Montefarmaco Otc Bechilar 3mg/ml Cough Suppressant Syrup Bottle 100ml

NAME
BECHILAR 3 MG / ML SYRUP

PHARMACOTHERAPEUTIC CATEGORY
Antitussives, excluding associations with expectorants.

ACTIVE PRINCIPLES
Dextromethorphan hydrobromide.

EXCIPIENTS
One bottle of syrup contains: fructose, glycerol, citric acid monohydrate, sodium hydroxide, black cherry flavor, acesulfame potassium, methyl p-hydroxybenzoate, propyl p-hydroxybenzoate, purified water.

INDICATIONS
Cough suppressant with central action; cough suppressant.

CONTRAINDICATIONS / SECONDARY EFFECT
Hypersensitivity to the active substance or to any of the excipients; patients with chronic respiratory disorders; patients who are taking or have taken monoamine oxidase inhibitor antidepressants (MAOIs) within the last two weeks.

DOSAGE
Adults: a tea spoon 1 to 3 times a day. Teens and children over 2 years: half to a coffee spoon from 1 to 3 times a day, depending on the age. Do not exceed the recommended dose. Do not use in children under the age of two unless otherwise indicated by a doctor.

STORAGE
This medicinal product does not require any special storage conditions.

WARNINGS
The treatment should not be continued beyond 5-7 days. The product is not recommended in asthmatic patients. Administer with caution in subjects with impaired liver function. Cases of dextromethorphan abuse have been reported. Special care is recommended with adolescents and young adult children, as well as with patients with a history of alcoholism and / or drug or psychoactive substance abuse. Dextromethorphan is metabolised by hepatic cytochrome P450 2D6. The activity of this enzyme is genetically determined. About 10% of the population metabolise CYP2D6 slowly. Exaggerated and / or prolonged effects of dextromethorphan may occur in poor metabolisers and patients with concomitant use of CYP2D6 inhibitors. Therefore, caution should be exercised in patients who are poor metabolisers of CYP2D6 or who use CYP2D6 inhibitors. This medicine contains fructose as an excipients therefore patients with rare hereditary problems of fructose intolerance should not take this medicine. This medicine contains Methyl p-hydroxybenzoate and Propyl p-hydroxybenzoate among the excipients therefore it can cause allergic reactions (even delayed).

INTERACTIONS
Administration of dextromethorphan in patients who have received MAO inhibitors can cause serious adverse reactions, including serotonin syndrome. Patients should consult their physician before taking dextromethorphan in case of concomitant therapy with selective serotonin reuptake inhibitor antidepressants or tricyclic antidepressants as serotonin syndrome may occur. Do not use at the same time and in the weeks following antidepressant therapy. The use of alcohol during therapy is not recommended because it can accentuate the undesirable effects of the drug. CYP2D6 inhibitors Dextromethorphan is metabolised by CYP2D6 and has extensive first pass metabolism. Concomitant use of potent inhibitors of the CYP2D6 enzyme can increase dextromethorphan concentrations in the body to levels many times above normal. This increases the patient's risk of the toxic effects of dextromethorphan (agitation, confusion, tremor, insomnia, diarrhea and respiratory depression) and of developing serotonin syndrome. Potent inhibitors of CYP2D6 are fluoxetine, paroxetine, quinidine and heterbinafine. In concomitant use with quinidine, plasma concentrations of dextromethorphan are increased up to 20-fold, resulting in increased adverse effects on the central nervous system of the agent. Amiodarone, flecainide and propafenone, sertraline, bupropion, methadone, cinacalcet, haloperidol, perphenazine and thioridazine also have similar effects on the metabolism of dextromethorphan. If concomitant use of CYP2D6 inhibitors and dextromethorphan is required, the patient should be monitored and the dextromethorphan dose may need to be reduced.

SIDE EFFECTS
Side effects are rare. Nervous system disorders: drowsiness; dizziness. Gastrointestinal disorders: gastrointestinal disorders; nausea; He retched; abdominal discomfort.

PREGNANCY AND BREASTFEEDING
Do not use during pregnancy and lactation, unless clearly needed.