Sodium citrate Ammonium chloride

Robitus 60ml EXPECTORANT

Formulation: Ammonium Chloride, USP..1.5 g Sodium citrate, USP.2.5 g Citric acid, USP.0.8 g Sodium benzoate0.12 g Glycerin.5 ml Ethyl alcohol, 95%.5 ml Simple syrup..20 ml PHARMACOLOGOC PROPERTIES
Pharmacodynamics The ammonium ion (NH4+) in the body plays an important role in the maintenance of acid-base balance. The kidney uses ammonium (NH4+) in place of sodium (Na+) to combine with fixed anions in maintaining acid-base balance, especially as a homeostatic compensatory mechanism in metabolic acidosis.When a loss of hydrogen ions (H+) occurs and serum chloride (Cl) decreases, sodium is made available for combination with bicarbonate (HCO3). This creates an excess of sodium bicarbonate (NaHCO3) which leads to a rise in blood pH and a state of metabolic alkalosis.The therapeutic effects of Ammonium Chloride depend upon the ability of the kidney to utilize ammonia in the excretion of an excess of fixed anions and the conversion of ammonia to urea by the liver, thereby liberating hydrogen (H+) and chloride (Cl) ions into the extracellular fluid.

Indication
Expectorants are drugs that increase the bronchial secretion and enhance the expulsion of mucus by air passages of the lungs. This makes it is easier to cough up the phlegm or sputum. Expectorants are used in cough mixtures for chesty coughs.

Contraindication
Ammonium chloride is contraindicated in patients with severe impairment of renal or hepatic function. Ammonium chloride should not be administered when metabolic alkalosis due to vomiting of hydrochloric acid is accompanied by loss of sodium (excretion of sodium bicarbonate in the urine). Patients on sodium-restricted diets; impaired renal function with oliguria, azotemia, or anuria; untreated Addison disease; adynamia episodica hereditaria; acute dehydration; heat cramps; severe myocardial damage; hyperkalemia.

DOSAGE AND ADMINISTRATION

Adults and children over 12 years: Two 5mL spoonfuls (10mL) three to four times daily. Children 6 to 12 years: One 5mL spoonful three times daily. Children 2 to 6 years: Half 5mL spoonful (2.5mL) three times daily.

Drug Interaction Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide,phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) within 2 weeks before and during treatment with this medication. In some cases a serious (possibly fatal) drug interaction may occur. Guaifenesin and dextromethorphan are available in both prescription and nonprescription products. Check the labels of all your medications to make sure you are not taking more than one product containing guaifenesin or dextromethorphan. Guaifenesin can affect the results of certain lab tests (such as urine levels of certain acids). Make sure laboratory personnel and all your doctors know you use this drug. Pregnancy and lactation During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown if guaifenesin or dextromethorphan passes into breast milk. Discuss the risks and benefits with your doctor before breast-feeding. Precaution Before taking this drug, tell your doctor or pharmacist if you are allergic to guaifenesin or dextromethorphan; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as emphysema, chronic bronchitis, asthma, smoker's cough), cough with blood or large amounts of mucus, liver problems. This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. Liquid forms of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, liver disease, or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely. Caution Food, Drugs, Devices and Cosmetics Act prohibits dispensing without prescription. Storage Condition Store in a dry place below 25C. Protect from light. Availability Ammonium Chloride, 60ml

Warnings
Ask a doctor before use if you have: a cough that occurs with too much phlegm (mucus) a persistent or chronic cough such as occurs with smoking, asthma, chronic bronchitis, or emphysema Stop use and ask a doctor if: cough lasts more than 7 days, comes back, or occurs with fever, rash, or headache that lasts These could be signs of a serious condition. PHILMEDPHARMA
Exp. Date: JUN 15 Mfg Date: JUN 13 Lot No.: PMP-4-023B