4．美舒咳
出处：按学科分类—医药、卫生 军事医学科学出版社《临床常用进口药物手册》第16页（8215字）
【中文释文】：
〔活性成分〕
盐酸溴环已胺醇
〔成分〕
每片含30mg盐酸溴环已胺醇，磷酸氢钙，乳糖，硬脂酸镁，多(氧—羧甲基)淀粉钠。
〔适应证〕
适用于急性和慢性带有病理性粘稠痰的呼吸道疾病，如急性和慢性支气管粘膜炎(支气管炎)、类哮喘性支气管炎、伴有分泌物排泄障碍的支气管性哮喘以及支气管病理性扩张等适应证，并有助于稀释鼻、咽腔发炎后产生的粘液。
〔禁忌证〕
禁忌证即不能使用或在严密的医疗监控下才能使用某些药物的疾病或情况，因为总的来说，在获得预计的效益的同时也存在可能的风险。为了让医生能仔细地检查是否有禁忌症状，病人必须让医生了解以前患过的疾病、并发症、正在进行的其他治疗以及本人特殊的生活环境和习惯。禁忌症状也有可能在使用本药后才出现或才被发现，在此情况下，病人也应告知医生。
对溴环已胺醇过敏者忌用本药。
支气管运动机能受阻和有大量分泌物时(如少见的恶性纤毛综合征)，应慎用本药，因为可能出现分泌物阻塞的情况。由于迄今尚无足够的经验，病人在妊娠期(尤其是在头3个月)和哺乳期应经仔细权衡利弊之后再服用本药。
〔副作用〕
药物除取得主要的理想效果外，也可能有一些不良的效果，即所谓的副作用。从当前对使用溴环已胺醇的情况看，本药不是对每位病人都有副作用。副作用主要表现如下：
个别病人可能出现胃、肠不适(如恶心和腹痛)以及过敏反应(如皮疹、面部肿胀、呼吸困难、体温上升和寒战)。有少数病人在服用本药后出现口腔和呼吸道干燥、流涎、鼻溢、便秘以及排尿困难等现象。
另外还出现过个别过敏性休克和过敏性皮炎的病例。
〔与其它药物的相互作用〕
同时使用其它药物有可能影响某些药物的作用。因此如果经常服用其它药或最近一直服用其它药以及希望在服用本药的同时服用其它药，均应向医生请教。医生将会告知，同时服用不同药物是否可能出现互不相容的反应，或者是否需要采取特殊措施，例如重新调整剂量。应注意本药与其它药物之间有下列影响：
如果同时服用溴环已胺醇和镇咳药，咳嗽反射虽得到控制，但有可能出现分泌物阻塞的危险，因此准确的诊断对这种综合治疗是非常必要的。
如果与本药同时使用羧氨苄青霉素、头孢氨呋肟和红霉素等抗生素药物，可增强上述药物渗入支气管分泌物中。如本药与强力霉素伍用治疗，已应用于临床。
目前溴环已胺醇与其它用于支气管综合征的基础治疗药物(如支气管解痉药、甲黄嘌呤和皮质类固醇)之间的相互作用尚不清楚。
〔剂量〕
如无其它医嘱，成年人在治疗初期每日3次，每次服1片。如疗程较长每日用量可减至2次，每次1片。5～12岁儿童，每日3次，每次15mg盐酸溴环已胺醇，相当于每日3次，每次半片。
〔用法和时间〕
饭后用水服用。用药时间长短由医生根据适应证和病情发展等个体情况来定。
〔注意事项〕
如严重肾功能不全(肾功能受限)，用量应相应减少或延长服药的间隔时间。
喝水有助于溴环已胺醇稀释粘液。
超过本药包装上注明的有效期请勿服用。
请注意保存，勿让药品落入儿童手中!
美舒咳使分泌作用正常化并促进粘液在呼吸道中的运输，致使粘液液化稀释从而更易被咳出。多喝水能有助于美舒咳的此种作用。
〔包装〕
原始包装为20片装、50片装或100片装。
〔生产厂家〕
德国赫素大药厂
(附本品别名：痰之保克，氨溴醇，沐舒痰，长效痰易净，兰勃素，盐酸氨溴索，Musco，Transbroncho，Mucosolvan，Bronchopront，Lambroxol)．
【外文释文】：
Active ingredient
ambroxol hydrochloride
Composition
1 tablet contains 30 mg of ambroxol hydrochloride；dibasic calcium phosphate；lactose；magnesium stearate；poly(O-carboxymethyl)starch，sodium．
Indications：
Acute and chronic diseases of the respiratory tract with pathologically inspissated mucus，such as
·acute and chronic inflammations of the bronchial mucous membrane(bronchitis)
·asthma-like(asthmoid)bronchitis
·bronchial asthma with disturbed elimination of secretory products
·pathological dilation of bronchi(bronchiectasis)
·in order to support mucolysis in case of inflammations of the nasopharyngial cavity
Contraindications
Contraindications include diseases or circumstances in which certain drugs may not be administered or may only be administered with careful medical monitoring，because，in general，there is not a favorable relationship between the expected benefits and the possible risks．In order that the physician can carefully check whether contraindications exist，he／she must be informed of previous illnesses，accompanying illnesses and other concomitant treatment as well as being informed of your special living conditions and habits．Contraindications can also first occur or become known first after starting the treatment with this preparation．You should also inform your physician in such cases．
Ambrohexal should not be administered in cases of hypersensitivity to ambroxol．
In cases of disturbed bronchial motoricity and an increasing amount of secretory products(e．g．，in case of the rare malign ciliary syndrome)，Ambrohexal should be used only with caution due to a possible congestion of secretion．
Application during pregnancy and lactation period
During pregnancy，especially in the first three months，and during lactation period，Ambrohexal should be administered only after careful benefit-to-risk calculation，because the experience in men is not yet sufficient．
Side effects
In addition to the desired main effects，drugs can also have undesired effects-so-called side effects．Side effects，which have been observed in temporal connection with the administration of ambroxol，but which may not necessarily occur in every patient，are named below．In rare cases，gastrointestinal complaints(e．g．，nausea and abdominal pain)as well as allergic reactions(e．g．，skin rashes，facial swelling，dyspnea，rising temperature with shivering)may occur．
In rare cases，patients reported to suffer from dryness of the mouth and the respiratory tract，sialorrhea(excessive salivation)，rhinorrhea(increased nasal secretion)，constipation and dysuria(aggravated urination)after administraion of ambroxol．
In one case，the occurrence of an anaphylactic(allergic)shock was reported．Furthermore，there is a single case report about allergic contact dermatitis(inflammation of the skin)．
Drug interactions
The effects of some drugs can be influenced when they are taken simultaneously with other substances．For this reason，ask your physician if you continuously take other drugs，or have recently taken or wish to take other medications together with the present drug．Your physician can tell you whether，under these circumstances，incompatibility reactions can be expected or whether special measures，such as a new dose fixing，are necessary when you take this preparation．The following drug interactions are observed between the present drug and other substances：
Due to the restricted cough reflex，concurrent administration of ambroxol with antitussives may lead to a dangerous congestion of secretions so that a very careful(acurate)diagnosis is necessary for this combination therapy．
Furthermore increased penetration of the antibiotics amoxicillin，cefuroxim and erythromycin into the bronchial secretion was reported，if these were administered together with ambroxol．In case of doxycyclin，this interaction is already used therapeutically．
Interactions of ambroxol with other drugs，which are used for the basic treatment of the bronchitic syndrome(bronchospasmolytics， methylxanthines， corticosteroids) are not known．
Dosage directions
If not otherwise directed：
Adults take 1 tablet three times a day at the beginning of treatment．In case of longterm therapy，the dosage may be reduced to 1 tablet twice a day．Children with 5 to 12 years of age receive 15 mg of ambroxol hydrochloride three times a day，corresponding to 1／2 Ambrohexal tablet three times a day．
Important inoformation
In cases of severe renal insufficiency(restricted function of kidneys)，dosage should be adequately reduced or the dosage interval should be prolonged．
Mode and duration of Administraton
The tablets Should be taken after the meals together with some liquid
The duration of therapy should be decided individually by the physician，according to the indication and the course of the disease
Important information
The secretolytic effect of ambroxol is supported by fluid supply
Do not use this drug after the expiration date printed on the package．
Keep medicines out of the reach of children!
Ambrohexal normalizes the secretion and promotes the transport of mucus in the respiratory tract．The viscous mucus is thus liquefied and can be expectorated more easily．You can support these effects of Ambrohexal by drinking a lot．
Presentation and package sizes
Original packages containing
20，50 and 100 tablets
Manufacturer
Hexal&．Co．，Germany