ammonium reference
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(ammonium · DailyMed)
Registered Malawi · PMRA

PUMA COMBINATION PRODUCT COUGH SYRUP

CAMPHOR, ANISED OIL, MENTHOL, AMMONIUM CHLORIDE, BULK LIQUID LIQUORIC EXTRACT

PMPB/PL25/26 COUGH SYRUP INN generic

What it does

Ammonium is a compound that can be used in various treatments but is not classified under a specific drug class.

Read more in plain English ↓

Plain-language summary for general understanding - not medical advice. Always follow your pharmacist/doctor.

Ask about this medicine

Answers come only from this medicine's registration record, BNF monograph and interaction data - not medical advice.

Medicine sourcing is available in Kenya only. We don't sell or dispense medicines - licensed pharmacies do.

Sourcing - Kenya only

Registration & product details

Registration no.
PMPB/PL25/26
Registration date
12/06/2001
Expiry date
31/03/2025
Status
Registered
Active ingredient
CAMPHOR, ANISED OIL, MENTHOL, AMMONIUM CHLORIDE, BULK LIQUID LIQUORIC EXTRACT
Dosage form
COUGH SYRUP
Strength
-
Pack size
-
Therapeutic class
-
RxNorm RxCUI
709
Manufacturer / MAH
-
Applicant / LTR
-
Country of origin
-

Source: Pharmacy and Medicines Regulatory Authority · fetched 2026-04-21 17:37:39 · updated 2026-09-19 04:30:22

Disclaimer: This information is sourced from Pharmacy and Medicines Regulatory Authority (Malawi). Always consult a qualified healthcare professional before using any medication.

About ammonium

Ammonium is a compound that can be used in various treatments but is not classified under a specific drug class.

How it works

Ammonium works by balancing chemical levels in the body.

Who it's for

It may be used in specific medical conditions as determined by a healthcare provider.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About anised

Aniseed is a natural herb often used for its flavor and potential health benefits.

What it treats

  • digestive problems
  • coughs
  • breathing issues
  • bloating
  • gas

How it works

Aniseed may help soothe the digestive system and can have a calming effect.

Who it's for

Adults and children who are experiencing digestive discomfort or respiratory issues.

Cautions

  • • Should be used with care in pregnant or breastfeeding women.
  • • May cause allergic reactions in some individuals.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About bulk

Bulk is a natural ingredient that helps improve bowel movements by increasing the amount of water in the stool, making it easier to pass.

What it treats

  • constipation
  • irregular bowel movements
  • hemorrhoids
  • diverticular disease

How it works

It works by absorbing water in the intestine, which helps to soften the stool and promote regular bowel movements.

Who it's for

It is suitable for adults and children who need help with constipation or have conditions that affect their bowel health.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About camphor

Camphor is a natural compound used for its soothing properties and is often found in topical products.

What it treats

  • muscle pain relief
  • cough relief
  • skin irritation treatment

How it works

Camphor works by creating a cooling sensation on the skin, which helps reduce pain and irritation.

Who it's for

Camphor is suitable for adults and children for topical use, but should be used with caution.

Cautions

  • • Do not apply to broken skin or open wounds.
  • • Avoid using on large areas of the body.
  • • Keep away from the eyes and mouth.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About extract

This medicine is an extract that is used for various health conditions.

What it treats

  • general health improvement
  • nutritional support

How it works

The extract may provide health benefits by supplying essential nutrients or compounds that support bodily functions.

Who it's for

This medicine is suitable for individuals looking to improve their overall health or address specific nutritional needs.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About liquid

Liquid medications can come in various forms, including solutions, syrups, and suspensions. They are often used for easier swallowing and faster absorption.

What it treats

  • nausea and vomiting
  • pain relief
  • fever reduction
  • cough relief

How it works

Liquid medications are absorbed quickly into the body, providing rapid relief for various symptoms.

Who it's for

Liquid medications can be suitable for people of all ages, especially those who have difficulty swallowing tablets or capsules.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About liquoric

Liquoric is derived from licorice root and is often used for its soothing properties.

What it treats

  • sore throat
  • cough
  • stomach upset

How it works

Liquoric contains compounds that can help reduce irritation and provide relief from discomfort.

Who it's for

Adults and children who are experiencing throat or stomach discomfort.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

About menthol

Menthol is a natural compound often used for its soothing and cooling effects.

What it treats

  • cough relief
  • muscle pain relief
  • skin irritation treatment

How it works

Menthol creates a cooling sensation on the skin and mucous membranes, which can help relieve discomfort.

Who it's for

Menthol is suitable for adults and children who need relief from coughs, muscle aches, or skin irritation.

AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.

Clinical monograph: ammonium

BNF-referenced

Ammonium is a positively charged ion (NH4+) that plays a crucial role in various biochemical processes, including nitrogen metabolism in living organisms. It is involved in the synthesis of amino acids and nucleotides, acting as a precursor in the biosynthesis of important biological compounds. Ammonium is also a key component in the nitrogen cycle, contributing to the fertility of soil and aquatic environments.

Indications

  • Nitrogen supplementation in clinical nutrition
  • Management of metabolic alkalosis
  • Treatment of certain types of kidney disorders

Dosage

Children: Specific pediatric dosing information is not detailed in the BNF. Refer to the BNF for Children for appropriate dosing based on age and condition.

Adults: Dosage varies based on clinical indication and should be guided by specific treatment protocols. Refer to clinical guidelines for detailed dosing information.

Mechanism of action

Ammonium ions participate in various metabolic pathways, including the biosynthesis of amino acids and nucleotides. It serves as a nitrogen source for organisms, facilitating the synthesis of essential biomolecules. The presence of ammonium can influence pH levels and osmotic balance within cells, thereby affecting cellular functions and enzyme activities.

Pharmacodynamics

Ammonium affects cellular metabolism by acting as a nitrogen donor in the synthesis of organic compounds. Its role in the nitrogen cycle and as a substrate in biochemical pathways allows for the maintenance of cellular functions, including energy production and cellular growth. Alterations in ammonium levels can influence various physiological processes, including neurotransmitter synthesis and energy metabolism.

Pharmacokinetics

Ammonium is readily absorbed and distributed in biological systems. It can be produced endogenously through amino acid metabolism or obtained from dietary sources. The excretion of ammonium primarily occurs through the kidneys, where it is converted to urea for elimination. Ammonium levels are regulated by various mechanisms, including the action of renal tubular cells that either secrete or reabsorb ammonium based on the body's needs.

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: ammoniumchloride

BNF-referenced

Ammonium chloride is an inorganic compound with the chemical formula ClH4N. It is primarily used as an expectorant and systemic acidifier. Its mechanism involves increasing hydrogen ion concentrations, thereby enhancing acidity and promoting the production of respiratory tract fluid, which aids in effective coughing. Additionally, it alters the bicarbonate:carbonic acid ratio in the body, potentially leading to acidosis and promoting the excretion of electrolytes and water.

Indications

  • Cough associated with respiratory tract infections
  • Acid-base disorders
  • Edema management

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing guidelines based on age and condition.

Adults: Refer to the BNF for specific adult dosing guidelines as they depend on the indication and clinical context.

Mechanism of action

Ammonium chloride increases acidity by raising hydrogen ion concentrations. It dissociates into ammonium and chloride ions; the ammonium is converted to urea in the liver, releasing hydrogen ions that lower pH. The chloride ions displace bicarbonate in extracellular fluid, leading to acidosis and increased renal excretion of electrolytes and water, resulting in fluid mobilization.

Pharmacodynamics

Ammonium chloride acts as a systemic acidifier, facilitating the excretion of chloride and sodium, while also increasing the acidity of body fluids. The conversion of ammonium to urea in the liver with the release of hydrogen ions contributes to a decrease in blood pH, affecting acid-base balance in the body.

Pharmacokinetics

Ammonium chloride is absorbed from the gastrointestinal tract and metabolized in the liver, where it is converted to urea. The dissociated ions impact renal function, leading to increased excretion of sodium, potassium, and water. The elimination half-life and specific metabolism details are not explicitly defined.

Adverse effects

  • Nausea
  • Vomiting
  • Abdominal pain
  • Diarrhea
  • Dizziness
  • Headache

Interactions

  • Antacids may reduce the effectiveness of ammonium chloride
  • Potassium-sparing diuretics may increase the risk of hyperkalemia

Precautions

  • Use with caution in patients with renal impairment
  • Monitor electrolyte levels during prolonged therapy
  • Consider potential for acidosis in patients with liver disease

Pregnancy

Ammonium chloride should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Consult a healthcare provider for individualized advice.

Breast-feeding

Ammonium chloride is excreted in breast milk. Use caution and consult a healthcare provider if breastfeeding.

Storage

Store in a cool, dry place, away from direct sunlight and moisture. Keep out of reach of children.

Formulations

  • Oral solution
  • Powder for oral solution

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: anised

Aniseed, derived from the Pimpinella anisum plant, is a spice and herbal remedy known for its aromatic properties. It has been used traditionally in culinary applications as well as in traditional medicine for its carminative and digestive benefits. Aniseed contains several active compounds, including anethole, which is responsible for its characteristic flavor and some of its therapeutic effects.

Indications

  • Digestive issues
  • Flatulence
  • Bloating
  • Cough relief
  • Menstrual discomfort

Dosage

Children: Refer to established herbal dosage guidelines and consult healthcare professionals for specific dosing information.

Adults: Refer to established herbal dosage guidelines and consult healthcare professionals for specific dosing information.

Mechanism of action

Anethole, the primary active component of aniseed, acts as a selective agonist for certain receptors, including the GABA(A) receptor, which may contribute to its calming effects. It also possesses anti-inflammatory and antimicrobial properties. The compounds in aniseed may enhance gastrointestinal motility and promote digestion by stimulating digestive enzymes.

Pharmacodynamics

Aniseed exhibits various pharmacodynamic effects, including anti-inflammatory, antifungal, and antispasmodic activities. It can promote the secretion of digestive juices, thereby aiding in digestion. Additionally, aniseed has been noted for its potential effects on the central nervous system, contributing to mild sedative effects.

Pharmacokinetics

The absorption of aniseed's active compounds occurs primarily in the gastrointestinal tract following oral ingestion. Anethole is metabolized in the liver, and its metabolites can be excreted in urine. Its half-life and specific metabolic pathways can vary based on individual factors such as age, health status, and concurrent medications.

Pregnancy

There is insufficient reliable information on the safety of anise during pregnancy. Caution is advised.

Breast-feeding

Anise is generally considered safe during breastfeeding in moderate amounts, but excessive consumption should be avoided.

Storage

Store in a cool, dry place away from direct sunlight.

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: bulk

Bulk-forming agents, commonly referred to as bulk laxatives, are substances that increase the bulk of the stool, facilitating bowel movements. They are usually derived from natural sources such as psyllium, methylcellulose, and bran. These agents work by absorbing water in the intestines, which helps to soften the stool and promote its passage. Bulk-forming agents are often used in the management of constipation and are considered a first-line therapy due to their safety profile and efficacy.

Indications

  • Constipation
  • Irritable bowel syndrome
  • Diverticular disease
  • Prevention of straining during defecation post-surgery
  • Management of stool consistency in patients with fecal incontinence

Dosage

Children: Refer to specific product guidelines for dosing information, as doses may vary depending on the formulation and the child's age and condition.

Adults: Refer to specific product guidelines for dosing information, as doses may vary depending on the formulation and the patient's condition.

Mechanism of action

Bulk-forming agents function by absorbing water in the intestinal lumen, which increases the stool volume. This mechanical effect stretches the intestinal walls, stimulating peristalsis and facilitating bowel movement. Additionally, the hydrated bulk can help to improve stool consistency and reduce the incidence of straining during defecation.

Pharmacodynamics

The pharmacodynamic effects of bulk-forming agents are primarily localized to the gastrointestinal tract. They increase stool bulk and moisture content, which can help to alleviate constipation. The onset of action typically occurs within 12 to 72 hours after ingestion, depending on the specific agent and individual patient factors.

Pharmacokinetics

Bulk-forming agents are not absorbed into the bloodstream and remain within the gastrointestinal tract. They exert their effects locally and are eliminated in the feces. The hydration of the bulk-forming agent occurs within the intestinal lumen, which helps to form a gel-like substance that enhances stool passage without systemic absorption.

Adverse effects

  • Gastrointestinal discomfort
  • Bloating
  • Flatulence
  • Diarrhea
  • Nausea

Precautions

  • Ensure adequate fluid intake to prevent gastrointestinal obstruction.
  • Monitor for signs of allergic reactions in sensitive individuals.
  • Use cautiously in patients with gastrointestinal disorders.

Pregnancy

Generally considered safe, but consult a healthcare provider for individual assessment.

Breast-feeding

Considered safe, but consult a healthcare provider for individual assessment.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

  • Powder
  • Capsules
  • Tablets
  • Granules

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: camphor

BNF-referenced

Camphor is a naturally occurring compound with a chemical formula of C10H16O. It is primarily used as an active ingredient in topical analgesics, such as balms and liniments, due to its ability to relieve pain and inflammation. Camphor has been traditionally utilized in various cultures for its soothing properties and is often applied to the skin for symptomatic relief.

Indications

  • Topical pain relief
  • Muscle aches
  • Joint pain
  • Inflammation

Dosage

Children: For children, the

Adults: For topical application, camphor is usually applied as needed to the affected area, following the instructions on the specific product used. Consult the product label or a healthcare professional for detailed dosing guidelines.

Mechanism of action

Camphor activates the transient receptor potential vanilloid 1 (TRPV1) and TRPV3 channels, which are involved in sensing pain and temperature. It requires higher concentrations to activate TRPV1 compared to capsaicin but notably desensitizes TRPV1 more rapidly and completely. This action is enhanced under inflamed conditions through phospholipase C-coupled receptor stimulation. The distinct activation pathways of camphor contribute to its analgesic effects, making it effective in reducing pain sensitivity.

Pharmacodynamics

The pharmacodynamic properties of camphor are primarily related to its interaction with TRPV1 and TRPV3 channels. By activating these receptors, camphor induces a sensation of warmth and can result in analgesia through sensory nerve excitation and subsequent desensitization. This mechanism is similar to that of other topical analgesics like capsaicin and menthol but is characterized by a faster desensitization of TRPV1. Additionally, camphor's effects may include local vasodilation and increased blood flow to the area of application, which can further alleviate pain and inflammation.

Pharmacokinetics

Camphor is absorbed through the skin when applied topically. Its pharmacokinetic profile involves distribution to various tissues, where it can exert local effects. The metabolism of camphor occurs primarily in the liver, and it is eliminated from the body mainly through urine. The onset of action is typically rapid due to its topical application, and the duration of effect may vary depending on the formulation and concentration used.

Adverse effects

  • Skin irritation
  • Allergic reactions
  • Nausea
  • Vomiting
  • Dizziness

Precautions

  • Use with caution in individuals with sensitive skin
  • Avoid contact with eyes and mucous membranes
  • Do not apply to broken or irritated skin
  • Keep out of reach of children

Pregnancy

Camphor should be used with caution during pregnancy. It is advisable to consult a healthcare professional before use.

Breast-feeding

Camphor should be used with caution while breastfeeding. Consult a healthcare professional for advice.

Storage

Store in a cool, dry place, away from direct sunlight and heat.

Formulations

  • Topical ointments
  • Liniments
  • Creams
  • Gels

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: extract

Extracts are concentrated preparations obtained from plants, herbs, or other natural sources through various extraction methods such as solvent extraction, steam distillation, or cold pressing. They are used for their therapeutic properties in herbal medicine and can contain a variety of bioactive compounds including alkaloids, flavonoids, terpenes, and essential oils. The specific effects and uses of an extract depend on its source material and the compounds it contains.

Indications

  • General wellness support
  • Anti-inflammatory effects
  • Antioxidant activity
  • Digestive aid
  • Support for immune function

Dosage

Children: Paediatric dosing should be determined based on the specific extract and its intended use. Consultation with a healthcare provider is recommended for accurate dosing.

Adults: Dosage varies widely depending on the specific extract and formulation. It is essential to follow the manufacturer's instructions or consult a healthcare professional for appropriate dosing.

Mechanism of action

The mechanism of action of herbal extracts can vary significantly based on their constituents. Commonly, they exert their effects through multiple pathways including modulation of neurotransmitter systems, interference with inflammatory processes, or direct antioxidant activity. Some extracts may activate certain receptors or inhibit enzymes related to disease processes.

Pharmacodynamics

The pharmacodynamics of extracts is complex due to the presence of multiple active compounds which can have synergistic or antagonistic effects. These compounds may influence cellular signaling pathways, alter gene expression, or modulate immune response. The overall pharmacological profile is determined by the specific composition of the extract, its concentration, and the biological target it interacts with.

Pharmacokinetics

The pharmacokinetics of extracts involves absorption, distribution, metabolism, and excretion of the active compounds. Generally, herbal extracts are absorbed in the gastrointestinal tract, with bioavailability influenced by factors such as formulation, the presence of food, and individual metabolic differences. Compounds may undergo hepatic metabolism, and elimination can occur through urine or feces, depending on their chemical nature.

Pregnancy

Consult a healthcare professional before use, as the safety of the extract during pregnancy has not been established.

Breast-feeding

Consult a healthcare professional before use, as the safety of the extract during breastfeeding has not been established.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: liquid

BNF-referenced

Methyl parathion is an organophosphate compound primarily used as an insecticide. It exerts its effects through inhibition of key enzymes involved in neurotransmission, leading to toxic effects associated with acute poisoning. It is important to note that toxic manifestations generally occur only after significant inhibition of plasma cholinesterase levels, specifically when more than 50% inhibition is observed. This compound has been studied for its acute toxicity and enzymatic interactions.

Indications

  • Insecticide for agricultural use
  • Research tool in toxicology

Dosage

Children: Refer to the BNF for Children for specific dosing and administration guidelines.

Adults: Refer to the BNF for specific dosing and administration guidelines.

Mechanism of action

Methyl parathion acts primarily by inhibiting the enzyme acetylcholinesterase, which is essential for the breakdown of the neurotransmitter acetylcholine. Its active metabolite, methyl paraoxon, is a potent inhibitor of both acetylcholinesterase and butyrylcholinesterase. The inhibition of these enzymes results in the accumulation of acetylcholine at synapses, leading to overstimulation of cholinergic receptors and resultant toxic effects.

Pharmacodynamics

The pharmacodynamics of methyl parathion involve its action as a noncompetitive inhibitor of acetylcholinesterase, causing prolonged effects of acetylcholine due to its inability to be hydrolyzed. The resultant cholinergic toxicity can lead to symptoms such as muscle twitching, respiratory distress, and potentially fatal outcomes if not treated promptly. The extent of inhibition is dose-dependent, with significant toxicity occurring after substantial enzyme inhibition.

Pharmacokinetics

Methyl parathion is absorbed through the gastrointestinal tract and can also be absorbed through the skin and respiratory tract. It is metabolized in the liver to form methyl paraoxon, which is responsible for the majority of its toxic effects. The distribution of methyl parathion in body tissues is influenced by its lipophilicity, and it is primarily excreted as metabolites in the urine. The elimination half-life and specific pharmacokinetic parameters can vary based on individual metabolism and exposure levels.

Pregnancy

There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether this drug is excreted in human milk. Caution is advised when administering to nursing women.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

  • Liquid formulation

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: liquoric

Liquoric, commonly known as licorice, is derived from the root of Glycyrrhiza glabra and has been used in traditional medicine for its various therapeutic properties. It contains glycyrrhizin, which is responsible for many of its pharmacological effects. Licorice is known for its sweet flavor and is often used as a flavoring agent in foods and beverages, as well as in herbal medicines.

Indications

  • Peptic ulcer disease
  • Gastroesophageal reflux disease (GERD)
  • Chronic cough
  • Inflammatory bowel disease (IBD)
  • Adrenal insufficiency
  • Respiratory tract infections

Dosage

Children: Pediatric dosing should be determined by a healthcare provider based on the child's condition, age

Adults: Dosage can vary widely depending on the formulation and indication. It is advisable to follow specific product guidelines or consult a healthcare professional for appropriate dosing.

Mechanism of action

The primary active component of licorice, glycyrrhizin, inhibits the enzyme 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2). This inhibition leads to increased levels of cortisol, which can bind to mineralocorticoid receptors, mimicking aldosterone's effects. Consequently, this results in sodium retention, potassium excretion, and possible edema. Additionally, glycyrrhizin has anti-inflammatory and antiviral properties, contributing to its therapeutic effects in various conditions.

Pharmacodynamics

Glycyrrhizin exerts several pharmacodynamic effects, including anti-inflammatory, antiviral, and immunomodulatory activities. It may enhance the effectiveness of certain corticosteroids and is known for its ability to soothe gastrointestinal inflammation. Licorice also acts as an expectorant, helping to clear mucus from the airways.

Pharmacokinetics

Glycyrrhizin is rapidly absorbed from the gastrointestinal tract. Its bioavailability can be affected by factors such as formulation and the presence of other substances. The metabolism of glycyrrhizin occurs primarily in the liver, where it is converted into various metabolites. The elimination half-life of glycyrrhizin is variable, but it can be prolonged in cases of liver impairment. Renal clearance also plays a role in the excretion of its metabolites.

Contra-indications

  • Hypersensitivity to liquoric or any of its components
  • Severe hypertension
  • Severe renal impairment

Adverse effects

  • Hypertension
  • Hypokalemia
  • Edema
  • Headache
  • Gastrointestinal disturbances
  • Fatigue

Interactions

  • May enhance the effect of corticosteroids, leading to increased sodium retention and potassium loss
  • May interact with antihypertensive medications, potentially reducing their effectiveness
  • May affect the metabolism of certain drugs due to its influence on liver enzymes

Precautions

  • Use with caution in patients with cardiovascular disease
  • Monitor potassium levels during prolonged use
  • Consider potential effects on blood pressure in patients taking antihypertensives

Pregnancy

Use during pregnancy only if clearly needed, as safety in pregnancy has not been established.

Breast-feeding

Caution is advised; limited information is available regarding excretion in breast milk.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

  • Liquid extract
  • Powder
  • Tablet

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Clinical monograph: menthol

BNF-referenced

Menthol is a cyclic monoterpene alcohol that is widely used as a flavoring agent and in topical analgesic preparations due to its cooling sensation. It is commonly derived from peppermint oil and is known for its soothing properties in various applications, including cough drops, ointments, and as a fragrance in personal care products.

Indications

  • Topical analgesic for muscle and joint pain
  • Cough suppressant in cough drops and lozenges
  • Relief of minor throat irritation
  • Cooling agent in various cosmetic and personal care products

Dosage

Children: Refer to BNF for Children for specific dosing guidelines, as doses may vary based on age and formulation.

Adults: For topical use, apply a thin layer to the affected area not more than 3 to 4 times daily. For cough drops, follow the product-specific instructions as per the formulation.

Mechanism of action

Menthol acts as an agonist for the transient receptor potential subtype M8 (TRPM8), a non-selective cation channel that is activated by cold temperatures. This activation leads to calcium influx in mast cells, inducing the release of histamine, which can trigger allergic responses such as urticaria, asthma, and rhinitis. Menthol's ability to induce histamine release via TRPM8 suggests potential therapeutic applications for TRPM8 antagonists in managing cold- and menthol-induced allergies.

Pharmacodynamics

Menthol produces a cooling effect by stimulating sensory neurons that convey cold sensations. It interacts with TRPM8 channels, leading to the activation of intracellular signaling pathways that can result in vasodilation and increased blood flow to the area of application. This cooling sensation can provide symptomatic relief in conditions characterized by pain or irritation.

Pharmacokinetics

Menthol is absorbed through the skin and mucous membranes, with systemic effects depending on the route of administration. Its bioavailability can vary, and it is metabolized primarily in the liver. The elimination half-life and excretion pathways have not been extensively characterized, but menthol is generally considered to have a rapid onset of action with effects lasting for a few hours.

Adverse effects

  • Allergic reactions
  • Urticaria
  • Asthma
  • Rhinitis
  • Skin irritation

Precautions

  • Use with caution in patients with known allergies to menthol or related compounds
  • May exacerbate asthma in sensitive individuals

Pregnancy

There are no well-controlled studies of menthol in pregnant women. Menthol should be used during pregnancy only if clearly needed.

Breast-feeding

Menthol is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

  • Topical ointment
  • Cream
  • Liquid

AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.

Molecular reference: ammoniumchloride

PubChem CID 25517

Molecular formula: ClH4N

Mechanism of action

Ammonium chloride increases acidity by increasing the amount of hydrogen ion concentrations. Ammonium chloride can be used as an expectorant due to its irritative action on the bronchial mucosa. This effect causes the production of respiratory tract fluid which in order facilitates the effective cough. The acid-forming properties of ammonium chloride result from dissociation of the salt to an ammonium cation and a chloride anion. In patients with normal hepatic function, the ammonium cation is converted to urea by the liver and a hydrogen cation is released which reacts with a bicarbonate ion to form water and carbon dioxide. The chloride anion combines with fixed bases in the extracellular fluid, thereby reducing the alkaline reserve of the body. The net result is the displacement of bicarbonate ions by chloride anions. The displacement of bicarbonate by chloride alters the bicarbonate:carbonic acid ratio if the body and acidosis results. The increased chloride concentration in the extracellular fluid produces an increased load to the renal tubules and appreciable amounts of chloride anions escape reabsorption. These anions are excreted along with cations and water. Sodium is the principal cation excreted; however, potassium excretion may also be increased to some degree. By increasing the excretion of both extracellular electrolytes and water, ammonium chloride causes a net loss of extracellular fluid and promotes the mobilization of edema fluid.

Pharmacodynamics

Systemic acidifier. In liver ammonium chloride is converted into urea with the liberation of hydrogen ions ( which lowers the pH) and chloride.

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

Molecular reference: camphor

PubChem CID 2537

Molecular formula: C10H16O

Mechanism of action

Camphor is a naturally occurring compound that is used as a major active ingredient of balms and liniments supplied as topical analgesics. ... Capsaicin and menthol, two other topically applied agents widely used for similar purposes, are known to excite and desensitize sensory nerves by acting on two members of transient receptor potential (TRP) channel superfamily: heat-sensitive TRP vanilloid subtype 1 (TRPV1) and cold-sensitive TRP channel M8, respectively. Camphor has recently been shown to activate TRPV3, and here /investigators/ show that camphor also activates heterologously expressed TRPV1, requiring higher concentrations than capsaicin. Activation was enhanced by phospholipase C-coupled receptor stimulation mimicking inflamed conditions. Similar camphor-activated TRPV1-like currents were observed in isolated rat DRG neurons and were strongly potentiated after activation of protein kinase C with phorbol-12-myristate-13-acetate. Camphor activation of rat TRPV1 was mediated by distinct channel regions from capsaicin, as indicated by camphor activation in the presence of the competitive inhibitor capsazepine and in a capsaicin-insensitive point mutant. Camphor did not activate the capsaicin-insensitive chicken TRPV1. TRPV1 desensitization is believed to contribute to the analgesic actions of capsaicin. /The authors/ found that, although camphor activates TRPV1 less effectively, camphor application desensitized TRPV1 more rapidly and completely than capsaicin. Conversely, TRPV3 current sensitized after repeated camphor applications, which is inconsistent with the analgesic role of camphor. /Investigators/ also found that camphor inhibited several other related TRP channels, including ankyrin-repeat TRP 1 (TRPA1). The camphor-induced desensitization of TRPV1 and block of TRPA1 may underlie the analgesic effects of camphor.

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

Molecular reference: liquid

PubChem CID 4130

Molecular formula: C8H10NO5PS

Mechanism of action

Acute poisoning ... is related to ... inhibiting action on enzyme acetylcholinesterase. Toxic manifestations generally occur only after more than 50% of plasma cholinesterase is inhibited. ... Methyl parathion ... depend on oxidative activation by replacement of thiono-sulfur with oxygen for ... toxicity. Methyl parathion has only a slight inhibitory action on acetylcholinesterase and butyrylcholinesterase, but its active metabolite, methyl paraoxon, is a potent inhibitor of both these enzymes. A study was conducted examining the inhibition of (Ca2+ and Mg2+)-ATPase by parathion (56382) and methyl parathion. Enzyme activity was assessed spectrophotometrically in pig erythrocyte membranes containing calcium2+ (Ca2+) and magnesium2+ and in solubilized membrane preparations incubated with the test agents. The enzyme response to ATP was biphasic. Equations expressing the kinetics of the substrate curves described two classes of the ATP binding active site, one with high affinity and low maximum rate and one with low affinity and high maximum rate. High affinity active sites were stimulated by low ATP concentrations (20 uM), whereas low affinity active sites were stimulated by high ATP levels (2 mM). Parathion and methylparathion dose dependently inhibited enzyme activity; parathion had a greater inhibitory effect than methylparathion. Lineweaver-Burke and Dixon plots indicated noncompetitive inhibition. Parathion and methylparathion induced enzyme inhibition occurred over a range of free calcium ion concentrations (0.5 to 5 mM); the inhibition was significantly greater at lower Ca2+ concentrations (1 to 100 uM) than at higher concentrations. The authors conclude that parathion and methylparathion inhibit ATPase activity by binding to a site on the enzyme rather than through an interaction with associated lipids. For more Mechanism of Action (Complete) data for METHYL PARATHION (6 total), please visit the HSDB record page.

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

Molecular reference: menthol

PubChem CID 1254

Molecular formula: C10H20O

Mechanism of action

Exposure to low temperatures often causes allergic responses or urticaria. Similarly, menthol, a common food additive is also known to cause urticaria, asthma, and rhinitis. However, despite the obvious clinical implications, the molecular mechanisms responsible for inducing allergic responses to low temperatures and menthol have not been determined. Because a non-selective cation channel, transient receptor potential subtype M8 (TRPM8) is activated by cold and menthol, we hypothesized that this channel mediates cold- and menthol-induced histamine release in mast cells. Here, we report that TRPM8 is expressed in the basophilic leukemia mast cell line, RBL-2H3, and that exposure to menthol or low temperatures induced Ca(2+) influx in RBL-2H3 cells, which was reversed by a TRPM8 blocker. Furthermore, menthol, a TRPM8 agonist, induced the dose-dependent release of histamine from RBL-2H3 cells. When TRPM8 transcripts were reduced by siRNA (small interfering RNA), menthol- and cold-induced Ca(2+) influx and histamine release were significantly reduced. In addition, subcutaneous injection of menthol evoked scratching, a typical histamine-induced response which was reversed by a TRPM8 blocker. Thus, our findings indicate that TRPM8 mediates the menthol- and cold-induced allergic responses of mast cells, and suggest that TRPM8 antagonists be viewed as potential treatments for cold- and menthol-induced allergies. /DL-Menthol/ Menthol's characteristic cooling sensation is due, in part, to the activation of sensory neurons generally termed transient receptor potential (TRP) channels, in particular transient receptor potential melastatin family member 8 (TRPM8) and transient receptor potential subfamily A, member 1 (TRPA1). Menthol acts upon TRPM8 receptors by rapidly increasing intracellular calcium and mobilizing calcium flux through the channels to induce cold response signals at the application site. Aside from its cold-inducing sensation capabilities, menthol exhibits cytotoxic effects in cancer cells, induces reduction in malignant cell growth, and engages in synergistic excitation of GABA receptors and sodium ion channels resulting in analgesia. /DL-Menthol/ In recent years, the transient receptor potential melastatin member 8 (TRPM8) channel has emerged as a promising prognostic marker and putative therapeutic target in prostate cancer. We have found that forced overexpression of TRPM8 in PC-3 cells can inhibit the cell proliferation and motility probably through the TRPM8 activation. In this study, we aimed to investigate whether activating the TRPM8 channel by its selective agonist menthol can inhibit the proliferation and motility of androgen-independent prostate cancer (AIPC) with remarkable expression of TRPM8. Menthol is a naturally occurring compound, which has been widely used in cosmetics and pharmaceutical products, and also as flavoring in food. DU145 cells are androgen-independent but have a remarkable expression of TRPM8. The demonstration of the existence of TRPM8 and the absence of TRPA1 in DU145 cells provided the foundation for the following experiments, because both TRPM8 and TRPA1 are molecular targets of menthol. The outcome of MTT assay indicated that menthol inhibited the cell growth (p < 0.01). Cell cycle distribution and scratch assay analysis revealed that menthol induced cell cycle arrest at the G(0)/G(1) phase (p < 0.01). Furthermore, menthol inhibited the migration of DU145 cells by downregulating the focal-adhesion kinase. So it suggests that the activation of the existing TRPM8 channels may serve as a potential and pragmatic treatment for those AIPC with remarkable expression of TRPM8, and menthol is a useful compound for future development as an anticancer agent. /DL-Menthol/

Source: PubChem (NCBI) · pathways from PathBank, Reactome, WikiPathways & PharmGKB.

This drug in other countries

The same active ingredient registered across other registries we cover - including different brands.