erdosteine: clinical use

Prescribing considerations

• Licensed for symptomatic treatment of acute exacerbations of chronic bronchitis in adults and as an expectorant.
• Establish renal and hepatic status and check for active peptic ulcer before prescribing.
• Review carefully in mild hepatic impairment and follow product-specific restrictions.

Contraindications and cautions

• Hypersensitivity to erdosteine or an excipient
• Active peptic ulcer
• Use is not recommended where creatinine clearance is below 25 mL/min because data are unavailable
• Use is not recommended in severe hepatic failure because data are unavailable

Monitoring

• No routine laboratory-monitoring schedule is specified.
• Assess clinical response and watch for gastrointestinal intolerance, hypersensitivity, angioedema or new breathing difficulty.

Clinical pharmacology

Erdosteine is rapidly absorbed and undergoes first-pass conversion to the active metabolite M1. Its free thiol group reduces mucus viscosity by opening disulfide bonds in bronchial mucoproteins. Metabolites are eliminated mainly in urine, and absorption is not affected by food.

Formulation and product differences

• The selected product is a prescription-only hard capsule with a green cap and yellow body.
• The capsule shell contains gelatin, titanium dioxide, yellow iron oxide and indigotine.
• The capsule must be swallowed whole with water.

Capsule

Route: Oral

Strengths: 300 mg