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1564 Cough Suppressants Expectorants Mucolytics and Nasal Decongestants

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1564 Cough Suppressants Expectorants Mucolytics and Nasal Decongestants 1564 Cough Suppressants Expectorants Mucolytics and Nasal Decongestants Levmetamfetamine (USAN, rINN) ⊗ Mecysteine Hydrochloride (BANM, rINNM) CAS — 93-30-1 (methoxyphenamine); 5588-10-3 (meth- oxyphenamine hydrochloride). l-Deoxyephedrine; L-Desoxiefedrina; L-Desoxyephedrine; Le- Hidrocloruro de mecisteína; Mécystéine, Chlorhydrate de; ATC — R03CB02. soxyephedrine; Levmétamfétamine; Levmetamfetaminum; Lev- Mecysteini Hydrochloridum; Methyl Cysteine Hydrochloride; ATC Vet — QR03CB02. metanfetamina; Levometanfetamina; l-Methamphetamine; l- Methylcysteine Hydrochloride. Methyl L-2-amino-3-mercapto- Methylamphetamine. (R)-N,α-Dimethylbenzeneethanamine; (−)- propionate hydrochloride. (R)-N,α-Dimethylphenethylamine. Мецистеина Гидрохлорид H Левметамфетамин C H NO S,HCl = 171.6. N 4 9 2 CH C10H15N = 149.2. CAS — 2485-62-3 (mecysteine); 18598-63-5 (mecysteine 3 CAS — 33817-09-3. hydrochloride); 5714-80-7 (mecysteine hydrochloride). CH3 OCH3 H OO (methoxyphenamine) N H3C CH3 Profile SH H CH3 H N Methoxyphenamine is a sympathomimetic with effects similar 2 to those of ephedrine (p.1558), given orally as the hydrochloride. It has been used as a bronchodilator mainly in combination prep- Pharmacopoeias. In US. (mecysteine) arations for the relief of cough and nasal congestion. USP 31 (Levmetamfetamine). A clear, practically colourless, Preparations liquid. Store in airtight containers. Protect from light. Adverse Effects and Precautions Nausea and heartburn have occasionally been reported. Since Proprietary Preparations (details are given in Part 3) Profile mucolytics may disrupt the gastric mucosal barrier mecysteine Multi-ingredient: Chile: Cheracol; Hong Kong: Asmeton; Irl.: Casacol; Levmetamfetamine is the laevo isomer of metamfetamine hydrochloride should be used with caution in patients with a his- Thai.: Asmeton†; Venez.: Metoxifilin. (p.2158) and is used topically in the treatment of nasal conges- tory of peptic ulcer disease. tion (p.1548). Uses and Administration Abuse. Levmetamfetamine is a less potent central stimulant Mecysteine hydrochloride is used as a mucolytic in respiratory Methyl Dacisteine (rINNM) than metamfetamine, but it has been subject to occasional disorders associated with productive cough (p.1547). It is given abuse.1,2 In addition, as a stimulant its use is prohibited in sport Dacisteína de metilo; Dacistéine Méthyle; Dacisteinum Methylis; orally in a usual dose of 200 mg three times daily before meals during competition. However, it is classed by the World Anti- EL-1035 (dacisteine); Methyl Diacetylcysteinate. Methyl N,S- reduced to 200 mg twice daily after 6 weeks. A rapid clinical ef- Doping Agency as one of the specified substances particularly diacetyl-L-cysteinate. fect can be achieved by giving 200 mg four times daily for the susceptible to unintentional anti-doping rule violations because first 2 days. For children’s doses, see Administration in Children, Дацистеин Метил of general availability in medicinal products or which are less 3 below. Mecysteine has also been given by inhalation. C8H13NO4S = 219.3. likely to be successfully abused as doping agents. CAS — 18725-37-6 (dacisteine); 19547-88-7 (methyl da- 1. Halle AB, et al. Drug abuse with Vicks nasal inhaler. South Med Administration in children. The recommended oral dose of cisteine). J 1985; 78: 761–2. mecysteine hydrochloride in children aged 5 to 12 years is 2. Ferrando RL, et al. Bizarre behavior following the ingestion of 100 mg 3 times daily. levo-desoxyephedrine. Drug Intell Clin Pharm 1988; 22: 214–17. Respiratory disorders. Mecysteine hydrochloride given oral- H3C O 3. World Anti-Doping Agency. The World Anti-Doping Code: ly has reduced symptoms of cough in patients with chronic bron- 2007 Prohibited List International Standard (issued 16 Septem- chitis or other respiratory disorders, but its effect on sputum pro- HNH ber, 2006). Available at: http://www.wada-ama.org/rtecontent/ duction and pulmonary function has been variable.1,2 The use of document/2007_List_En.pdf (accessed 04/04/07) mucolytics in chronic obstructive pulmonary disease (p.1112) is H3CS OH Preparations controversial. Proprietary Preparations (details are given in Part 3) 1. Aylward M, et al. Clinical therapeutic evaluation of methyl- O O USA: Vicks Vapor Inhaler. cysteine hydrochloride in patients with chronic obstructive bron- chitis: a balanced double-blind trial with placebo control. Curr (dacisteine) Med Res Opin 1978; 5: 461–71. 2. Sahay JN, et al. The effect of methyl cysteine (Visclair) in respi- Marrubium ratory diseases: a pilot study. Clin Trials J 1982; 19: 137–43. Profile Like acetylcysteine (p.1548), methyl dacisteine has been used as Andornkraut; Herba Marrubii; Hurtanminttu; Jablečníková nat’; Preparations a mucolytic in respiratory disorders associated with productive Juanrubio; Kransborre; Malva de sapo; Malvarrubia; Marrube Proprietary Preparations (details are given in Part 3) cough (p.1547). It has been given orally in a usual dose of blanc, parties aériennes fleuries de; Marrubii herba; Marrubio; Irl.: Visclair; UK: Visclair. 600 mg daily, divided into 3 or 4 doses. Šantru˛ žole˙; White Horehound. Multi-ingredient: Ital.: Donatiol. Preparations Шандра Обыкновенная Proprietary Preparations (details are given in Part 3) Fr.: Mucothiol; Hung.: Mucothiol†; Ital.: Mucothiol. Menglytate (rINN) Menglitato; Menglytatum; Menthol Ethylglycolate. p-Menth-3-yl O ethoxyacetate. Methylephedrine Hydrochloride (BANM) ⊗ CH3 OH CH3 Менглитат dl-Methylephedrine Hydrochloride; dl-N-Methylephedrine Hy- C H O = 242.4. drochloride; Metilefedrina, hidrocloruro de. (1RS,2RS)-2- H 14 26 3 CAS — 579-94-2. Dimethylamino-1-phenylpropan-1-ol hydrochloride. Метилэфедрина Гидрохлорид H3C H O C11H17NO,HCl = 215.7. CH3 CAS — 552-79-4 ((−)-methylephedrine); 1201-56-5 ((±)- O methylephedrine); 38455-90-2 ((−)-methylephedrine hy- drochloride); 942-46-1 ((±)-methylephedrine hydrochlo- (marrubiin) ride); 18760-80-0 ((±)-methylephedrine hydrochloride). O Pharmacopoeias. In Eur. (see p.vii). Ph. Eur. 6.2 (White Horehound). The whole or fragmented H3C O CH3 OH CH3 dried flowering aerial parts of Marrubium vulgare. It contains a CH3 O N minimum 0.7% of marrubiin (C20H28O4 = 332.4), calculated as the dried drug. CH3 Profile CH Profile Menglytate is an ingredient of a number of preparations promot- 3 Marrubium is the flower or leaf of Marrubium vulgare (Labia- ed for the treatment of cough. tae). It has been used for its supposed expectorant properties in (methylephedrine) herbal preparations for the treatment of cough. It has also been Preparations used as a flavouring. Proprietary Preparations (details are given in Part 3) Pharmacopoeias. In Jpn. Preparations Multi-ingredient: Ital.: Coryfin C; Neo Borocillina Balsamica. Profile Proprietary Preparations (details are given in Part 3) Methylephedrine hydrochloride is a sympathomimetic with ef- Ger.: Angocin Bronchialtropfen. fects similar to those of ephedrine (p.1558). It has been used as a Multi-ingredient: Austral.: Broncafect; Verbascum Complex†; Austria: Methoxyphenamine Hydrochloride bronchodilator and is given orally in combination preparations Asthmatee EF-EM-ES; Gallen- und Lebertee St Severin; Canad.: Herbal for the relief of cough and nasal congestion. Throat†; Original Herb Cough Drops; Swiss Herb Cough Drops; Chile: (BANM, rINNM) ⊗ Fucus Compuesto†; Cz.: Original Schwedenbitter; Species Cholagogae Preparations Planta; The Salvat; Zlucnikova Cajova Smes; Ital.: Altuss; Broncosedina; Hidrocloruro de metoxifenamina; Methoxiphenadrin Hydro- Pol.: Amarosal; S.Afr.: Cough Elixir; Spain: Natusor Asmaten†; Natusor chloride; Méthoxyphénamine, Chlorhydrate de; Methoxyphen- Proprietary Preparations (details are given in Part 3) Broncopul†; Switz.: Hederix; UK: Allens Chesty Cough; Asthma & Catarrh amini Hydrochloridum; Mexyphamine Hydrochloride. 2-Meth- Multi-ingredient: Austria: Tussoretardin; Hong Kong: Codaewon; Jpn: Relief; Catarrh-eeze; Chest Mixture; Cough-eeze; Herb and Honey Cough Colgen Kowa IB Toumei; Sin Colgen Kowa Kaze; S.Afr.: Ilvico; Switz.: Elixir; Honey & Molasses; Horehound and Aniseed Cough Mixture; Mod- oxy-Nα-dimethylphenethylamine hydrochloride. Tossamine plus; Thai.: Coughmin†; Hustazol-C†; Methorcon; Venez.: Ilvi- ern Herbals Cough Mixture; Vegetable Cough Remover. Метоксифенамина Гидрохлорид co. C11H17NO,HCl = 215.7. Levmetamfetamine/Naphazoline 1565 Metizoline Hydrochloride (BANM, USAN, rINNM) ⊗ Naphazoline Hydrochloride (BANM, rINNM) ⊗ Uses and Administration EX-10-781; Hidrocloruro de metizolina; Métizoline, Chlorhy- Hidrocloruro de nafazolina; Nafatsoliinihydrokloridi; Nafazolin Naphazoline is a sympathomimetic (p.1408) with drate de; Metizolini Hydrochloridum; Metyzoline Hydrochloride; Hidroklorür; Nafazolin-hidroklorid; Nafazolin-hydrochlorid; Na- marked alpha-adrenergic activity. It is a vasoconstric- RMI-10482A. 2-(2-Methylbenzo[b]thienylmethyl)-2-imidazoline fazolinhydroklorid; Nafazolino hidrochloridas; Naphazoline, chlo- tor with a rapid and prolonged action in reducing swell- hydrochloride. rhydrate de; Naphazolini hydrochloridum. ing and congestion when applied to mucous mem- Метизолина Гидрохлорид Нафазолина Гидрохлорид branes. C H N S,HCl = 266.8. 13 14 2 C14H14N2,HCl = 246.7. Naphazoline and its salts are used for the symptomatic CAS — 17692-22-7 (metizoline); 5090-37-9 (metizoline CAS — 550-99-2. hydrochloride). relief of nasal congestion (p.1548). Solutions contain- ATC — R01AA08; R01AB02; S01GA01. ing 0.05 to 0.1% of the hydrochloride or the nitrate ATC — R01AA10. ATC Vet — QR01AA08; QR01AB02;
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