Recently IAP is highlighting some of irrational drug combination. Bronchodilator along with ambroxol is one of them. Why is it irrational? Most of leading pharmaceutical companies are coming with this combination.

J.P. Goyal,
Assistant Professor,
Department of Pediatrics,
P.D.U.Medical College,Rajkot (GT), India
E-mail: [email protected]

There is hardly any concrete evidence for short-term effectiveness of ambroxol with respect to improvement of symptoms or pulmonary function in asthmatic children(1). It is not mentioned as a drug useful for this condition in any textbook including Nelson. The drug ambroxol does not find a place in the Medicines for Children 2003, BNF for children 2005 and the IAP Drug Formulary. There is some evidence that long-term use of ambroxol could alleviate symptoms but it takes more than a month of use to have any significant effect (2). Therefore, it may have a place in the treatment of COPD in adults and very little use in acute asthma in children. Hence, any fixed combination of drugs with ambroxol, whether it be with an antibiotic or with bronchodilators, must be considered as irrational.

Jeeson Unni,
Editor-in-Chief,
IAP Drug Formulary 2004,
Dr. Kanhalu’s Nursing Home,
T.D. Road, Kochi 682 01, India.
E-mail: [email protected]  

1. Guyatt GH, Townsend M, Kazim F, Newhouse MT. A controlled trial of ambroxol in chronic bronchitis. Chest 1987; 92: 618-620.

2. Olivieri D, Zavattini G, Tomasini G, Daniotti S, Bonsignore G, Ferrara G, et al. Ambroxol for the prevention of chronic bronchitis exacerbations: long-term multicenter trial. Protective effect of ambroxol against winter semester exacerbations: a double-blind study versus placebo. Respiration 1987; 51 Suppl 1: 42-51.