Carbolin DS

• Chronic Obstructive Pulmonary Disease (COPD):
  As a mucolytic agent to reduce sputum viscosity and facilitate expectoration.
• Chronic Bronchitis:
  To relieve productive cough and improve mucus clearance.
• Bronchiectasis:
  Adjunct therapy to aid mucus clearance and reduce exacerbations.
• Other Respiratory Conditions with Excessive Mucus Production:
  Including cystic fibrosis (off-label use), asthma with mucus hypersecretion.

• Adults:
  Oral dose typically 750 mg to 1500 mg daily, divided into 2–3 doses (e.g., 250 mg three times daily or 375 mg twice daily).
  Dose may be adjusted based on clinical response.
• Pediatrics:
  Generally not recommended for children under 2 years. For older children, dosing should be carefully adjusted by a physician.
• Elderly:
  Use standard dosing with monitoring for tolerability.
• Renal/Hepatic Impairment:
  No specific dose adjustments established; use with caution in severe impairment.
• Administration Route:
  Oral tablets or syrup.
• Duration:
  As prescribed; typically used during acute exacerbations or as maintenance in chronic conditions.

Carbocisteine acts as a mucolytic agent by regulating the structure of mucus glycoproteins, specifically by breaking disulfide bonds within mucus molecules. This reduces mucus viscosity and elasticity, facilitating easier expectoration. Additionally, carbocisteine may exert antioxidant effects by replenishing intracellular glutathione, helping reduce oxidative stress in the respiratory tract and improving mucociliary clearance.

• Absorption:
  Well absorbed from the gastrointestinal tract after oral administration.
• Bioavailability:
  High oral bioavailability.
• Distribution:
  Widely distributed; crosses into respiratory secretions.
• Metabolism:
  Partially metabolized in the liver to active metabolites.
• Half-life:
  Approximately 1 to 2 hours.
• Elimination:
  Primarily excreted in urine as metabolites.

• Pregnancy:
  Limited human data; generally considered category B or equivalent—use only if clearly needed.
• Lactation:
  Excretion in breast milk is not well documented; use with caution during breastfeeding.

• Primary: Mucolytic agent
• Subclass: Thiol derivative

• Known hypersensitivity to carbocisteine or any formulation components.
• Severe liver or kidney impairment (use caution).
• Peptic ulcer disease (relative contraindication due to potential mucosal irritation).

• Use cautiously in patients with asthma, as mucolytics may provoke bronchospasm.
• Monitor for signs of hypersensitivity reactions.
• Caution in patients with impaired hepatic or renal function.
• Avoid concurrent use with cough suppressants that may impair mucus clearance.

Common:

• Gastrointestinal discomfort (nausea, vomiting, diarrhea)
• Abdominal pain
• Headache
• Dizziness

Serious/Rare:

• Hypersensitivity reactions (rash, urticaria)
• Bronchospasm (especially in asthmatic patients)
• Anaphylaxis (very rare)

• Possible interaction with antitussive agents (may reduce effectiveness of mucus clearance).
• No significant interactions via CYP450 enzymes reported.
• Avoid combination with other mucolytics without medical advice.

• Current respiratory guidelines recommend carbocisteine as part of symptomatic management in COPD and chronic bronchitis to reduce sputum viscosity and exacerbation frequency.
• Newer studies continue to evaluate antioxidant benefits in chronic respiratory diseases.
• No major recent changes in dosing or safety warnings.

• Store at 20°C to 25°C (room temperature).
• Protect from moisture and direct sunlight.
• Keep container tightly closed.
• Keep out of reach of children.