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Treating heavy coughs

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Many years ago, my then five-year-old son was diagnosed as asthmatic. This was a major shock; at that time, effective treatments were only just starting to appear on the broader market. Our earliest signs were that our family doctor treated our son for his heavy cough about three to four times every winter. When asthma first became a health issue in our family, there were none of the current treatments that provided immediate relief for people struggling to get their breath during an asthma attack. Some remedies, like injections of adrenaline, were too radical for us to subject a small child to. A few years later, fast-acting bronchodilators like Ventolin (generic salbutamol) appeared and significantly impacted our lives. To this day, my (now adult) son wouldn’t dream of leaving home without his Ventolin puffer in his pocket. However, as good as Ventolin is at providing short-term relief from asthmatic attacks, there are some longer-term issues that it can’t help him with, and for this reason, he has been looking further afield to find other medications that can help him manage the ancillary conditions in his respiratory system that most sufferers of asthma are subject to. It’s necessary to accept that there’s no cure for asthma. Changes in lifestyle, environment, and diet can make attacks less frequent and lower the intensity, but there’s always the chance that something will trigger an attack entirely without warning. That is how we learned that keeping the right medication on hand and working hand in hand with our doctors and the latest pharmaceutical developments was such an important consideration.

Is asthma related to bronchitis?

At first, the main focus for treating our son was to handle his bronchitis. Asthma and bronchitis are different conditions with separate causes but share some symptoms. Pre-existing asthma can make a person susceptible to bronchitis, as was the case for our boy. Bronchitis and asthma can occur simultaneously without any apparent link. The doctors explained that when acute bronchitis and asthma are diagnosed simultaneously, it is called chronic asthmatic bronchitis Both asthma and bronchitis cause difficulty in breathing, but they require very different treatment approaches. We learned that the quickest way to distinguish between an attack of one or the other was to pay attention to our son’s breathing. Asthma’s primary symptoms are shortness of breath, wheezing, and shallow coughing. Attacks can be triggered by exertion, air pollution (especially smoke), and pollen. His attacks occurred most often in the early morning but were entirely unpredictable. When it was bronchitis, the breathing patterns were different, with more persistent coughing that produced mucus, complaints of soreness in his chest, headaches, and feverish chills. The attacks usually lasted for only a few days to a couple of weeks as long as proper medication and bed rest were administered. In those attacks, the medication was changed to long-acting bronchodilators, antibiotics, and a tablet or liquid medicine that was intended to loosen up the phlegm and make the coughing easier.

Is asthma related to COPD?

Another condition with which asthma shares many symptoms is chronic obstructive pulmonary disease (COPD). Here, the signs are persistent wheezing, coughing, difficulty in breathing during exercise, chest tightness and shortness of breath. Asthma can even cause COPD, in a person whose lungs have been damaged by poorly controlled asthma such as when the person was subjected to continuous exposure to irritants (tobacco smoke, pollution, chemicals in the air, etc.) The main COPD diagnosis comes from coughing with increased mucus or phlegm. Some people have both asthma and COPD. This is referred to as Asthma-COPD Overlap or ACO. When this does happen, treatment has to be more aggressive, usually involving inhaled corticosteroids, a bronchodilator inhaler with longer action than Ventolin (like Trelegy Ellipta), and muscarinic medication like Mucolit (tablets or liquid) to reduce the viscosity of phlegm. COPD can develop into other progressive lung diseases, including emphysema and chronic bronchitis.  Since all three conditions led to our son experiencing the same symptoms, a heavy cough that produces lots of mucus, we searched for the simplest remedy that would help break up the phlegm and shorten his time spent coughing.

What have we learned about treating heavy coughs?

Before resorting to prescribed treatments, we discovered Mucolit (generic carbocisteine), an over-the-counter medicine that reduces the viscosity of phlegm and sputum in the lungs. The drug is intended to relieve disorders in the respiratory system that are accompanied by increased viscous mucus secretion. It is available in three forms:
  • Mucolit Syrup (250mg per 5ml)
  • Mical Tablets (375mg)
  • Mucolit Capsules (375mg)
Be sure to read the patient package that comes enclosed with the medicine. It may be worthwhile to consult a prescribing doctor to determine the right dose according to the type of preparation chosen. Mucolit is not intended for children two years of age or younger. Mucolit syrup may be the best option for children over that age, since capsules and tablets are not recommended for children.

Questions People Have Asked

Is the incidence of asthma rising?

The number of people who have been diagnosed with asthma has increased by nearly 50% since 1999, according to Healthline. Furthermore, the recent trends of wildfires and extreme weather is having an additional impact. According to the Associated Press (quoted by the NY website Spectrum News), smoke from the recent Canadian wildfires drifted into North-eastern US states and led to a spike in people with asthma visiting emergency rooms.

How long does it take for Mucolit to ease breathing?

The onset of the effect of carbocisteine is quick – usually, it will begin treating heavy coughs within one to two hours of taking a dose.

What is the recommended dose of Mucolit?

Be sure to follow the printed instructions. The usual dose for treating heavy coughs in adults with carbocisteine with capsules or tablets is two, three times a day, or one, four times a day. It must be swallowed whole with a glass of water. For a child, the assigned dose of Mucolit syrup must be measured using the original dropper in the bottle. The dropper is calibrated to dispense a measured and precise amount. Count the drops accurately and pour them onto a spoon. The medicine is effective as long as it is taken according to the instructions.

Should Mucolit be taken with food or on an empty stomach?

Food does not affect the drug. It can be taken with food or between meals.

Can Mucolit be crushed or chewed?

Mucolit capsules should be swallowed whole. Don’t break or crush them. Mical tablets can be crushed for immediate use.

For how long can you store Mucolit?

Mucolit syrup should be kept in the original packaging at room temperature. After opening the bottle for the first time, the medicine must be used within two months. Pharmacists recommend writing down the date when it was opened for the first time.

Is carbocisteine allowed in pregnancy and during breastfeeding?

The following information is based on general information obtained from published sources. It is advisable to consult with a doctor or a specialist if there are special concerns. The preferred way to treat a pregnant or breastfeeding woman with a persistent  heavy cough is with warm drinks like tea or herbal tea – not coffee. Mucolit can be prescribed during pregnancy by an attending physician.

Is it permitted to drink alcohol while being treated with Mucolit?

There have been no reports of any interaction with low levels of alcohol consumption. However, combining the drug and drinking too much alcohol may increase the risk of stomach ulcers.

When can Mucolit not be prescribed?

Doctors do not advise use of carbocisteine if there is any hypersensitivity to one or more of the components of the medicine. Patients who have an active stomach ulcer, especially elderly patients, should not take carbocisteine without consulting a doctor.

What are the most common side effects of Mucolit?

Apart from the positive effects of this medicine, there have been some reported side effects. If nausea and vomiting, skin rash, diarrhea, runny nose, nausea, or gingivitis are persistent or worsening, make sure to consult a doctor or pharmacist. 
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