INTRODUCTION

DOXOMAX XP is a combination of Ambroxol and Doxophylline which belongs to the group of medicines called Mucolytics and Bronchodilators respectively. It is used to manage asthma (condition in which the airways become narrow, swell and produce extra mucus which leads to breathing difficulties, chest pain, severe dry cough, and increased heartbeat).

Also, used to manage chronic obstructive pulmonary disorder (lung disorder in which the flow of air to the lungs is obstructed which leads to shortness of breath, dry cough with phlegm, wheezing, fatigue and weight loss).

Limit the consumption of beverages and foods containing caffeine while taking DOXOMAX XP as it may increase the risk of side effects. DOXOMAX XP is not recommended for use in patients with acute myocardial infarction and low blood pressure. If you are pregnant or breast-feeding, consult your doctor for advice before taking DOXOMAX XP.

DOXOMAX XP is not recommended for use in children (under 6 years of age) and it should be used with caution in elderly patients. Consult your doctor before taking it. The most common side effects of taking DOXOMAX XP are taste changes, nausea, numbness in the throat and mouth. Consult your doctor if any of the symptom worsens.

USES OF DOXOMAX XP

To Manage:

• asthma
• chronic obstructive pulmonary disorder (COPD)

HOW DOXOMAX XP WORKS

DOXOMAX XP helps to manage asthma and chronic obstructive pulmonary disorder, where ambroxol stimulates the production of a substance that lowers surface tension, which keeps the air sacs in the lungs from collapsing after exhalation. Doxophylline inhibits certain enzymes in the body called phosphodiesterase, which in turn increases the substance that leads to muscle relaxation leading to dilation of the constricted airway tract. It also acts as an anti-inflammatory agent to reduce inflammation. This combined action together makes breathing easier.

DIRECTIONS FOR USE

Take DOXOMAX XP as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. The correct dose and duration will be decided by your doctor for you depending upon your age, body weight and disease condition.

SIDE EFFECTS OF DOXOMAX XP

HOW TO MANAGE SIDE EFFECTS

Nausea:

Take this medicine with, or just after meals. Stick to simple meals. Avoid eating oily, fried or spicy foods. If the symptom does not improve, consult your doctor.

Stomach pain:

Try to take rest and relax. Eat and drink slowly or try to have smaller and frequent meals. Keep a heat pad on your stomach. If the symptom does not improve, consult your doctor.

Dry mouth:

Sip water regularly and other sugar free liquids. Do not use mouthwashes that contain alcohol because they can make your mouth dry, use mouthwash that is used only for dry mouth. Limit your caffeine intake. Avoid smoking or using tobacco products. Consult your doctor if the symptom does not improve.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

Before taking DOXOMAX XP, inform your doctor if you have received or taking any of the following medicines:

• medicines used as antibiotics (Ex. erythromycin, troleandomycin, lincomycin, clindamycin) (used to manage bacterial infections)
• allopurinol (used to manage gout)
• cimetidine (used to manage ulcers and indigestion)
• propranolol (used to manage high blood pressure)
• influenza vaccine (protects against flu infection)
• phenytoin (used to manage epilepsy)
• medicines used to manage certain types of cancer (Ex. melphalan, busulfan, methotrexate)

B. Drug - food interaction:

Avoid consuming beverages and foods containing caffeine while taking DOXOMAX XP as it may increase the risk of side effects.

Overdosage:

If you or anyone else accidentally take too much DOXOMAX XP, consult your physician immediately or visit the nearby hospital. Symptoms of overdosage are severe cardiac arrhythmias (irregular heart rhythm) and tonic-clonic seizures.

SYNOPSIS

MORE INFORMATION

• Keep DOXOMAX XP out of reach of children
• Store at room temperature

FAQs ABOUT DOXOMAX XP

What is DOXOMAX XP used for?

DOXOMAX XP is used to manage asthma (condition in which the airways become narrow, swell and produce extra mucus which leads to breathing difficulties, chest pain, severe dry cough, and increased heartbeat) and chronic obstructive pulmonary disorder (lung disorder in which the flow of air to the lungs is obstructed which leads to shortness of breath, dry cough with phlegm, wheezing, fatigue and weight loss).

What are the common side effects of DOXOMAX XP?

The most common side effects of taking DOXOMAX XP are changes in taste sensation, nausea, numbness in the throat or mouth. Consult your doctor if any of the symptom worsens.

What recommendations should be followed while taking DOXOMAX XP?

Avoid consuming beverages and foods containing caffeine while taking DOXOMAX XP as it may increase the risk of side effects. Also, avoid smoking or use of tobacco products as it may worsen the condition of the patient by reducing the lung function.

What happens if I forget to take a dose of DOXOMAX XP?

You should take DOXOMAX XP immediately when you remember. If it is time for your next dose skip the missed dose and follow your regular dose schedule. Do not double the dose to match up your missed dose.

Is DOXOMAX XP safe to use in patients with lung diseases?

DOXOMAX XP should be used with caution in patients with existing lung conditions such as chronic obstructive lung disorder, severe uncontrolled asthma, pneumonia or bronchial motor activity disorder along with excessive mucous secretion (risk of a mucous plug). Consult your doctor before taking it.

REFERENCES

1. KD. Tripathi. Drugs for Cough and Bronchial Asthma. Essentials of medical pharmacology. Seventh edition. 2013. Page – 218-219, 227.

2. Ahmad Kantar, Ludger Klimek, Dorotheea Cazan, Annette Sperl, Ulrike Sent, and Margarida Mesquita. An overview of efficacy and safety of ambroxol for the management of acute and chronic respiratory diseases with a special regard to children. Journal of Multidisciplinary Respiratory Medicine. March 2020. [Accessed on 15th June 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137760/

3. Paola Rogliani, Luigino Calzetta, Josuel Ora, Mario Cazzola and Maria Gabriella Matera. Efficacy and safety profile of doxofylline compared to theophylline in asthma: a meta-analysis. Journal of Multidisciplinary Respiratory Medicine. August 2019. [Accessed on 15th June 2022] https://mrmjournal.biomedcentral.com/articles/10.1186/s40248-019-0189-0

4. Mario Cazzola, Maria Gabriella Matera. The effect of doxofylline in asthma and COPD. Journal of Respiratory Medicine. April 2020. [Accessed on 15th June 2022] https://www.resmedjournal.com/article/S0954-6111(20)30044-5/fulltext

5. Vibcare Pharma Pvt. Ltd. Vibodoxo AM (Doxofylline and Ambroxol). [Accessed on 15th June 2022] https://vibcare.co.in/doxofylline-ambroxol/#!/SIDEEFFECTS

6. Pharmaceutical Society of Singapore. Ambroxol Tablets. hsa.gov. [Revised in April 2017] [Accessed on 15th June 2022] https://www.hsa.gov.sg/docs/default-source/announcements/prescription-only-medicines-(pom)/ambroxol-pil-26-04-2017.pdf

7. Abc FarMaceutici. Ansimar (Doxofylline Tablets). [Revised in March 2011] [Accessed on 15th June 2022] https://www.abcfarmaceutici.it/uploads/news/40_file3_en.pdf