Tulsi Syrup

1. Expectoration in the following diseases

• Upper respiratory inflammation (pharyngitis, laryngitis)
• Acute bronchitis
• Bronchial asthma
• Chronic bronchitis
• Bronchiectasis
• Pulmonary tuberculosis

2. Drainage in chronic sinusitis
3. Drainage in otitis media with effusion

carbocisteine reduces the viscosity of non-infected secretions from mucous cells in the respiratory tract. The mucolytic action is due to two mechanisms. It breaks the disulphide bonds which cross-link certain glycoprotein molecules present in the mucus and it also alters local ionic charges, both of which factors affect the viscosity of mucus. There is also evidence that it alters the composition of mucin secreted by the respiratory mucosa, decreasing the proportion of neutral glycopeptides and increasing the sialoglycopeptides.

Adults (including elderly): Dosage is based upon an initial dosage of 2250 mg daily in divided doses (750 mg 3 times daily), reduced to 1500 mg daily in divided doses (375 mg 4 times daily), when a satisfactory response has been obtained.

Children: Normal daily dose is 20 mg/kg body weight in divided doses.
2-5 years: 62.5-125 mg 4 times daily.
6-12 years: 250 mg 3 times daily.
Infants: Dosage in infants has not been established.

Neither hazardous nor therapeutically useful interactions have been reported.

Contraindicated in active peptic ulceration and in patients with hypersensitivity to the drug.

Gastrointestinal discomfort, nausea, diarrhoea, gastrointestinal bleeding, headache and skin rash may occur.

Although there are no reports of teratogenic effects with carbocisteine, the drug is not recommended in the first trimester of pregnancy. No information available on the use of carbocisteine during lactation.

No specific precaution is recommended but Tulsi should be used with caution in patients with a recent history of peptic ulcer and recurrent gastrointestinal bleeding.

Cough expectorants & mucolytics

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.