kafno syrup - Terbutaline (1.25mg) + Ambroxol (15mg) medicine

Ambro S 1.25mg/15mg Syrup: Complete Medicine Guide

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🏭 Bio-Med Pvt Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 23, 2026
📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Moderate for the combination in acute bronchitis; limited for other uses.
Reviewed by
SaathiMed Expert Panel | Sep 23, 2026

When to Call Your Doctor IMMEDIATELY

  • Difficulty breathing or worsening of asthma symptoms after taking the medicine.
  • Chest pain, palpitations, or irregular heartbeat.
  • Severe allergic reaction: rash, itching, swelling of face, lips, or throat.
  • Severe dizziness or fainting.
  • Muscle weakness or cramps (possible low potassium).
  • Yellowing of eyes or skin (jaundice).
  • Blood in cough or vomit.

If experiencing severe symptoms, call emergency services immediately.

What is kafno syrup used for?

This medicine is a combination syrup containing terbutaline (a bronchodilator) and ambroxol (a mucolytic). It is used to relieve cough with thick mucus and to ease breathing in conditions like bronchitis, COPD, and asthma. It works by relaxing airway muscles and thinning mucus. It should be taken only as prescribed by a doctor.

  • Generic Name: Terbutaline (1.25mg) + Ambroxol (15mg)
  • Manufacturer: Bio-Med Pvt Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 kafno syrup के बारे में (Hindi Summary)

उपयोग: यह दवा टर्ब्यूटालीन और एम्ब्रोक्सोल का संयोजन है, जिसका उपयोग बलगम वाली खांसी और सांस लेने में कठिनाई के इलाज के लिए किया जाता है। यह ब्रोंकाइटिस, सीओपीडी और अस्थमा जैसी स्थितियों में राहत देती है। यह वायुमार्ग की मांसपेशियों को आराम देकर और बलगम को पतला करके काम करती है। इसका उपयोग डॉक्टर के परामर्श के अनुसार ही करें।

साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, सिरदर्द, चक्कर आना, धड़कन बढ़ना और कंपन शामिल हैं। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन एलर्जी, अनियमित धड़कन या सांस लेने में कठिनाई हो तो तुरंत डॉक्टर से मिलें।

सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। खुराक से अधिक न लें। उपयोग से पहले बोतल को अच्छी तरह हिलाएं। सही मापने वाला कप या चम्मच इस्तेमाल करें। चक्कर आने पर वाहन न चलाएं। दवा को ठंडी और सूखी जगह पर रखें।

💡 Did You Know? The first generic medicine was introduced in India in 1970 after the Patents Act was amended.

💊 kafno syrup Uses & Benefits

[{"condition":"Acute bronchitis with productive cough","description":"Helps loosen mucus and relax airways, making cough more productive and easing breathing.","evidence":"Well-established"},{"condition":"Chronic obstructive pulmonary disease (COPD) exacerbation","description":"Provides symptomatic relief by bronchodilation and mucus clearance.","evidence":"Established"},{"condition":"Asthma (adjunctive therapy)","description":"Used as add-on therapy for acute bronchospasm, but not for long-term control.","evidence":"Established"},{"condition":"Cough with thick mucus","description":"Ambroxol thins mucus, making it easier to cough out.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Prevention of respiratory distress syndrome in premature infants","description":"Ambroxol has been studied off-label for this purpose, but not with this combination.","evidence":"Limited"}]

Primary treatment for: Productive cough associated with bronchitis

Also treats: COPD, Asthma, Emphysema

📋 Drug Information

Generic Name(s)Terbutaline (1.25mg) + Ambroxol (15mg)
Brand Namekafno syrup
ManufacturerBio-Med Pvt Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassRESPIRATORY
Action Class
Route of AdministrationOral
StorageStore at room temperature (15-30°C) in a dry place, away from direct sunlight. Do not refrigerate. Keep the bottle tightly closed.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Always prescribe this medicine for short-term use only, typically not exceeding 7-10 days without reassessment.
2
Advise patients to take the syrup with food if it causes stomach upset.
3
Warn patients about the possibility of tremors and dizziness; advise caution while driving.
4
Monitor heart rate and blood pressure in patients with cardiovascular disease.
5
Check potassium levels if the patient is on diuretics or corticosteroids.
6
Do not prescribe to patients with known hypersensitivity to any component.
7
Use with caution in patients with diabetes, hyperthyroidism, or renal/hepatic impairment.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Cough with thick mucus
This medicine is commonly prescribed for this.
Likely Use
Wheezing
Terbutaline helps relax airways.
Likely Use
Dry cough
This medicine is not for dry cough.
Not Primary
Fever
This medicine is not a fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionTerbutaline is well absorbed from the gastrointestinal tract after oral administration. Ambroxol is also rapidly absorbed. However, oral bioavailability of terbutaline is reduced due to first-pass metabolism.
DistributionTerbutaline distributes widely into body tissues, including the lungs. Ambroxol crosses the placental barrier and is distributed to various tissues. Protein binding information is not established from the available information.
Protein BindingNot established from the available information.
MetabolismTerbutaline undergoes extensive first-pass metabolism in the liver, primarily by conjugation. Ambroxol is metabolized in the liver by glucuronidation and other pathways.
Half-LifeTerbutaline: approximately 3-4 hours. Ambroxol: approximately 7-12 hours. These values may vary.
ExcretionTerbutaline and its metabolites are excreted mainly in urine. Ambroxol is excreted primarily in urine as metabolites.
BioavailabilityOral bioavailability of terbutaline is approximately 10-15% due to first-pass metabolism. Ambroxol bioavailability is not well established but is considered moderate.
Onset of ActionBronchodilation from terbutaline occurs within 30 minutes after oral administration. Ambroxol's mucolytic effect may take a few hours to become noticeable.
Peak Plasma TimeTerbutaline: 1-2 hours. Ambroxol: 1-3 hours.
Duration of ActionTerbutaline: 4-6 hours. Ambroxol: up to 12 hours.

How It Works

Terbutaline is a selective beta-2 adrenergic agonist that binds to beta-2 receptors on bronchial smooth muscle, leading to relaxation and bronchodilation. Ambroxol is a mucolytic agent that increases serous bronchial secretion, reduces mucus viscosity, and promotes ciliary clearance. Together, they improve airflow and ease cough.

Mechanism Steps

1
Beta-2 receptor activation: Terbutaline binds to beta-2 adrenergic receptors on bronchial smooth muscle cells.
2
Increased cyclic AMP: This binding activates adenylate cyclase, increasing cyclic AMP levels within the cells.
3
Smooth muscle relaxation: Elevated cyclic AMP leads to relaxation of bronchial smooth muscle, widening the airways.
4
Mucus thinning by ambroxol: Ambroxol increases serous secretion and reduces mucus viscosity, making it easier to expel.
5
Enhanced mucociliary clearance: Thinned mucus is more effectively moved by cilia, helping clear the airways.

💡 How to Take kafno syrup

Strength: Each 5 mL contains Terbutaline 1.25 mg and Ambroxol 15 mg.

1Shake the bottle well before each use.
2Use the measuring cup or spoon provided to measure the correct dose.
3Take the syrup orally, with or without food, as directed by your doctor.
4If it upsets your stomach, take it with a small amount of food.
5After use, close the bottle tightly and store as directed.

Dosage Information

Adult DosageThe usual adult dose is 5-10 mL (1-2 teaspoons) two to three times a day, or as directed by your physician. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. Do not exceed the recommended dose.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician for appropriate dosing in children.
Elderly DosageElderly patients may be more sensitive to the effects of terbutaline, especially cardiac effects. Use with caution and lower doses may be considered. Individualize by a clinician.
Renal ImpairmentUse with caution in renal impairment. Dose adjustment may be needed. Consult your doctor.
Hepatic ImpairmentUse with caution in hepatic impairment. Dose adjustment may be needed. Consult your doctor.
Maximum Daily DoseThe maximum daily dose should not exceed 30 mL (6 teaspoons) in adults, unless otherwise prescribed by a doctor.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset.
Caffeine
Limit
May increase nervousness and heart rate.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of kafno syrup

✅ Common Side Effects

Nausea (Common (5-10%))
Take with food to reduce stomach upset. If persistent, consult your doctor.
Headache (Common (5-10%))
Usually resolves on its own. Rest and hydration may help. Consult if severe.
Dizziness (Common (5-10%))
Avoid driving or operating machinery until you know how it affects you.
Increased heart rate (Common (5-10%))
Monitor your pulse. If it feels very fast or irregular, contact your doctor.
Tremors (Common (5-10%))
Usually temporary. If bothersome, consult your doctor.

🚨 Serious Side Effects

Severe allergic reaction (anaphylaxis) (Rare (<0.1%))
Seek immediate medical attention if you experience rash, swelling, or difficulty breathing.
Irregular heartbeat (arrhythmia) (Rare (<0.1%))
Contact your doctor immediately if you feel palpitations or chest discomfort.
Paradoxical bronchospasm (Rare (<0.1%))
If breathing worsens after taking this medicine, stop and seek emergency care.
Hypokalemia (low potassium) (Rare (<0.1%))
Report muscle weakness or cramps to your doctor.

⚠️ Rare Side Effects

Restlessness
Consult your doctor if it interferes with daily activities.
Sleep disturbances
Avoid taking close to bedtime if it affects sleep.
Skin rash
Discontinue and consult your doctor if rash appears.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Propranolol Major
Furosemide Moderate
Digoxin Moderate
MAOIs Major
Tricyclic antidepressants Major
Corticosteroids Moderate
Theophylline Moderate
Other beta-2 agonists Moderate
Anticholinergics Minor
Caffeine Minor

🚨 Major Interactions

  • Beta-blockers (e.g., propranolol)
  • Monoamine oxidase inhibitors (MAOIs)
  • Tricyclic antidepressants

⚡ Moderate Interactions

  • Diuretics (e.g., furosemide)
  • Corticosteroids
  • Digoxin

🍷 Alcohol Interaction

Alcohol may increase dizziness and drowsiness. Avoid or limit alcohol consumption while taking this medicine.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Hypersensitivity to terbutaline, ambroxol, or any component","Severe cardiac disease","Hypertrophic obstructive cardiomyopathy","Thyrotoxicosis","Children under 2 years (unless directed by specialist)"]

⚠️ Warnings & Precautions

["Use with caution in patients with cardiovascular disorders, including coronary insufficiency and hypertension.","May cause tremors and nervousness; avoid driving if affected.","Use with caution in diabetes mellitus; may increase blood glucose.","Use with caution in hyperthyroidism.","Not for prolonged use without medical supervision.","Do not exceed recommended dose."]

🤱 Lactation Safety

Terbutaline is excreted in breast milk in small amounts. Ambroxol is also likely excreted. Consult your doctor before breastfeeding while taking this medicine.

💊 Overdose Management

Symptoms of overdose include severe tachycardia, palpitations, tremor, nausea, and vomiting. Seek immediate medical attention. Treatment is supportive and symptomatic. Monitor cardiac function and electrolytes.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

Additional Safety Advice

General Safety

Take this medicine exactly as prescribed by your doctor. Do not exceed the recommended dose. Shake the bottle well before each use. Use a proper measuring cup or spoon to ensure accurate dosing. Avoid driving or operating heavy machinery if you feel dizzy or shaky. Inform your doctor if you have heart disease, high blood pressure, diabetes, thyroid problems, or liver/kidney disease. Do not use this medicine for a prolonged period without medical advice. Keep out of reach of children. Store at room temperature, away from direct sunlight and moisture. Do not use if the syrup is discolored or has particles.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are more prone to cardiac side effects like tachycardia and arrhythmias. Use with caution and monitor heart rate. Lower doses may be needed.

🤰 Pregnancy Planning (TTC)

Consult your doctor before planning pregnancy if you are taking this medicine. Terbutaline is FDA category C; ambroxol safety is not established. Use only if clearly needed.

🏥 Post-Surgery Considerations

Inform your surgeon and anesthesiologist if you are taking this medicine, as it may interact with anesthetic agents and affect heart rate.

🦷 Dental Procedures

Inform your dentist if you are taking this medicine. It may cause dry mouth or interact with local anesthetics containing epinephrine.

💚 Lifestyle Tips for Better Results

🏃
Stay well hydrated to help thin mucus.
🥗
Avoid smoking and exposure to secondhand smoke.
😴
Use a humidifier to keep air moist.
💧
Practice deep breathing exercises.
🧘
Get plenty of rest to aid recovery.
🌞
Avoid caffeine as it may increase side effects.

🏋️ Exercise Considerations

Avoid strenuous exercise if you feel dizzy, shaky, or have a rapid heartbeat. Light activity like walking may be beneficial, but consult your doctor before starting any exercise routine.

🥗 Diet Recommendations

Drink warm fluids like herbal tea or soup.
Include fruits rich in vitamin C.
Avoid cold and processed foods.
Limit caffeine intake.

💼 Impact on Daily Work & Life

This medicine may cause dizziness or tremors, which can affect your ability to drive or operate machinery. Avoid these activities until you know how the medicine affects you. It is advisable to rest and recover.

🛑 When to Stop This Medicine

Stop taking this medicine and consult your doctor if your symptoms do not improve within 7 days, or if you experience severe side effects. Do not stop abruptly if you have been on it for a long time without medical advice.

📅 Long-Term Use Effects

Long-term use of terbutaline may lead to tolerance and reduced effectiveness. Prolonged use of ambroxol is generally well tolerated but monitoring of liver function may be advisable. This medicine is usually prescribed for short-term relief. Do not use for extended periods without medical supervision.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Steam inhalation

Helps loosen mucus and ease breathing.

Evidence: Well-established
Chest physiotherapy

Techniques to clear mucus from airways.

Evidence: Established
Saline nasal irrigation

May help with congestion.

Evidence: Limited

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

Ensure vaccinations like influenza and pneumococcal are up to date, especially if you have chronic respiratory conditions. This medicine does not interact with vaccines.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

Carry this medicine in its original packaging with the prescription label intact. Bring a copy of your prescription. Store at room temperature and protect from direct sunlight. If traveling across time zones, adjust dosing times gradually as advised by your doctor. Check customs regulations for carrying prescription medicines.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 35-year-old man with acute bronchitis
He was prescribed this medicine for a productive cough and wheezing. After two days, he noticed his cough became more productive and breathing was easier. He experienced mild tremors initially, which subsided after a few days. He was advised to take it with food to avoid stomach upset.
💡 Lesson: This medicine effectively relieves cough and breathing difficulty when taken as prescribed. Mild side effects like tremors are usually temporary.
👤 A 60-year-old woman with COPD exacerbation
She was given this syrup along with other medications. Her breathing improved significantly, but she felt her heart racing. Her doctor reduced the dose and monitored her heart rate. She was advised to avoid caffeine.
💡 Lesson: Elderly patients may be more sensitive to cardiac effects. Dose adjustment and monitoring are important.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: Terbutaline starts working within 30 minutes, while ambroxol's effect on mucus may take a few hours.

Q: Can I take this medicine with food?

A: Yes, you can take it with or without food. If it upsets your stomach, take it with a meal.

Q: Is it safe for children?

A: Consult a pediatrician. Dosing in children is not established from available information.

Q: What should I do if I miss a dose?

A: Take it as soon as you remember, but if it's almost time for the next dose, skip it. Do not double dose.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my heart?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for kafno syrup

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can be taken for any type of cough.
    Fact: It is specifically for cough with thick mucus and breathing difficulty. It is not effective for dry cough or cough due to allergies.
  • Myth: It is safe to take this medicine for a long time.
    Fact: Prolonged use without medical supervision can lead to side effects. It is usually prescribed for short-term relief.
  • Myth: More syrup means faster relief.
    Fact: Taking more than the prescribed dose can cause serious side effects like rapid heartbeat and tremors. Always follow the prescribed dose.

🔄 Alternative Options

Generic Alternatives

  • Terbutaline + Ambroxol syrup (various manufacturers)

Brand Alternatives

  • Ambro S 1.25mg/15mg syrup (Galpha Laboratories Ltd)

📊 Comparison with Similar Medicines

[{"medicine":"Terbutaline + Ambroxol","composition":"Terbutaline 1.25mg + Ambroxol 15mg per 5mL","uses":"Cough with mucus, bronchitis, COPD, asthma","notes":"Combination provides bronchodilation and mucolysis."},{"medicine":"Terbutaline + Bromhexine","composition":"Terbutaline 1.25mg + Bromhexine 4mg per 5mL","uses":"Similar to above","notes":"Bromhexine is another mucolytic."},{"medicine":"Ambroxol alone","composition":"Ambroxol 15mg per 5mL","uses":"Cough with thick mucus","notes":"No bronchodilator effect."}]

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