COMPOSITION :

Each 5 ml of Relievo LS Syrup contains:

• Levosalbutamol 1 mg
• Ambroxol Hydrochloride 30 mg
• Guaiphenesin 50 mg

DESCRIPTION

Levosalbutamol is a selective β-2-adrenoceptor agonist. At therapeutic doses it acts on the β-2-adrenoreceptors of bronchial muscle with little or no action on the α1-adrenoreceptors of cardiac muscle. Levosalbutamol (LEV) has approximately 2 fold greater affinity than racemic salbutamol (RAC) for the β2 adrenergic receptor and approximately 100 fold greater binding affinity than S-Salbutamol. Levosalbutamol stimulates the production of intracellular cyclic-AMP, enhancing the binding of intracellular calcium to the cell membrane and endoplasmic reticulum, resulting in bronchodilation. It also enhances mucociliary clearance.

Activation of the β-2-adrenoreceptors opens ATPase channels and drives potassium from the extracellular to the intracellular space. This both decreases extracellular hyperkalemia and increases intracellular potassium, so decreasing the chance of arrhythmia.

Ambroxol hydrochloride is a mucolytic agent, which liquefies thick, tenacious sputum. Ambroxol dissolves mucopolysaccharide fibers and thus reduces viscosity of sputum. It also improves mucocilliary clearance of secretions.

Guaiphenesin is an expectorant. It increases the output of sputum and bronchial secretions by reducing adhesiveness and surface tension. By increasing the volume of bronchial secretions, it reduces the viscosity of tenacious sputum. The increased flow of less viscid secretions also promotes ciliary action.

Relievo LS Syrup is an ideal combination. The ingredients are well absorbed after oral administration and provide prompt relief.

INDICATIONS

Relievo LS Syrup is indicated for the treatment of productive cough associated with bronchospasm in conditions such as bronchitis and bronchial asthma as well as all conditions associated with tenacious mucus, wheezing and chest congestion.

CONTRAINDICATIONS

Relievo LS Syrup is contraindicated in patients with hypersensitivity to any ingredient of the formulation.

PRECAUTIONS

While treating cough as a symptom, it is important to make every effort to determine and treat appropriately the underlying cause, such as a specific infection.

Caution should be observed while prescribing Relievo LS Syrup to children with hypertension, cardiovascular disease, uncontrolled juvenile diabetes mellitus, hyperthyroidism, seizures or in patients who are unusually hypersensitive to sympathomimetic amines.

DRUG INTERACTIONS

Hypokalemia with high doses of ß2 -agonists may result in increased susceptibility to digitalis induced cardiac arrhythmias. Hypokalemia may be enhanced by concomitant administration of aminophylline or other xanthines, corticosteroids or by diuretic therapy.

Other sympathomimetic bronchodilators or epinephrine should not be used concomitantly with salbutamol, since their combined effect on the cardiovascular system may be deleterious to the patient.

Salbutamol should be administered with caution in patients being treated with monoamine oxidase (MAO) inhibitors or tricyclic antidepressants, since the action of salbutamol on the vascular system may be potentiated.

ADVERSE REACTIONS

The adverse reactions to Levosalbutamol are similar in nature to those of other sympathomimetic agents and include nervousness and tremor. The frequency of these side effects appears to diminish with continued therapy. Other commonly reported reactions include increased heart rate, palpitations, dizziness, headache, drowsiness, vomiting, nausea, sweating and muscle cramps. These reactions are generally transient and usually do not require treatment.

With ambroxol gastrointestinal side effects may occur occasionally and a transient rise in serum aminotransferase values has been reported. Gastrointestinal discomfort has occasionally been reported with Guaiphenesin.

DOSAGE & ADMINISTRATION

The usual recommended dose of Relievo LS in children is as under:

• 2-5 years: 2.5 ml twice daily
• 6-12 years: 5 ml twice daily daily
• Adults: 10 ml twice daily

PRESENTATION

Relievo LS Syrup is available in 100 ml bottle.