Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

COPD exacerbation treatment

Erdosteine (Erdotin®) has been launched in the UK for the symptomatic treatment of acute exacerbations of chronic bronchitis in adults.

The Summary of Product Characteristics contains detailed prescribing information. This drug is contraindicated in:

  • pregnancy or breast feeding
  • individuals under the age of 18 years
  • patients with severe liver failure
  • patients with creatinine clearance below 25ml/min
  • patients with active peptic ulceration

Side effects include nausea, vomiting, diarrhoea, epigastric pain, headache, urticaria, erythema and eczema. These effects are all classified as very rare (occurring in less than 1 in 10,000 patients).

Data available about the drug reveal that it reduces cough severity and frequency and is more effective in combination with antibiotics, compared to antibiotics alone, at resolving symptoms of expectoration, cough and dyspnoea at approximately 1 week. No data are available on the impact on hospital admissions and future exacerbations.

The recommended dose is one 300 mg capsule twice daily for maximum 10 days. A course of 20 capsules will cost £5.00.

Action: Current management of exacerbations involves using steroids and bronchodilators to control breathlessness and inflammation. Adjunctive therapy with erdosteine may be considered as an option to prevent admission to hospital in patients with recurrent exacerbations.

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