Butamirate

Butamirate is a cough suppressant primarily used to treat dry, non-productive coughs. It works by acting centrally in the brain to suppress the cough reflex and peripherally by relaxing the airway muscles. Butamirate is not an opioid and does not cause sedation or respiratory depression, making it a safer alternative to some other cough suppressants. Butamirate has been approved in several countries for the treatment of dry coughs, typically available in syrup form. It is approved as a prescription medication in many regions, while in others, it may be available over-the-counter. Approval processes vary by country, with regulatory agencies assessing its safety, efficacy, and quality before granting market authorization.

BRAND NAMES

Sinecod: Primarily used as a cough suppressant to treat dry, non-productive coughs, including those caused by respiratory infections or irritants

Tussofen: Often used to relieve dry coughs and irritation in the throat, acting as a central antitussive.

MECHANISM OF ACTION

Butamirate works through a combination of central and peripheral mechanisms to suppress the cough reflex. It acts on the cough center in the brain, specifically in the medulla, to reduce the cough reflex. This helps to decrease the urge to cough without causing sedation or respiratory depression, unlike opioid-based cough suppressants and also has bronchodilatory effects, helping to relax the airway muscles, which can reduce airway irritation and make it easier to breathe. Additionally, it exhibits some anti-inflammatory properties, which can help reduce inflammation in the respiratory tract.

PHARMACOKINETICS

Absorption:

Butamirate is well absorbed after oral administration, with peak plasma concentrations typically occurring within 1 to 2 hours.

Distribution:

It is widely distributed throughout the body, including the respiratory tissues, where it exerts its effects. Butamirate binds moderately to plasma proteins.

Metabolism:

Butamirate undergoes extensive metabolism in the liver, primarily forming inactive metabolites, such as Butamirate N-Oxide. Its metabolic pathways involve cytochrome P450 enzymes.

Excretion:

The metabolites are excreted mainly through the urine, with a small portion being exhaled. The half-life of Butamirate is around 4 to 8 hours.

DOSAGE AND ADMINISTRATION

The typical oral dosage for Butamirate varies based on age and the specific formulation used (e.g., syrup, tablet). Below are general guidelines, but it's important to follow the exact instructions provided by a healthcare professional:

Adults:

Syrup: 10 to 20 mg, 3 times a day.

Tablets: 20 mg, 2 to 3 times a day.

Children (depending on age):

2-6 years: 5 mg, 3 times a day.

6-12 years: 10 mg, 3 times a day.

Administration:

Butamirate should be taken orally, with or without food, according to the prescribed dosage. For the syrup, it is important to use the provided dosing spoon or device for accurate measurement.

DRUG INTERACTION

Butamirate may interact with CNS depressants (e.g., sedatives, alcohol), increasing sedation, and with other cough suppressants, leading to excessive suppression of the cough reflex. Always consult a healthcare provider before combining it with other medications.

CONTRAINDICATIONS