kofno-ad syrup - Ambroxol (15mg/5ml) + Dextromethorphan Hydrobromide (10mg/5ml) medicine

Allerhin D Plus Syrup: Complete Medicine Guide

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🏭 Mediquest Inc. 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 25, 2026
🤰 Pregnancy Category Not established from the available information. Use only if clearly needed and prescribed by a doctor. Avoid in the first trimester. 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Moderate for ambroxol and dextromethorphan individually; limited for the fixed-dose combination.
Reviewed by
SaathiMed Expert Panel | Sep 25, 2026
🩺
Medically Fact-Checked & Clinically Verified by SaathiMed Clinical Review Board
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026

When to Call Your Doctor IMMEDIATELY

  • Difficulty breathing or shortness of breath
  • Swelling of the face, lips, tongue, or throat
  • Severe rash or blistering of the skin
  • Hallucinations or confusion
  • Rapid heart rate with agitation or fever
  • Cough lasting more than 7 days or worsening
  • Cough with blood or rust-colored sputum
  • Severe drowsiness or inability to stay awake

If experiencing severe symptoms, call emergency services immediately.

What is kofno-ad syrup used for?

This medicine is a combination cough syrup containing ambroxol (15 mg/5 ml) and dextromethorphan hydrobromide (10 mg/5 ml). It is used to treat productive cough by loosening mucus and suppressing the cough reflex. It is for adults and children over 12 years, and should be taken as prescribed.

  • Generic Name: Ambroxol (15mg/5ml) + Dextromethorphan Hydrobromide (10mg/5ml)
  • Manufacturer: Mediquest Inc.
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 kofno-ad syrup के बारे में (Hindi Summary)

उपयोग: यह दवा एक संयुक्त कफ सिरप है जिसमें एम्ब्रोक्सोल (15 मिलीग्राम/5 मिली) और डेक्सट्रोमेथोर्फन हाइड्रोब्रोमाइड (10 मिलीग्राम/5 मिली) शामिल हैं। इसका उपयोग बलगम वाली खांसी के इलाज के लिए किया जाता है। यह बलगम को पतला करके बाहर निकालने में मदद करती है और खांसी की तीव्रता को कम करती है। यह दवा 12 वर्ष से अधिक उम्र के बच्चों और वयस्कों के लिए है। इसे डॉक्टर के निर्देशानुसार ही लें।

साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में नींद आना, चक्कर आना, जी मिचलाना, उल्टी, पेट में असहजता और मुंह सूखना शामिल हैं। ये आमतौर पर हल्के होते हैं और कुछ समय में ठीक हो जाते हैं। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन अगर आपको त्वचा पर चकत्ते, सूजन, सांस लेने में कठिनाई, या मतिभ्रम जैसे लक्षण दिखें तो तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। खुराक से अधिक न लें। उपयोग से पहले बोतल को अच्छी तरह हिलाएं और मापने वाले कप से सही मात्रा लें। अगर आपको नींद या चक्कर आते हैं तो वाहन चलाने या मशीन चलाने से बचें। इस दवा के साथ शराब न पिएं। अगर आपको लीवर या किडनी की समस्या है, अस्थमा है, या नशीली दवाओं का सेवन किया है तो डॉक्टर को बताएं। 7 दिनों से अधिक इस दवा का उपयोग बिना डॉक्टर की सलाह के न करें।

💡 Did You Know? The Indian pharmaceutical market is expected to reach $130 billion by 2030.

💊 kofno-ad syrup Uses & Benefits

[{"condition":"Productive cough with thick mucus","description":"Helps loosen mucus and reduce cough frequency in acute or chronic bronchitis.","evidence":"Well-established"},{"condition":"Acute bronchitis","description":"Provides symptomatic relief of cough and mucus congestion.","evidence":"Moderate"},{"condition":"Chronic bronchitis","description":"Used to ease cough and improve mucus clearance in chronic obstructive pulmonary disease.","evidence":"Moderate"},{"condition":"Tracheobronchitis","description":"Reduces cough and helps expectoration in inflammation of the trachea and bronchi.","evidence":"Limited"}]

Off-label uses: [{"condition":"Post-operative cough","description":"Sometimes used to suppress cough after surgery to prevent strain on surgical sites.","evidence":"Limited"}]

Primary treatment for: Productive cough

Also treats: Acute bronchitis, Chronic bronchitis, Tracheobronchitis

📋 Drug Information

Generic Name(s)Ambroxol (15mg/5ml) + Dextromethorphan Hydrobromide (10mg/5ml)
Brand Namekofno-ad syrup
ManufacturerMediquest Inc.
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassRESPIRATORY
Action Class
Route of AdministrationOral
StorageStore at room temperature (15-30°C) in a cool, dry place. Protect from direct sunlight and moisture. Do not freeze. Keep the bottle tightly closed.
Shelf Life24 months from the date of manufacture. Do not use after the expiry date printed on the pack.
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 productive cough only, not for dry cough.
2
Advise patients to take the medicine with food to reduce stomach upset.
3
Warn patients about drowsiness and advise against driving or operating machinery.
4
Instruct patients not to exceed the recommended dose or duration of use.
5
Check for interactions with MAO inhibitors, SSRIs, and CYP2D6 inhibitors before prescribing.
6
Advise patients to stop the medicine and seek medical help if they experience hallucinations or severe allergic reactions.
7
Use with caution in elderly patients and those with liver or kidney impairment.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Productive cough with thick mucus
This medicine is commonly prescribed for this.
Likely Use
❌
Dry cough
This medicine is not primarily for dry cough; it contains a cough suppressant but also a mucolytic.
Not Primary
❌
Fever
This medicine is not a fever reducer.
Not Primary
✅
Chest congestion
This medicine helps loosen mucus and relieve congestion.
Likely Use

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionAmbroxol is rapidly absorbed from the gastrointestinal tract after oral administration. Dextromethorphan is also well absorbed orally. Peak plasma concentrations are typically reached within 1 to 2 hours for both ingredients.
DistributionAmbroxol distributes widely into body tissues, including lung tissue, where it reaches higher concentrations than in plasma. Dextromethorphan crosses the blood-brain barrier to exert its central effects.
Protein BindingAmbroxol is approximately 90% bound to plasma proteins. Dextromethorphan is about 60-70% bound to plasma proteins.
MetabolismAmbroxol is metabolized in the liver by conjugation to glucuronic acid and sulfate. Dextromethorphan undergoes extensive first-pass metabolism in the liver via CYP2D6 to its active metabolite dextrorphan.
Half-LifeThe elimination half-life of ambroxol is approximately 7 to 12 hours. Dextromethorphan has a half-life of about 2 to 4 hours.
ExcretionAmbroxol and its metabolites are primarily excreted in the urine. Dextromethorphan metabolites are also excreted mainly in urine.
BioavailabilityThe oral bioavailability of ambroxol is about 70-80% due to first-pass metabolism. Dextromethorphan has a bioavailability of approximately 10-20% due to extensive first-pass metabolism.
Onset of ActionCough suppression from dextromethorphan begins within 15 to 30 minutes after oral administration. Ambroxol's mucolytic effect starts within 30 to 60 minutes.
Peak Plasma TimePeak plasma concentrations for both ambroxol and dextromethorphan are reached within 1 to 2 hours after oral administration.
Duration of ActionThe cough suppressant effect of dextromethorphan lasts for about 4 to 6 hours. Ambroxol's mucolytic effect lasts for about 6 to 8 hours.

How It Works

This medicine combines two active ingredients with complementary actions. Ambroxol is a mucolytic that increases serous bronchial secretion, reduces mucus viscosity, and promotes ciliary clearance, making it easier to cough out mucus. Dextromethorphan hydrobromide is a centrally acting cough suppressant that acts on the cough center in the medulla oblongata to raise the threshold for coughing. Together, they provide both mucus clearance and cough suppression.

Mechanism Steps

1
Ambroxol increases serous secretion: Ambroxol stimulates serous cells in the respiratory tract to produce more fluid, which thins the mucus.
2
Reduction of mucus viscosity: By breaking down acidic mucopolysaccharide fibers, ambroxol reduces the stickiness of mucus, making it easier to expel.
3
Enhanced ciliary movement: Ambroxol promotes the beating of cilia, helping to move loosened mucus upward for expulsion.
4
Dextromethorphan acts on cough center: Dextromethorphan binds to receptors in the medulla oblongata to suppress the cough reflex.
5
Combined effect: The two ingredients work together to reduce cough frequency and clear mucus from the airways.

💡 How to Take kofno-ad syrup

Strength: Each 5 ml of syrup contains Ambroxol 15 mg and Dextromethorphan Hydrobromide 10 mg.

1Shake the bottle well before each use.
2Measure the dose accurately using the measuring cup or spoon provided.
3Take the medicine orally with or without food.
4Swallow the syrup slowly. Do not chew or crush.
5Drink a glass of water after taking the medicine.
6Wash the measuring cup after each use.
7Close the bottle tightly after use.

Dosage Information

Adult DosageThe usual adult dose of this medicine is 10 ml (two teaspoons) taken orally three times a day, or as directed by your doctor. The dose may be adjusted based on the severity of your symptoms and your response to treatment. Do not exceed the recommended dose. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician. This medicine is not recommended for children under 12 years of age.
Elderly DosageElderly patients may be more sensitive to the side effects of this medicine, especially drowsiness and dizziness. Use with caution. Dose adjustment may be necessary based on kidney and liver function. Consult your doctor for appropriate dosing.
Renal ImpairmentUse with caution in patients with severe kidney impairment. Dose adjustment may be needed. Consult your doctor for appropriate dosing.
Hepatic ImpairmentUse with caution in patients with severe liver impairment. Dose adjustment may be needed. Consult your doctor for appropriate dosing.
Maximum Daily DoseThe maximum recommended daily dose for adults is 30 ml (6 teaspoons) in divided doses. Do not exceed this dose.

Dosage Timeline

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

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset.
Grapefruit
Avoid
May increase drug levels and side effects.
Alcohol
Avoid
Increases drowsiness and risk of CNS depression.

⏰ 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 kofno-ad syrup

✅ Common Side Effects

Drowsiness (Common (5-10%))
Avoid driving or operating machinery. Usually resolves on its own.
Dizziness (Common (5-10%))
Sit or lie down until it passes. Consult doctor if persistent.
Nausea (Common (5-10%))
Take with food or milk to reduce stomach upset.
Vomiting (Uncommon (1-5%))
Stay hydrated. Consult doctor if severe or persistent.
Stomach discomfort (Common (5-10%))
Take with meals. Consult doctor if it continues.
Dry mouth (Common (5-10%))
Sip water frequently. Chew sugar-free gum.

🚨 Serious Side Effects

Severe allergic reaction (anaphylaxis) (Rare (<0.1%))
Seek immediate medical attention if you experience rash, swelling of face or throat, or difficulty breathing.
Serotonin syndrome (Rare (<0.1%))
Seek immediate medical help if you have agitation, confusion, rapid heart rate, fever, or muscle twitching.
Hallucinations (Rare (<0.1%))
Stop the medicine and consult a doctor immediately.
Respiratory depression (Very rare (<0.01%))
Seek emergency medical care if breathing becomes slow or shallow.

⚠️ Rare Side Effects

Severe skin reactions (Stevens-Johnson syndrome)
Stop the medicine and seek immediate medical attention if you develop a painful rash with blisters or peeling skin.
Liver enzyme elevation
Report to your doctor if you notice yellowing of eyes or skin, or dark urine.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
MAO inhibitors Major
SSRIs Major
CYP2D6 inhibitors Major
Antihistamines Moderate
Opioids Moderate
Alcohol Moderate
Grapefruit juice Minor

🚨 Major Interactions

  • MAO inhibitors (e.g., phenelzine, tranylcypromine)
  • SSRIs (e.g., fluoxetine, paroxetine)
  • CYP2D6 inhibitors (e.g., quinidine, terbinafine)

⚡ Moderate Interactions

  • Antihistamines (e.g., diphenhydramine)
  • Opioid analgesics (e.g., codeine, morphine)
  • Alcohol

🍷 Alcohol Interaction

Alcohol should be strictly avoided while taking this medicine. Both dextromethorphan and alcohol cause drowsiness and can depress the central nervous system. Combining them can lead to excessive sedation, impaired coordination, and difficulty breathing. It also increases the risk of liver damage.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known allergy to ambroxol, dextromethorphan, or any component of the formulation","Children under 12 years of age","Respiratory depression or severe respiratory insufficiency","Concurrent use with MAO inhibitors or within 14 days of stopping them","First trimester of pregnancy","Breastfeeding without medical advice","Chronic cough associated with smoking, asthma, or emphysema without diagnosis","Cough with excessive secretions where suppression could be harmful"]

⚠️ Warnings & Precautions

["Do not exceed the recommended dose. High doses of dextromethorphan can cause hallucinations and dissociation.","Avoid driving or operating machinery until you know how this medicine affects you.","Do not use for chronic cough or cough with excessive mucus without consulting a doctor.","Use with caution in patients with liver or kidney disease.","Use with caution in patients with a history of drug abuse or addiction.","Do not use in children under 12 years.","Consult a doctor if cough persists for more than 7 days, or if it is accompanied by fever, rash, or persistent headache.","Keep out of reach of children. In case of accidental overdose, seek medical help immediately."]

🤱 Lactation Safety

Not established from the available information. Dextromethorphan and ambroxol may pass into breast milk. Consult your doctor before use if you are breastfeeding.

💊 Overdose Management

Overdose of this medicine can cause severe drowsiness, dizziness, nausea, vomiting, hallucinations, agitation, rapid heart rate, and difficulty breathing. In case of overdose, seek immediate medical attention. Treatment is supportive and symptomatic. There is no specific antidote. Gastric lavage may be considered if the patient presents early. Monitor vital signs and provide supportive care.

⏰ 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 take a double dose to make up for a missed one.

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 and measure the dose with the provided measuring cup or spoon. Avoid driving or operating heavy machinery if you feel drowsy or dizzy after taking this medicine. Do not drink alcohol while taking this medicine, as it can increase drowsiness and other side effects. Inform your doctor if you have liver or kidney problems, asthma, or a history of drug abuse. Do not use this medicine for more than 7 days without consulting your doctor. Keep it out of reach of children. Store in a cool, dry place away from direct sunlight. Do not use this medicine if the seal is broken or the expiry date has passed.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more sensitive to the side effects of this medicine, particularly drowsiness, dizziness, and confusion. They may also have reduced liver and kidney function, which can affect drug clearance. Use with caution and consider dose reduction. Monitor for falls and cognitive changes.

🤰 Pregnancy Planning (TTC)

If you are planning to become pregnant, consult your doctor before taking this medicine. The safety of this medicine during pregnancy is not well established. It is generally recommended to avoid use in the first trimester. Discuss alternative treatments for cough with your doctor.

🏥 Post-Surgery Considerations

After surgery, cough can be painful and may strain surgical sites. This medicine can help suppress cough and loosen mucus, but use only under medical supervision. Inform your surgeon and anesthesiologist about all medicines you are taking. Dextromethorphan may interact with anesthetic agents.

🦷 Dental Procedures

If you are undergoing dental procedures, inform your dentist that you are taking this medicine. Dry mouth is a common side effect, which can increase the risk of dental problems. Stay hydrated and maintain good oral hygiene. The cough suppressant effect may be beneficial if you have a cough that could interfere with dental work.

💚 Lifestyle Tips for Better Results

🏃
Stay well hydrated to help thin mucus.
🥗
Use a humidifier to add moisture to the air.
😴
Avoid smoking and exposure to secondhand smoke.
💧
Get plenty of rest to help your body recover.
🧘
Practice good hand hygiene to prevent infections.
🌞
Avoid irritants like dust, pollen, and strong fumes.

🏋️ Exercise Considerations

Avoid strenuous exercise while taking this medicine, especially if you feel drowsy or dizzy. Light activity like walking may be fine, but listen to your body and rest when needed.

🥗 Diet Recommendations

Drink warm fluids like herbal tea or soup to soothe your throat.
Include honey in warm water to help relieve cough.
Eat a balanced diet rich in vitamins and minerals to support immunity.
Avoid cold drinks and ice cream which may worsen cough.
Reduce intake of processed foods and sugar.

💼 Impact on Daily Work & Life

This medicine can cause drowsiness and dizziness, which may affect your ability to drive or operate machinery. Avoid these activities until you know how the medicine affects you. It may also cause nausea or stomach discomfort, which can impact your work. Take it with food to minimize these effects. If your job requires mental alertness, discuss with your doctor about timing your doses.

🛑 When to Stop This Medicine

Stop taking this medicine and consult your doctor if your cough persists for more than 7 days, if it worsens, or if you develop new symptoms like fever, rash, or difficulty breathing. Do not stop abruptly if you have been taking it for a long time without consulting your doctor, as withdrawal symptoms may occur.

📅 Long-Term Use Effects

Long-term use of this medicine is not recommended without medical supervision. Prolonged use of dextromethorphan can lead to tolerance, dependence, and withdrawal symptoms. Ambroxol is generally well tolerated, but long-term effects are not well studied. If your cough persists for more than 7 days, consult a doctor to determine the underlying cause. Regular monitoring of liver and kidney function may be advised if used for extended periods.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Steam inhalation

Helps loosen mucus and soothe airways.

Evidence: Well-established
Saline nasal irrigation

Can help clear nasal congestion and postnasal drip.

Evidence: Moderate
Honey and warm fluids

Soothes throat and reduces cough frequency.

Evidence: Moderate

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

There are no known interactions between this medicine and vaccines. However, if you are scheduled for vaccination, inform your healthcare provider that you are taking this medicine. It is generally safe to continue, but your doctor will advise based on your condition.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ 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

✅ DO

Keep out of reach of children

❌ DON'T

Do not use after expiry date

✈️ Traveling with This Medicine

When traveling with this medicine, carry it in its original packaging with the prescription label intact. Bring a copy of your prescription to avoid issues at customs. Store it in a cool, dry place away from direct sunlight. If traveling across time zones, continue taking the medicine at regular intervals as prescribed. Do not leave it in a hot car or checked luggage. If you need to take a dose during travel, ensure you have access to safe water to take it with.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 35-year-old man with acute bronchitis
He had a persistent cough with thick yellow mucus for 5 days. His doctor prescribed this medicine. After 2 days, his cough became more productive and less frequent. He took it with food to avoid stomach upset and avoided driving due to mild drowsiness. By day 5, his symptoms had significantly improved.
💡 Lesson: Taking this medicine as prescribed and with food helps manage symptoms effectively while minimizing side effects.
👤 A 60-year-old woman with chronic bronchitis
She experienced frequent coughing episodes with difficulty bringing up mucus. Her doctor added this medicine to her regimen. She noticed that her cough became easier to manage and mucus was easier to expel. She was advised to monitor for dizziness and to stay hydrated. She reported no serious side effects.
💡 Lesson: This medicine can be beneficial for chronic bronchitis when used under medical supervision, but patients should be monitored for side effects.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine starts working within 30 to 60 minutes. Cough suppression may begin within 15 to 30 minutes, while mucus loosening takes about 30 to 60 minutes.

Q: Can I take this medicine with food?

A: Yes, you can take this medicine with or without food. Taking it with food may help reduce stomach upset.

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

A: 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 dose.

Q: Is this medicine safe during pregnancy?

A: The safety of this medicine during pregnancy is not well established. It should be used only if clearly needed and prescribed by a doctor. Avoid use in the first trimester.

Q: Can I drink alcohol while taking this medicine?

A: No, you should avoid alcohol while taking this medicine as it can increase drowsiness and the risk of central nervous system depression.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • 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?
  • Is it safe for my child?
  • Can I take it with other cough medicines?

🔄 Substitutes for kofno-ad 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 cure any type of cough.
    Fact: This medicine is only for productive cough with thick mucus. It is not effective for dry cough or cough due to other causes.
  • Myth: More medicine means faster relief.
    Fact: Taking more than the recommended dose can cause serious side effects like hallucinations and respiratory depression. Always follow the prescribed dose.
  • Myth: It is safe to take this medicine with alcohol.
    Fact: Alcohol increases the sedative effects and can be dangerous. Avoid alcohol completely while taking this medicine.

🔄 Alternative Options

Generic Alternatives

  • Ambroxol + Dextromethorphan Hydrobromide syrup (various manufacturers)

Brand Alternatives

  • Allerhin D Plus Syrup

📊 Comparison with Similar Medicines

[{"medicine":"This medicine","composition":"Ambroxol 15mg/5ml + Dextromethorphan 10mg/5ml","primary_use":"Productive cough","key_difference":"Combines mucolytic and cough suppressant"},{"medicine":"Ambroxol + Guaifenesin","composition":"Ambroxol + Guaifenesin","primary_use":"Productive cough","key_difference":"Guaifenesin is an expectorant, no cough suppressant"},{"medicine":"Dextromethorphan + Chlorpheniramine","composition":"Dextromethorphan + Chlorpheniramine","primary_use":"Dry cough with allergy","key_difference":"Antihistamine added for allergic symptoms"}]

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