INTRODUCTION

KOFIRAX SYRUP contains Ambroxol, Levosalbutamol and Guaifenesin which belong to the group of medicines known as Mucolytics, Bronchodilators, and Expectorants. It is indicated for the treatment of productive cough with mucous for adults and children (above 6 years) associated with bronchospasm (spasm of lung muscle causing breathing difficulty).

The conditions can be bronchitis (inflammation of bronchial tubes which carries air from and to the lungs), bronchial asthma (inflammatory airway disease), wheezing, chest congestion, cough, etc.

KOFIRAX SYRUP is not recommended for use in patients having heart disease and gastric ulceration. Before taking KOFIRAX SYRUP tell your doctor if you have lung, kidney or liver problems, habit of alcohol consumption, and ulcers in the lining of the stomach or intestine.

KOFIRAX SYRUP is not recommended for use in pregnant and breastfeeding women. KOFIRAX SYRUP is not recommended for use in children below 6 years of age. Consult with your doctor before taking.

The most common side effects of taking KOFIRAX SYRUP are altered or disturber taste sensation, numbness sensation in the throat, tongue, and mouth, and nausea. Contact your doctor if any of the symptoms does not improve or worsen.

USES OF KOFIRAX SYRUP

It is indicated for the treatment of productive cough with mucous for adults and children (above 6years) associated with following conditions:

• bronchospasm
• bronchitis
• bronchial asthma
• wheezing
• chest congestion

HOW KOFIRAX SYRUP WORKS

Ambroxol is a mucolytic agent that promotes mucus clearance by decreasing its viscosity and increasing its volume. It facilitates expectoration and eases productive cough. Guaiphenesin is an expectorant which works by reducing the viscosity of lung secretions and aids in spitting out the mucous. Levosalbutamol is a beta agonist that activates certain receptors called beta-2 adrenergic receptors in the lungs which facilitates smooth muscle relaxation and makes airways open for easy breathing and also acts as an anti-inflammatory agent. Together, they help patients with congestion, breathe freely and deeply.

DIRECTIONS FOR USE

Take KOFIRAX SYRUP as advised by your physician. Shake well before use. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.

SIDE EFFECTS OF KOFIRAX SYRUP

HOW TO MANAGE SIDE EFFECTS

Diarrhea

Take lots of fluids, such as water or fruit juice to stay hydrated. Do not consume any medicine on your own without consulting your doctor. Ask for your doctor’s advice if diarrhoea does not improve.

Nausea And Vomiting

Stick to simple meals. Eating oil-rich or spicy foods can be avoided. Try to drink lemonade or water slowly. Ask for your doctor’s advice if nausea does not improve.

Dry Mouth

Dry mouth can be managed by chewing sugar-free gum or sucking on sugar-free hard candies to stimulate the flow of saliva. Sip water at regular intervals of time. Do not use mouthwashes that contain alcohol because they can be drying. Consult your physician for advice

Skin Rash Or Itching

Hot water makes your skin irritated, so avoid taking hot showers. Do not scratch the affected area. Use sunscreen and protective clothing when outdoors. To soothe and hydrate the irritated skin, apply moisturizers. Contact your doctor if itching worsens.

Stomach Pain

Try to rest and relax. Eat slowly or try to keep frequent and smaller meals. Keep a heat pad on your stomach. If the symptom does not improve or worsens, contact your doctor.

WARNING & PRECAUTIONS

PREGNANCY

Contraindicated

KOFIRAX SYRUP is not recommended for use in pregnant women or if you are planning to have a baby. Consult your doctor before taking.

BREASTFEEDING

Contraindicated

KOFIRAX SYRUP is not recommended for use in breastfeeding women. Consult your doctor before taking KOFIRAX SYRUP.

DRIVING AND USING MACHINES

Use with Caution

Do not drive or operate machineries if you feel palpitation (awareness of increased heartbeats), skeletal muscle tremors (shaking movements of hand and legs) and muscle cramps after taking KOFIRAX SYRUP.

ALCOHOL

Consult your doctor

Inform your doctor before taking KOFIRAX SYRUP if you consume alcohol.

KIDNEY

Use with Caution

KOFIRAX SYRUP should be taken with caution in patients having kidney diseases. Consult your doctor before taking.

LIVER

Use with Caution

GBNKEYWORD] should be taken with caution in patients having kidney diseases. Consult your doctor before taking.

ALLERGY

Contraindicated

Do not take KOFIRAX SYRUP if you are allergic to Ambroxol, Levosalbutamol, Guaifenesin or any other ingredients of this medicine.

LUNGS

Consult your doctor

KOFIRAX SYRUP should be taken with caution in patients having lung diseases such as cough for a long time, asthma, or severe asthma attacks and primary ciliary dyskinesia (chronic respiratory tract infection with compromised airway movement). Consult your doctor for advice before taking KOFIRAX SYRUP.

HEART DISEASE

Contraindicated

KOFIRAX SYRUP is not recommended for use in patients having heart diseases such as pre-existing ischaemic heart disease or having any risk factors of developing ischaemic heart disease. Consult your doctor before taking KOFIRAX SYRUP.

INTERACTIONS

A. Drug - Drug interactions:

Before taking KOFIRAX SYRUP inform your doctor if you are taking nay of the following medicines:

• antibiotics like amoxicillin, cefuroxime, and erythromycin (medicines used to treat bacterial infections)
• medicines used for cough suppression (Ex. codeine)
• short-acting sympathomimetic bronchodilators such as albuterol, levalbuterol (used to provide relief from breathlessness)
• epinephrine (medicine used to severe allergic reactions)
• diuretics such as furosemide, bumetanide, spironolactone (used to remove excess fluid or water from the body)
• digoxin and beta blockers like atenolol, propranolol (used to treat heart problems like angina, heart failure, etc)
• monoamine oxidase inhibitors such as isocarboxazid, phenelzine, selegiline and tricyclic antidepressants such as amitriptyline, doxepin (used to treat depression)
• halogenated anaesthetic such as halothane, isoflurane, desflurane (used as anaesthetic agents in surgeries)

Overdosage:

If you or anyone else accidentally take too much of KOFIRAX SYRUP, consult your doctor immediately or visit the nearby hospital. Symptoms of overdose of KOFIRAX SYRUP are tachycardia (fast heart rate), low blood pressure, nervousness, tremor (shaking movements of hands, legs or body), headache, nausea (feel sick), vomiting or retching, dizziness or drowsiness, fatigue (overtiredness), sleeplessness, excessive salivation, and signs of hypokalaemia like muscle cramps and muscle weakness.

SYNOPSIS

MORE INFORMATION

• Keep KOFIRAX SYRUP out of reach of children
• Store KOFIRAX SYRUP at a temperature below 30°C

FAQs ABOUT KOFIRAX SYRUP

What are the uses of KOFIRAX SYRUP?

KOFIRAX SYRUP is indicated for the treatment of productive cough with mucous for adults and children (above 6years) associated with conditions like, bronchospasm, bronchitis, bronchial asthma, wheezing, fever, chest congestion, chronic obstructive pulmonary disease (COPD) and lower respiratory tract infections (LRTI).

When should I stop taking KOFIRAX SYRUP?

Take KOFIRAX SYRUP as long as your doctor advised you to take it. Do not discontinue the medicine on your own as it may not lead to expected results if discontinues prematurely. If you want to discontinue taking KOFIRAX SYRUP, talk to your doctor.

Is KOFIRAX SYRUP safe for use in heart patients?

KOFIRAX SYRUP is not recommended for use in patients having pre-existing ischaemic heart disease or having any risk factors of developing ischaemic heart disease. Consult your doctor before taking.

Can KOFIRAX SYRUP be given to infants?

KOFIRAX SYRUP is not recommended for use in infants or children below 6years of age. Your doctor will decide the correct dose or select a suitable alternative therapy for your child. Consult your doctor.

What should I do if I forgot to take KOFIRAX SYRUP?

If you have missed a dose by chance, try to take the KOFIRAX SYRUP as soon as possible when you notice. However, if the time for next dose is closer skip the dosage and do not try to take the double dosage. 

REFERENCES

1. KD. Tripathi. Drugs for Cough and Bronchial Asthma. Essentials of medical pharmacology. Eighth edition. 2013. Page – 238.

2. Ahmad Kantar, Ludger Klimek, Dorotheea Cazan, Annette Sperl, Ulrike Sent, and Margarida Mesquita. An overview of efficacy and safety of ambroxol for the treatment of acute and chronic respiratory diseases with a special regard to children. NIH National Library of Medicine, National centre for biotechnology information. PubMed Central. January 2020. [Accessed 22nd October 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137760/

3. Helmut H. Albrecht, Peter V. Dicpinigaitis, and Eric P. Guenin, Role of guaifenesin in the management of chronic bronchitis and upper respiratory tract infections. NIH National Library of Medicine, National centre for biotechnology information. PubMed Central. December 2017. [Accessed 22nd October 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5724298/

4. NIH National Library of Medicine, National center for biotechnology information. Pubchem. Ambroxol. [Accessed on 22nd October 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Ambroxol#section=Mechanism-of-Action

5. NIH National Library of Medicine, National center for biotechnology information. Pubchem. Levalbuterol. [Accessed on 22nd October 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Levalbuterol

6. M/s Tirupati Medicare Ltd. ASTHALIN AX Syrup. (Ambroxol + Levosalbutamol + Guaifenesin). Ciplamed. [Revised in December 2020] [Accessed 22nd October 2022] https://ciplamed.com/content/asthalin-ax-syrup https://www.ciplamed.com/content/urimax-d-tablets

7. Ravenbhel Biotech. CORDINE LS Syrup (Ambroxol + Levosalbutamol + Guaifenesin). Torrent Pharmaceuticals Ltd. [Accessed 22nd October 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/3058.pdf

8. US & VG Healthcare Pvt. Ltd. Ambroxol + Levosalbutamol + Guaifenesin Syrup. [Accessed 22nd October 2022] https://usvg.in/syrup-suspension/

9. Ellanjay Lifesciences. Ellkuff – LS (Ambroxol + Levosalbutamol + Guaifenesin). [Accessed 22nd October 2022] https://ellanjey.com/product/ellkuff-ls-100ml/

USEFUL DIAGNOSTIC TESTS

• CT scan
• MRI
• Chest X-rays
• Blood test