A fixed-dose combination syrup used primarily for the symptomatic management of acute and chronic bronchospastic conditions like asthma and COPD. Terbutaline is a selective β2-adrenergic agonist providing rapid bronchodilation. Acebrophylline is a mucolytic and bronchodilator that also exhibits anti-inflammatory properties. Guaifenesin is an expectorant that increases respiratory tract fluid secretions and reduces mucus viscosity. This combination provides a triple-action approach: opens airways, reduces inflammation, and facilitates mucus clearance.
Adult: 10 ml (2 teaspoonfuls) two to three times daily. Maximum: 30 ml per day.
Note: To be taken orally after meals with a full glass of water to minimize gastric irritation and aid expectorant action. Use the measuring cup/spoon provided. Shake the bottle well before use. Do not take at bedtime if it causes insomnia.
The combination works synergistically. Terbutaline stimulates β2-adrenergic receptors on bronchial smooth muscle, leading to relaxation via increased cAMP. Acebrophylline acts as a phosphodiesterase (PDE) inhibitor (increasing cAMP/cGMP) and a mucolytic by breaking down acid mucopolysaccharide fibers in sputum. Guaifenesin acts as an expectorant by stimulating vagal receptors in the gastric mucosa, leading to a reflex increase in respiratory tract fluid (via the vagus nerve), which thins and loosens mucus.
Pregnancy: Category B (US FDA) for terbutaline and guaifenesin; Acebrophylline is Category C. Terbutaline is used for tocolysis but oral use for asthma should be limited to clear benefit outweighing risk. Avoid in first trimester unless absolutely necessary. Use only under strict medical supervision.
Driving: May cause dizziness, nervousness, or tremor. Patients should not drive or operate machinery until they know how the medication affects them.
| Beta-blockers (e.g., Propranolol) | Antagonizes bronchodilator effect of terbutaline; may cause severe bronchospasm. | Major |
| Diuretics (especially loop & thiazides) | Increased risk of hypokalaemia when combined with terbutaline. | Major |
| Other Xanthines (Theophylline, Aminophylline) | Additive toxicity (nausea, seizures, arrhythmias) with acebrophylline. | Major |
| MAO Inhibitors & TCAs | Potentiates cardiovascular effects of terbutaline (hypertension, tachycardia). | Major |
| Digoxin | Terbutaline-induced hypokalaemia increases risk of digoxin toxicity. | Moderate |
| Corticosteroids (Systemic) | Enhanced hypokalaemic effect. | Moderate |
| CYP1A2 Inhibitors (Ciprofloxacin, Fluvoxamine) | Increase theophylline (from acebrophylline) levels, risk of toxicity. | Major |
| CNS Depressants (Alcohol, Benzodiazepines) | Guaifenesin may have additive sedative effect (though mild). | Minor |
Same composition (Terbutaline (1.25mg/5ml) + Acebrophylline (50mg/5ml) + Guaifenesin (50mg/5ml)), different brands: