carbocisteine

Action and Spectrum

Actions and Spectrum: 

carbocisteine is a mucolytic agent, which modifies mucus’s properties in the respiratory tract. Its mechanism of action involves breaking down the disulfide bonds that link mucus proteins together. carbocisteine reduces mucus’s viscosity (thickness) and stickiness by disrupting these bonds.

Thinned mucus is more accessible to clear from the airways through coughing and natural respiratory movements. This helps improve airflow, aids in the removal of irritants and pathogens and eases breathing. carbocisteine’s spectrum of activity is primarily focused on conditions that involve excessive and thick mucus production in the respiratory tract. 

Drug Interaction

Adverse Reaction

Frequency undefined 

Gastrointestinal bleeding 

Epigastric discomfort 

Diarrhea 

Rash 

Black Box Warning

Black box warning: 

None 

Contraindication / Caution

Contraindications/caution: 

• Hypersensitivity: Individuals with known hypersensitivity or allergy to carbocisteine or its components should not use the medication. 
• Active Peptic Ulcer: carbocisteine may increase gastrointestinal bleeding risk and worsen an active peptic ulcer. Therefore, it is typically contraindicated in individuals with active peptic ulcers. 
• Previous Gastrointestinal Hemorrhage: Individuals with a history of gastrointestinal bleeding should avoid using carbocisteine due to the potential risk of exacerbating bleeding. 
• Asthma: While carbocisteine is generally used to manage respiratory conditions, it is contraindicated in individuals with asthma. There have been concerns that carbocisteine might trigger bronchospasm in some instances of asthma. 

Pregnancy / Lactation

Pregnancy consideration: Insufficient data available 

Lactation: Excretion of the drug in human breast milk is unknown 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

carbocisteine works by disrupting the disulfide bonds that hold mucus proteins together. This action reduces the viscosity and stickiness of the mucus, making it less thick and easier to expel from the respiratory tract. By thinning the mucus, carbocisteine helps to improve airflow and clearance of respiratory secretions. 

Pharmacodynamics:  

The pharmacodynamics of carbocisteine involve its ability to thin and reduce the stickiness of respiratory mucus. Disrupting mucus protein bonds makes mucus less viscous, enhancing its clearance from airways. This promotes effective coughing, prevents airway blockages, and eases breathing. carbocisteine’s effects improve mucus mobility, aid in removing irritants and pathogens, and contribute to symptom relief in respiratory conditions characterized by excess mucus production. 

Pharmacokinetics: 

Absorption 

carbocisteine is well-absorbed after oral administration. It is absorbed from the gastrointestinal tract into the bloodstream, where it reaches therapeutic concentrations. 

Distribution 

carbocisteine is distributed throughout the body, including the respiratory tract, exerting mucolytic effects on mucus. It crosses the blood-brain barrier minimally. 

Metabolism 

carbocisteine undergoes minimal metabolism in the liver. It is primarily excreted unchanged or as its metabolites. 

Elimination and Excretion 

The primary route of excretion for carbocisteine is through the urine. A portion of the dose is eliminated, while some are eliminated as metabolites.

Adminstartion

Administration: 

Oral administration 

carbocisteine is typically administered orally and comes in various formulations, such as capsules, tablets, or liquid solutions. carbocisteine is typically taken with meals to enhance absorption and reduce the likelihood of stomach upset. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: carbocisteine 

Why do we use carbocisteine? 

carbocisteine is a medication primarily used to manage respiratory conditions that involve excessive and thick mucus production.  

• Chronic Obstructive Pulmonary Disease (COPD): carbocisteine can be used as part of the management strategy for COPD, a chronic lung disease that involves airflow limitation. It helps improve mucus clearance and alleviate symptoms associated with excessive mucus production. 
• Chronic Bronchitis: It is characterized by inflamed airways and increased mucus production. carbocisteine is used to reduce the viscosity of mucus, making it easier to cough up and improving breathing. 
• Cystic Fibrosis: It is a genetic disorder that leads to sticky and thick mucus in the respiratory and digestive systems. carbocisteine can be used as an adjunct treatment to help clear mucus from the airways of individuals with cystic fibrosis. 
• Other Respiratory Conditions: carbocisteine may also be used in other respiratory disorders where excessive mucus production is a concern, such as bronchiectasis or certain upper respiratory tract infections. 
• Mucus Clearance Aid: In various respiratory conditions, carbocisteine is a supportive treatment to remove mucus from the airways. Reducing mucus viscosity promotes effective coughing and improves overall lung function.