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Physicochemical Characteristics
Incompatibility
UK licensed product information states that mixing carbocisteine with pholcodine linctus causes precipitation of carbocisteine from solution but no information is given on whether this incompatibility is with the pholcodine or some component of the formulation used.
(last reviewed 2010-08-27; last modified 2006-06-29)
Uses and Administration
Carbocisteine is used for its mucolytic activity in respiratory disorders associated with productive cough ( Refer to ). It is given orally in a dose of 750 mg three times daily, reduced by one-third when a response is obtained. Carbocisteine is also given orally as the sodium or lysine salts.
For doses in children, see Refer to .
(last reviewed 2010-08-27; last modified 2010-01-18)
Reviews.
(last reviewed 2010-08-27; last modified 2010-01-18)
References
1. Macciò A, et al.. Carbocysteine: clinical experience and new perspectives in the treatment of chronic inflammatory diseases.Expert Opin Pharmacother. 2009; 10: 693–703. PubMed
Administration in children
Children aged from 2 to 5 years may be given oral carbocisteine 62.5 to 125 mg four times daily and those aged 5 to 12 years 250 mg three times daily.
(last reviewed 2010-08-27; last modified 2010-01-18)
Chronic obstructive pulmonary disease
The value of mucolytic therapy in chronic obstructive pulmonary disease (COPD— Refer to ) is controversial. Two studies have reported some improvements in lung function in patients with chronic bronchitis given carbocisteine for up to 6 months,1,2 but it appeared to have no effect on the number of acute exacerbations.1However, later studies3-5 have reported reductions in the number of acute exacerbations; the number of common colds was also lower in the carbocisteine group in one of the studies.4Carbocisteine may also produce some beneficial effects on sputum rheology.2,6
(last reviewed 2010-08-27; last modified 2010-01-18)
References
1. Grillage M, Barnard-Jones K. Long-term oral carbocisteine therapy in patients with chronic bronchitis: a double blind trial with placebo control.Br J Clin Pract. 1985; 39: 395–8. PubMed
2. Aylward M, et al.. Clinical evaluation of carbocisteine (Mucolex) in the treatment of patients with chronic bronchitis: a double-blind trial with placebo control.Clin Trials J. 1985; 22: 36–44.
3. Allegra L, et al.. Prevention of acute exacerbations of chronic obstructive bronchitis with carbocysteine lysine salt monohydrate: a multicenter, double-blind, placebo-controlled trial.Respiration. 1996; 63: 174–80. PubMed
4. Yasuda H, et al.. Carbocisteine reduces frequency of common colds and exacerbations in patients with chronic obstructive pulmonary disease.J Am Geriatr Soc. 2006; 54: 378–80. PubMed
5. Zheng J-P, et al.. Effect of carbocisteine on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo-controlled study.Lancet. 2008; 371: 2013–18. PubMed
6. Braga PC, et al.. Identification of subpopulations of bronchitic patients for suitable therapy by a dynamic rheological test.Int J Clin Pharmacol Res. 1989; IX: 175–82. PubMed
Adverse Effects, Treatment and Precautions
Adverse Effects and Precautions
Nausea and gastric discomfort, and gastrointestinal bleeding have occasionally occurred with carbocisteine. Skin rashes have also been reported.
Carbocisteine should be used with caution in patients with a history of peptic ulcer disease because of the risk that mucolytics may disrupt the gastric mucosal barrier.
(last reviewed 2010-08-27; last modified 2007-07-28)
Effects on endocrine function
Transient hypothyroidism associated with the use of carbocisteine developed in a patient with compromised thyroid function.1
(last reviewed 2010-08-27; last modified 2004-06-15)
References
1. Wiersinga WM. Antithyroid action of carbocisteine.BMJ. 1986; 293: 106. PubMed
Pharmacokinetics
Carbocisteine is rapidly and well absorbed from the gastrointestinal tract and peak plasma concentrations occur about 2 hours after an oral dose. It appears to penetrate into lung tissue and respiratory mucus. Carbocisteine is excreted in the urine as unchanged drug and metabolites. Acetylation, decarboxylation, and sulfoxidation have been identified as the major metabolic pathways. Sulfoxidation may be governed by genetic polymorphism.
(last reviewed 2010-08-27; last modified 2010-01-18)
References.
(last reviewed 2010-08-27; last modified 2007-04-24)
References
1. Karim EFIA, et al.. An investigation of the metabolism of S-carboxymethyl-L-cysteine in man using a novel HPLC-ECD method.Eur J Drug Metab Pharmacokinet. 1988; 13: 253–6. PubMed
2. Brockmoller J, et al.. Evaluation of proposed sulphoxidation pathways of carbocysteine in man by HPLC quantification.Eur J Clin Pharmacol. 1991; 40: 387–92. PubMed
3. Steventon GB. Diurnal variation in the metabolism of S-carboxymethyl-L-cysteine in humans.Drug Metab Dispos. 1999; 27: 1092–7. PubMed
4. Jovanovic D, et al.. A comparative bioavailability study of a generic capsule formulation containing carbocysteine.Pharmazie. 2006; 61: 446–9. PubMed
Preparations: Single-Ingredient
The following preparations list represents a compilation of all available salt forms or related substances for this drug product.
The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.
ARGENTINA: Mucolitic; Pectox¤; Salvitos;BELGIUM: Balsoclase Mucolyticum; Bronchathiol¤; Broncho-Pectoralis Carbocisteine; Muco Rhinathiol; Mucosteine¤; Pulmoclase¤; Romilar Mucolyticum¤; Siroxyl; Soludril Expectorans¤;BRAZIL: Carbocin; Carbofan; Carbotoss¤; Carboxil¤; Certuss¤; Fluilitic¤; Fluitoss; Fluizan¤; Mucocil¤; Mucocis¤; Mucocistein; Mucodestrol¤; Mucofan; Mucoflux; Mucolab¤; Mucolisil; Mucolitic; Mucolix¤; Mucomax¤; Mucotoss; Santoss¤; Tossimel¤;CHILE: Broncotusilan; Carbotos; Coldin¤;CHINA: Bai Yue (百越); Baling (霸灵); Kang Pu Li (康普利);CZECH REPUBLIC: Fenorin¤; Mucopront¤; Pectodrill; Rhinathiol¤; Sinecosin¤;FINLAND: Pulmoclase¤; Reodyn; Toclapekt¤;FRANCE: Actifed Expectorant¤; Bronchathiol; Bronchocyst¤; Bronchokod; Bronchyteine¤; Broncoclar; Broncorinol Expectorant¤; Bronkirex¤; Clarix Expectorant; Codotussyl Expectorant¤; Dimotapp Expectorant¤; Drill Expectorant; Ergix Expectorant; Exotoux; Fluditec; Fluvic¤; Hexafluid¤; Humex Expectorant¤; Medibronc; Muciclar¤; Mucidoral¤; Mucoplexil¤; Mucotrophir¤; Pectojuvene¤; Pharmakod expectorant¤; Pneumoclar¤; Rhinathiol; Sirop des Vosges Expectorant¤; Solutricine Expectorant¤; Toclase Expectorant¤; Tussilene¤;GERMANY: Mucopront¤; Pectox¤; Pulmoclase¤; Sedotussin muco¤; Transbronchin;GREECE: Allstam¤; Bronchiole¤; Ceflavit¤; Chilvax; Convenil¤; Divalio¤; Drizak; Duxil; Dynax¤; Ectofus¤; Estival¤; Grossenel¤; Methovix¤; Mucopront¤; Mucorem¤; Mucothiol; Neo-Adinal¤; Nystetrin¤; Pneumol¤; Pulmoclase; Santamex-Expectorant¤; Santamex¤; Siroxyl¤; Trusil¤;HONG KONG: Expetan; Fluicarbo; Fluifort; Kasteine; Mucodyne¤; Mucosin; Mucospect; Neo-Carbo; Purasol¤; Rhinathiol; Sincotan; Solmux; Tanlin; Uni-Carbotine;HUNGARY: Drill Expectorant¤; Drill¤; Fenorin¤; Mucopront; NeoCitran Expectorant¤; Rhinathiol; Solucis¤;INDIA: Mucodyne;INDONESIA: Broncholit; Mucocil¤; Rhinathiol; Solmux¤;IRELAND: Benylin Mucus Relief¤; Exputex; Mucodyne; Mucogen¤; Mucolex¤; PectoDrill¤; Pulmoclase¤; Unicough Chesty¤; Viscolex;ISRAEL: Mical; Muco-Treat; Mucolit; Mucomed¤; Mucosol¤;ITALY: Broncomucil¤; Bronx¤; Carbocit¤; Fluicare; Fluifort; Lisil¤; Lisomucil; Mucocis; Mucojet¤; Mucolase; Mucosol¤; Mucostar; Mucotreis; Polifluidil¤; Polimucil; Recofluid; Reomucil¤; Sinecod Tosse Fluidificante; Solfomucil¤; Solucis; Superthiol¤; Tossefluid¤;JAPAN: C-Cysten; Cisdyne; Cyscarbon¤; Kuinsron; Luvoravon¤; Mucodyne; Mucothio¤;MALAYSIA: Fluifort; Kastipron; Mucopront¤; Pabron Cough; Rhinathiol; SCMC; Zoradine;MEXICO: Arbistin; Expelin; Loviscol¤; Mucolin Pediatrico;NETHERLANDS: Bronchipect¤; Dampo Solvopect¤; Mucodyne; Mucotab¤; Nattermann Solvopect¤; Pectocold¤; Pulmoclase¤; Rami Slijmoplossende¤; Rhinathiol; Siroxyl¤;PHILIPPINES: Abluent¤; Aflem; Alivox; Ameustyn; Bromycil¤; Broncocent; Broxytone; Bysbalon¤; Carbobase; Carboflem; Carbomed; Carbosol¤; Ceascol; CRB; Cysdexpel; Emuxel¤; Esboxyl; Fayerex; Flemsol; Fluralex; Genecar; Lofenin; Loviscol; Mediphlegm; Nivicof; Pediaplex¤; Pertussin; Phlegmol; Pulmin-CMC; Robikids; S-Muxine¤; Solmux; Solplem¤; Trimulex; Viscodec¤; Vosol; Westcarbox; Zylotin; Zymelytic¤;POLAND: Bronles; Flegamax; Mukolina; Pecto Drill;PORTUGAL: Drill Mucolitico; Finatux; Griflux; Mucolex¤; Mucoral; Mucorespiral¤; Mucorhinathiol Infantil¤; Pulmiben; Pulmoclase¤;RUSSIAN FEDERATION: Bronchobos (Бронхобос); Fluditec (Флюдитек); Fluifort (Флуифорт); Libexin Muco (Либексин Муко); Mucodin (Мукодин)¤; Mucosol (Мукосол)¤;SOUTH AFRICA: Acuphlem¤; Arcanacysteine¤; Betaphlem; Bronchette; Carbo-Syrup¤; Carbospect¤; Co-Flem; Corbar M¤; Dis-chem Mucolytic; Dynaphlem¤; Flemex; Flemgo; Flemlite; Flusin Mucous Cough; Flutex Mucous Cough; Ilvicaps¤; Ilvispect¤; Lessmusec; Medphlem¤; Mucocaps¤; Mucoflem¤; Mucoless; Mucolinct¤; Mucopan; Mucopront¤; Mucosirop¤; Mucosol; Mucosolve; Mucospect; Rinofan¤;SINGAPORE: Mucodin; Mucon; Mucopront; Rhinathiol; Robitussin CM¤; SCMC; Solmux¤; SP-Mucoplex;SPAIN: Actithiol Mucolitico; Anatac; Arimuc; Auromucol; Cinfamucol; Cisbedal¤; Fluidin Mucolitico; Frimuce; Iniston Mucolitico; Mucoactiol; Mucovital; Notus Mucolitico; Pectodrill¤; Pectox; Rinatiol¤; Viscoteina;SWITZERLAND: Apotheke zur Eiche Mucolyticum; GEM Mucolyticum; MAKU Mucolyticum; Mephathiol¤; Mucogeran¤; Mucoseptal; Mucosil Carbo-C; Oberland Apotheke Hustenloser; Pectorex Mucolyticum; Pectox; Rhinathiol; Rhinatussol; Rotpunkt Apotheke Mucolytique Sirop; Tussantiol;THAILAND: Amicof; Bocytin; Carbocter; Carbocys; Carbomed; Carbopect; Carsemex; Cicough; Cisteine; Copharmex; Exflem; Expetan; Flemex; Fluifort; I-Cof; Mucolex; Mucomex; Mucopront¤; Muflex; Murhinol; Pectox¤; Rhinamex; Rhinathiol; Rhinatol; Rhinex; Siflex; Solmax; Solmux¤; Throatsil-CBS;TURKEY: Mucosis¤; Mukobron; Mukoliz; Mukotik;UNITED KINGDOM: Mucodyne;UKRAINE: Fluditec (Флюдитек); Langes (Лангес); Mucolik (Муколик);VENEZUELA: Broxolflem; Cisteinol¤; Gulaper; Loganil; Loviscol; Mucofar; Mucopront;
Preparations: Multi-Ingredient
The following preparations list represents a compilation of all available salt forms or related substances for this drug product.
The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.
ARGENTINA: Mucolitic Antitusivo; Polimucil¤;CHILE: Elastolabor;CHINA: Bang Ao Shu (邦奥舒); Kai Yin (凯茵);FRANCE: Acnaveen¤; Collu "S"¤; Rhinathiol Promethazine; Rhinathiol Tetracycline¤; Thio-Theo¤;GREECE: Carbozor¤; Flemagon¤; Grupozil; Gutman¤; Mucostein¤; Pneumol Plus¤; Polimucil¤; Respinorm¤; Sevlenyl¤; Sobrein¤; Sorbexyl¤; Tussifren; Vanesin¤;HONG KONG: Cameburol; Complex Sobnal; Mucoprom; Rhinathiol Promethazine;INDIA: Caceff; Carbasma; Carbicef; Carbomox; Carlymox; Carmox; Cecarb; Cidoresp; Cismox; Cystamox; Moxycarb; Mucobron; Muconal;ITALY: Broncofluid¤; Duplamox Mucolitico¤; Keraflex; Libexin Mucolitico; Lisomucil Teofillina¤; Sebaveen¤;MALAYSIA: CP Cough Syrup; Mucoease Plus; Mucoprom; Rhinathiol Promethazine; SCMC Promethazine¤; Zoradine-Pro;MEXICO: Mucolin;PHILIPPINES: Solmux-Broncho;PORTUGAL: Acnaveen¤; Bronquial; Niflux; Sebaveen¤;SINGAPORE: Rhinathiol Promethazine;SPAIN: Actithiol Mucolitico Antihistaminico; Amoxtiol¤; Ampiorus Balsamico¤; Bronquicisteina¤; Eduprim Mucolitico¤; Electopen Balsam¤; Pectoral Funk Antitus¤; Pectox Ampicilina¤; Tilfilin¤; Tuselin Expectorante¤;SWITZERLAND: Broncatar¤; Rhinathiol Promethazine¤; Triofan Rhume;UKRAINE: Milistan Cough (Мілістан Кашлю); Pectolvan C (Пектолван Ц);
Therapeutic Use
- Cough Suppressants Expectorants Mucolytics and Nasal Decongestants
Last Updated 1/21/20
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