INN monograph
Ambroxol hydrochloride + Terbutaline sulphate + Guaiphenesin)
Beta-2 adrenergic agonist (bronchodilator) · POM
Verified · Updated 01 Aug 2026 · Source: Local active-ingredient clinical extract; PubChem; Component monographs (multi-source pipeline); Professional class pharmacology (Beta-2 adrenergic agonist (bronchodilator))
Kenya market
Wholesale / list prices where loaded
Risk first
Contraindications
- Allergy to any of the components of the formulation, pre-existing ischaemic heart disease or those patients with significant risk factors for ischaemic heart disease, and
- gastric ulceration.
Precautions
- Paradoxical bronchospasm.
- Hypokalaemia with high dose/nebs especially with steroids/diuretics/xanthines.
- CV disease: tachycardia/arrhythmia risk.
- Thyrotoxicosis caution.
Point of care
Dosing
Adult
Adults: 10-20 mL TID. Children (6-12 years). 10 mL TID. Children (under 6 years). 5-10 mL TID
Paediatric
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Renal
Low for inhaled; monitor electrolytes if continuous nebs.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Hepatic
Low clinical concern for inhaled therapy.
Safety
Drug interactions
- Fixed-dose/multi-ingredient product.
- Clinical details partially inherited from component monographs: Terbutaline sulphate.
- Confirm combination SmPC for exact dosing.
Safety
Adverse effects
- [From component Terbutaline sulphate] Tachycardia, skeletal muscle cramp, palpitation, headaches, severe emotional disturbances, resistance after prolonged use, acidosis, GI disturbances, hypokaleamia, sweat
Use
Indications
- Relief of cough associated with bronchitis, bronchial asthma, emphysema and other bronchopulmonary disorders where bronchospasm, mucous plugging, and problems of expectoration co-exist.
- Clinical selection for Ambroxol hydrochloride + Terbutaline sulphate + Guaiphenesin) should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Beta-2 adrenergic agonist (bronchodilator).
- Confirm site-specific dose, duration and monitoring before prescribing.
Pharmacology
Mode of action
Combination product.
Full mechanism text
Combination product. Component mechanism (Terbutaline sulphate): It stimulates Beta-agonist in the lungs to relax bronchial smooth muscle, thereby relieving bronchospasm. This action may result from increased production of cAMP and ensuing reduction in intracellular calcium concentration caused by activation of the enzyme adenylate cyclase that catalyzes the conversion ATP to cAMP. Increased cAMP concentrations, in addition to relaxing bronchial smooth muscle, inhibit release of mediators of immediate hypersensitivity from cells, especially from mast cells.
ADME
Pharmacokinetics & PD
| Onset | Minutes (SABA) |
|---|---|
| Duration | 3–6 h SABA; 12 h LABA |
| Route | INHALATION / ORAL / NEB / IV (rare) |
| Absorption | causes tremor/tachycardia. Hepatic |
| Metabolism | of many agents. [Terbutaline sulphate] Inhaled route maximises lung delivery and reduces systemic effects. Systemic |
Full PK/PD text
[Ambroxol] Inhaled route maximises lung delivery and reduces systemic effects. Systemic absorption causes tremor/tachycardia. Hepatic metabolism of many agents. [Terbutaline sulphate] Inhaled route maximises lung delivery and reduces systemic effects. Systemic absorption causes tremor/tachycardia. Hepatic metabolism of many agents.
Kenya
Brands & prices
| Brand | Company | Pack | KES |
|---|---|---|---|
| Axalin Expectorant | Cipla Ltd. | Standard Commercial Pack | — |
| Broxol | Bliss GVS Pharma Ltd (See also GVS) | Standard Commercial Pack | — |
Special populations
Pregnancy & lactation
Pregnancy
[Ambroxol] Inhaled salbutamol widely used; uncontrolled asthma risk > drug risk. [Terbutaline sulphate] Inhaled salbutamol widely used; uncontrolled asthma risk > drug risk.
Lactation
Inhaled therapy generally compatible.
Diet
Food & alcohol
- Food
- Food
Trust
Sources & disclaimer
Source: Local active-ingredient clinical extract; PubChem; Component monographs (multi-source pipeline); Professional class pharmacology (Beta-2 adrenergic agonist (bronchodilator))
Last reviewed: 01 Aug 2026
Decision support only — not a substitute for clinical judgment, product SmPC, or Kenya STG/EML.