INDICES> Flomax & Ambromucil (3)

["Janet McNeece" <jmcneece@gp.rah.sa.gov.au>]

Dear David
Flomax is the trade name for the drug morniflumate.  It is made by 
the company Chiesi Farmaceutici spa in Palermo Italy.  It is a 
prodrug of the non-steroidal antiinflammatory agent (NSAID) niflumic 
acid which is a fenamate.  The recommended (oral) dose is 700mg twice 
a day in adults (halved in the elderly).  For paediatric patients the 
average recommended dose is 17.5 mg/kg daily in one or two divided 
doses.  (Rectal dosing information is also available).  It has all 
the standard NSAID adverse effects ie epigastric pain, heartburn 
nausea dyspepsia etc etc.  Nothing different or special!!  
It is absorbed from the GI tract and rapidly and completely 
hydrolysed in the plasma into its bioactive metabolite niflumic acid, 
which is responsible for the antiinflammatory, analgesic and 
antipyretic activity.  It has a mean elimination half life of 4 
hours.

Ambromucil is the trade name for the drug Ambroxol.  Made by the 
company Malesci Istituto Farmacobiologico s.p.a. Italy.  Ambroxol is 
an expectorant and mucolytic.  As a mucolytic oral ambroxol has been 
given in doses of 60 to 180mg.  For hyaline membrane disease,  IV 
doses of 1gram/day for 5 days have been prophylactically administered 
to the mother.  For treatment 20mg/kg/day for 7 days have been 
administered to the neonate as rescue.
Adverse effects include fatigue, dry mouth, rhinorrhea, constipation, 
dysuria and contact dermatitis.
The primary role of ambroxol may be in pulmonary medicine as an 
expectorant/mucolytic.  With its main use in the treatment of 
bronchitis and pulmonary infections to facilitate the removal of 
secretions from the respiratory tract. {Efficacy - no firm data}
The mucolytic and pulmonary surfactant stimulating properties of 
ambroxol have generated interest in its use in the prevention and 
treatment of neonatal respiratory distress syndrome (hyaline membrane 
disease) and in the prophylaxis of antineoplastic mulmonary injury.  
Initial research appears encouraging but further research needed.
Neither preparation are marketed in Australia.
Hope this information is useful
Janet McNeece
Drug Information
Royal Adelaide Hospital Australia



> Date:          Mon, 18 Jan 1999 02:43:01 -0500 (EST)
> To:            indices@usa.healthnet.org
> From:          Bratt <dbratt@trinidad.net>
> Subject:       INDICES> Flomax & Ambromucil
> Reply-to:      indices@usa.healthnet.org

> 
> Can anyone tell me what is the generic content of  Flomax and 
> Ambromucil that a young patient of mine from Italy is using?  
> Indications?  Side effects?
> Thanks.  David, paediatrics, Trinidad & Tobago, West Indies
> 
> From: Bratt <dbratt@trinidad.net>
> 
> 
> 
> 
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> 
Janet McNeece
Senior Pharmacist, Drug Information centre,
Royal Adelaide Hospital
South Australia, SA5063


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