proteins and reaching the maximum concentration of butamirate approximately 90 minutes after administration. Butamirate undergoes hydrolysis, the resulting metabolites are pharmacologically active. Excretion is 90% renal, T1/2 is six hours.

After taking Erespal, the maximum content of fenspiride in the blood is observed after five to six hours, gradually decreasing. The drug is excreted mainly by the kidneys with a 12-hour period of excretion of half the dose taken.

After oral administration and absorption in the gastrointestinal tract, Clenbuterol enters the blood, the average level of bioavailability is 93-94%. It is metabolized in the liver, metabolites are excreted by the kidneys in the urine.

Kofeks is absorbed in the gastrointestinal tract and begins to act one and a half to two hours after administration. Both codeine and chlorpheniramine are broken down by liver enzymes and excreted through the kidneys. The half-life of codeine is about 12 hours, chlorpheniramine is twice as long.

Method of administration and dosage

All cough mixtures are taken orally. Ascoril is prescribed to adults at 10 ml three times a day, a single dose for children 6-12 years old is 5 ml.

You can take Flegamine three times a day; a measuring spoon is included with the bottle of mixture for dosing.

Adults should take Ambrobene three times a day, 10 ml; children aged 5-12 years – 5 ml, and under five years – 2.5 ml two to three times a day.

5% Fluditec syrup is prescribed to adults and older adolescents - three times a day, one tablespoon (half an hour before meals). 2% syrup is intended for children: over 5 years old - one teaspoon three times a day, 2-5 years old - one teaspoon twice a day. Duration of use - no more than 10 days.

Marshmallow should be taken: adults and teenagers - a tablespoon up to five times a day, children 7-14 years old - a dessert spoon, children 2-7 years old - a teaspoon, 1-2 years old - half a teaspoon three times a day, children under one year - half a teaspoon twice a day. Pertussin is also taken, but only three times a day. And Pectosol is added to a tablespoon of water (about 25 drops) and taken no more than three times a day.

Adults and children over 14 years of age are recommended to take a tablespoon of Gerbion 3-5 times a day (for a week); a single dose for children aged 7-14 is a dessert spoon, the number of doses is three, and children under seven years of age take a teaspoon of syrup three times a day. The dosage of Stodal is similar.

The dosage of Prospan for adults is 1-1.5 teaspoons three times a day, for children over six years old - one teaspoon, and under six - half a teaspoon.

The dose of Sinekod syrup is measured out with a measuring cap: three times a day, 15 ml for adults, 10 ml for children over six years old, 5 ml for children 3-6 years old.

Erespal is dosed based on body weight - 4 mg per kilogram per day, the resulting amount of the drug is divided into two doses. The daily dose of Clenbuterol is calculated at 0.01-0.02 mg/kg, and for children in the first year of life - at 0.0025-0.005 mg/kg (two doses per day).

Adults take Rengalin mixture three times a day, 10 ml, children 4-12 years old, 5 ml.

If the drug Kofeks is prescribed, it is taken for no longer than 10 days - three times a day, 5 ml each, and the dose for children 7-12 years old is half as much.

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Use during pregnancy

The use of drugs such as Ascoril, Erespal, Sinekod, and Kofeks during pregnancy is prohibited.

Sinekod (Omnitus), Clenbuterol, Flegamine, Ambrobene (Lazolvan), Fluditec are contraindicated during the first trimester of pregnancy. Clenbuterol is also not used after the 36th week of gestation.

Rengalin has not been studied for safety in pregnant women.

According to the instructions, there are no contraindications for use during pregnancy for cough mixtures and syrups Alteika, Pertussin, Pectosol, Gerbion, Prospan. Stodal, like other homeopathic remedies, is best not used during pregnancy.

It should also be borne in mind that pregnant women are contraindicated in the use of oregano, licorice, and spring primrose (primrose), as well as anise oil.

Read also – How to treat a cough during pregnancy

Contraindications for use

The main contraindications for the use of these cough remedies:

• mixtures with marshmallow or thermopsis - gastritis, stomach ulcers;
• Ascoril - cardiovascular diseases, acute gastric ulcer and/or duodenal ulcer, thyrotoxicosis, diabetes mellitus, increased intraocular pressure;
• Ambrobene (Lazolvan), Flegamine - gastric ulcer;
• Fluditec - severe renal failure, gastric ulcer and/or duodenal ulcer;
• Pectosol, Gerbion – inflammatory diseases of the digestive system;
• Stodal is a malabsorption syndrome, congenital fructosuria.
• It should be borne in mind that expectorant cough mixtures are not recommended in cases where the patient is bedridden.
• Sinekod is contraindicated in lung diseases accompanied by bleeding;
• Erespal and Rengalin - in case of hypersensitivity to these drugs;
• Clenbuterol - for hyperthyroidism, heart rhythm disturbances, myocardial infarction;
• Cofex - in the presence of obstructive respiratory diseases, bronchial asthma, pneumonia, increased intracranial and/or arterial pressure, heart or kidney failure, glaucoma, intestinal obstruction, epilepsy, chronic alcoholism.

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Side effects

The use of the drugs included in the review may cause the following side effects:

• Ascoril – dyspepsia, decreased blood pressure, tachycardia, tremor, convulsions, sleep disorders;
• Sinekod (Omnitus) – headaches, nausea and vomiting, diarrhea or constipation, allergic skin reactions;
• Erespal - nausea, vomiting, intestinal disorders, increased drowsiness, increased heart rate, urticaria;
• Clenbuterol - dry mouth, nausea, headache, tachycardia, arterial hypotension, increased nervousness;
• Cofex - headache, dizziness, hyperhidrosis, fever, nausea, vomiting, increased heart rate, ataxia, convulsions, increased irritability, decreased appetite, deterioration in sleep quality, etc.;
• Phlegamine - nausea, vomiting, dyspepsia;
• Ambrobene (Lazolvan), Fluditec – allergic skin rashes, dry mucous membranes, nausea and vomiting, headaches, general weakness, etc.;
• Pectosol - intestinal disorders, heart rate disturbances;
• Prospan - diarrhea;
• Stodal - skin allergic reaction.

Overdose

Exceeding the dose of marshmallow can cause nausea and vomiting, and Pectosol, Ambrobene, Fluditec and Rengalin can also cause dyspepsia with abdominal pain.

In case of Ascoril overdose, its side effects may increase. In addition to nausea, vomiting and diarrhea, signs of an overdose of the drug Sinekod are manifested by a decrease in blood pressure, dizziness, increased drowsiness; a significant excess of the dose can lead to fainting. In such cases, gastric lavage and respiratory support are necessary.

Similar measures are taken in case of an overdose of Erespal and Clenbuterol, which is expressed in cardiac arrhythmia or increased heart rate.

The greatest dangers are posed by an overdose of codeine-containing drugs: from more intense manifestations of their side effects to respiratory depression and coma. Emergency measures include intravenous administration of a specific antidote – the opioid receptor antagonist naloxone.

Interactions with other drugs

First of all, bronchodilator mixtures should not be used simultaneously with expectorants, as this will cause accumulation of phlegm in the bronchi and their obstruction.

Ambrobene (Lazolvan), as well as products with bromhexine, are not used with mixtures containing sodium bicarbonate. Ambroxol potentiates the action of antibiotics.

Ascoril is incompatible with drugs based on ephedrine, phenamine and methylxanthine, and Fluditec is incompatible with corticosteroids.

Clenbuterol significantly reduces the effectiveness of drugs that lower blood sugar levels and increases the effect of cardiotonic drugs that contain cardiac glycosides (digoxin, strophanthin, corglycon, etc.).

To avoid serious intestinal problems, Kofeks should not be taken together with medications containing piperidine derivatives (Imodium, Loperamide, etc.). In addition, codeine can potentiate the effect of simultaneously taken alcohol-containing products, drugs to lower blood pressure and relieve symptoms of depression and neurasthenia.

Storage conditions

Cough mixtures should be stored at room temperature, away from direct sunlight and heating devices.

Althea, Stodal and Pectosol in opened bottles are best stored at the bottom of the refrigerator (temperature not lower than +4-5°C).

Best before date

The shelf life of Alteyka, Pertussin, Lazolvan, Ascoril, Erespal, Rengalin is three years; Pectosol, Gerbion, Prospan, Clenbuterol, Fluditec, Flegamin, Kofeks is two years. The cough mixture Sinekod (Omnitus) is suitable for use for five years from the date of manufacture.

How to make cough mixture?

How to make a cough mixture? If there is a dry, that is, powdered cough mixture with thermopsis in bags, then its contents are simply dissolved in water (naturally boiled and cooled to room temperature). And the same is done with all similar cough remedies. By the way, these are inexpensive cough mixtures, and in hermetically sealed bags they can be stored for quite a long time and always be, as they say, at hand. Although there are no reviews from doctors regarding their effectiveness.

But there are cough mixture recipes that can be used to prepare a liquid remedy for wet cough at home.

For example, buy a Breast Cough Collection from a pharmacy: there are four types, depending on the composition of the plant material, including oregano, plantain, coltsfoot, marshmallow and licorice root, elderberry flowers and wild pansies, etc. In addition, buy a bottle of ammonia-anise drops and several ampoules of 4% sodium bicarbonate solution (20 ml in one ampoule).

Brew the medicinal herbs as indicated in the instructions (usually take a tablespoon of dry mixture per 200 ml of water), the decoction should be infused and cooled completely. The expectorant anise mixture will be ready when for every 50 ml of decoction add the amount of ammonia-anise drops corresponding to the age of the person suffering from cough (if he or she is 20 years old, then add 20 drops). This homemade miracle cough mixture is taken one tablespoon three to four times a day.

If for some reason anise is contraindicated, a solution of sodium bicarbonate is added to the cooled herbal decoction (the contents of one ampoule per 150 ml of decoction). Sodium bicarbonate (baking soda) enhances the mucolytic effect of medicinal herbs, as it alkalizes bronchial secretions and makes them less thick.

What is eggnog cough mixture? Obviously, this is a regular eggnog (milk with egg yolks and butter). However, it is important to keep in mind that this remedy is not for cough, but for sore throat and hoarseness.

Instead, you should add either alkaline mineral water (1:1) or burnt sugar to the milk, which can be obtained by placing a tablespoon of sugar in a hot, dry frying pan, adding a teaspoon of water and bringing it to a brown color.

And if you have saffron in your spice supply, then this spice in a cough mixture – thanks to a set of biologically active glycosides – will help to relieve coughing fits, relieving spasms of the bronchial muscles.