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All about: Guaifenesin(Glyceryl Guaiacolate)

Big Image ( Glyceryl Guaiacolate ) Pronouncation: (GWHY-fen-ah-sin)
Class: Expectorant

Trade Names:
Allfen Jr
- Tablets 400 mg

Trade Names:
Diabetic Tussin EX
- Liquid 100 mg per 5 mL

Trade Names:
Guiatuss
- Syrup 100 mg per 5 mL

Trade Names:
Humibid Maximum Strength
- Tablets, extended-release 1,200 mg

Trade Names:
Liquibid
- Tablets 400 mg

Trade Names:
Mucinex
- Tablets, extended-release 600 mg

Trade Names:
Naldecon Senior EX
- Liquid 200 mg per 5 mL

Trade Names:
Organidin NR
- Tablets 200 mg
- Liquid 100 mg per 5 mL

Trade Names:
Robitussin
- Syrup 100 mg per 5 mL

Trade Names:
Scot-tussin Expectorant
- Syrup 100 mg per 5 mL

Trade Names:
Siltussin SA
- Syrup 100 mg per 5 mL

Trade Names:
Tussin
- Syrup 100 mg per 5 mL

Balminil Expectorant (Canada)
Benylin E Extra Strength (Canada)
Robitussin Extra Strength (Canada)

Mechanism of Action

Pharmacology

May enhance output of respiratory tract fluid by reducing adhesiveness and surface tension, thus facilitating removal of viscous mucus and making nonproductive coughs more productive and less frequent. Efficacy not well documented.

Pharmacokinetics

Absorption

Readily absorbed.

Elimination

The t ½ is 1 h; renal excretion; major urinary metabolite is β-2-(methoxyphenoxy) lactic acid

Indications and Usage

Temporary relief of cough associated with respiratory tract infections and related conditions such as sinusitis, pharyngitis, bronchitis, and asthma when these conditions are complicated by tenacious mucus or mucus plugs and congestion; effective for productive as well as nonproductive cough, particularly dry, nonproductive cough that tends to injure mucous membranes of the air passages; helps loosen phlegm and thin bronchial secretions in patients with stable chronic bronchitis.

Contraindications

Standard considerations.

Dosage and Administration

Immediate-release
Adults and Children (older than 12 yr of age)

PO 200 to 400 mg every 4 h (max, 2.4 g/day).

Children (6 to younger than 12 yr of age)

PO 100 to 200 mg every 4 h (max, 1.2 g/day).

Children (2 to younger than 6 yr of age)

PO 50 to 100 mg every 4 h (max, 600 mg/day). Allfen Jr is not recommended for use in children younger than 6 yr of age.

Children (6 mo to younger than 2 yr of age)

PO Individualize dose, 25 to 50 mg every 4 h (max, 300 mg/day).

Extended-release
Adults and children (older than 12 yr of age)

PO 600 mg to 1.2 g every 12 h (max, 2.4 g/day).

General Advice

Extended-release tablets
  • Have patient swallow whole with a full glass of water. Caution patient not to chew, crush, or break tablet.
  • Administer without regard to meals, but administer with food if GI upset occurs.
Syrup, liquid and immediate-release tablets
  • Administer without regard to meals, but administer with food or milk if GI upset occurs.
  • Measure and administer liquid or syrup dose using dosing spoon, syringe, or cup.

Storage/Stability

  • Store liquid, syrup, and immediate-release tablets at controlled room temperature (59° to 86°F).
  • Store extended-release tablets at controlled room temperature (68° to 77°F).
  • Protect from light. Protect tablets from moisture.

Drug Interactions

None well documented.

Laboratory Test Interactions

Guaifenesin may increase renal Cl for urate, which may lower serum uric acid levels; may produce an increase in urinary 5-hyroxyindoleacetic acid, which may interfere with interpretation of this test for diagnosis of carcinoid syndrome; may falsely elevate vanillymandelic acid in certain serotonin metabolite chemical tests because of color interference.

Adverse Reactions

CNS

Dizziness; headache.

Dermatologic

Rash; urticaria.

GI

Nausea; vomiting.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Persistent cough

May indicate serious condition. Notify health care provider if cough persists for more than 1 wk, tends to recur, or is accompanied by high fever, rash, or persistent headache.

Patient Information

  • Explain that expectorants are not usually used for chronic cough conditions such as those caused by smoking, asthma, chronic bronchitis, or emphysema, or when cough is accompanied by excessive secretions.
  • Explain importance of maintaining increased fluid intake to help thin bronchial secretions.
  • Advise patient using syrup, liquid, or immediate-release tablets to take prescribed dose every 4 h as needed, up to 6 times a day.
  • Advise caregiver to use dosing spoon, syringe, or cup when giving liquid or syrup to children.
  • Advise patient using extended-release tablets to take every 12 h as needed, up to 2 times a day. Caution patient to swallow tablets whole with a full glass of water and not to chew, crush, or break the tablet.
  • Advise patient or caregiver that medication can be taken without regard to meals, but to take with food if stomach upset occurs.
  • Advise patient that if a dose is missed, to take as soon as remembered unless it is nearing time for the next dose, in which case the dose should be skipped and the next dose taken at the regularly scheduled time. Caution patient not to double the dose to catch up.
  • Advise patient that if cough is not controlled, not to increase the dose of medication but to inform a health care provider.
  • Instruct patient to inform health care provider if any of the following occur: cough persists for more than 1 wk; cough keeps coming back; cough is accompanied by high fever, skin rash, or headache.

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