Ammonium Chloride/ Sodium Citrate/ Terbutaline Sulphate

Registered South African indications:

• Symptomatic relief of cough associated with bronchospasm

Registered South African contraindications

• Hypersensitivity to the active ingredient or any of the excipients in this combination product
• Hepatic and renal disease
• Patients already on any other asthma medicine

South African recommendations

• Pregnancy
• Breastfeeding
• Elderly

Consultation timeline

• Advise patients to consult a doctor immediately if no improvement within 12 to 24 hours

Conditions where there is increased susceptibility to sympathomimetic amines

• Use with caution in patients with hyperthyroidism, diabetes mellitus, ischaemic heart disease, arrhythmia or tachycardia, and hypertension

Arrhythmogenic potential

• Beta2-stimulants can induce arrhythmias; consider this in patient treatment

Cardiac toxicity risk

• Possible ventricular arrhythmias and fatalities, especially if misused or overdosed

Not indicated for use in adults

Paed. forms avail. in SA and covered in this monograph: syr 

South African registered indications and dosages

Symptomatic relief of cough associated with bronchospasm

Ammonium Chloride/ Sodium Citrate/ Terbutaline Sulphate
60/25/1.25 (mg/5ml)

• Younger than 3 years: No specific recommendation provided
• Between 3-6 years: Oral (syr): 2.5-5ml, 3 times daily
• 7 years and older: Oral (syr): 5-10ml, 3 times daily

Do not exceed the recommended dosage

Pregnancy 

South African recommendations

• Caution
• Safety in pregnancy has not been established

Breastfeeding

South African recommendations

• Caution
• Safety in lactation has not been established

Fertility

South African recommendations

• No information available

South African recommendations

• Contraindicated

South African recommendations

• Contraindicated

South African recommendations

• Not indicated for use in geriatric patients

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

Gastrointestinal Disorders

• Gastric irritation
• Nausea and vomiting

Psychiatric Disorders

• Nervousness

Musculoskeletal Disorders

• Muscle tremor

Nervous System Disorders

• Headache

Cardiac Disorders

• Tachycardia
• Palpitations

Vascular Disorders

• Fainting

General Disorders and Administration Site Conditions

• Flushing
• Hypokalaemia

Combination products may have additional pharmacological effects not accounted for by the action of the individual ingredients

• Non-selective β-blocking agents
• Monoamine oxidase inhibitors

None routine

Expectorant cough mixture with a selective bronchodilatory action.

COMBINATION PREPARATIONS

Ammonium Chloride/ Sodium Citrate/ Terbutaline Sulphate

Syrup (per 5ml) 60mg/25mg/1.25mg

• Bronchoped (Adcock)