Experiences with

Carbocisteine

Carbocisteine is a type of medicine called a mucolytic.

A mucolytic helps you cough up phlegm (also called mucus or sputum). It works by making your phlegm less thick and sticky.

This can help if you have a condition that affects your lungs, including:

• chronic obstructive pulmonary disease (COPD)
• cystic fibrosis

Carbocisteine is only available on prescription.

It comes as capsules and as a syrup or a liquid that you drink.

Who can take carbocisteine

Most adults and children aged 2 years old and over can take carbocisteine.

Who may not be able to take carbocisteine

Carbocisteine is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have ever had an allergic reaction to carbocisteine or any other medicine
• have ever had a stomach ulcer
• are pregnant, planning to get pregnant, or are breastfeeding

Dosage and strength

Carbocisteine usually comes as capsules.

It also comes as a liquid (oral solution) and as a syrup. These types are for children or people who find it difficult to swallow pills. Some solutions should only be taken by adults due to the alcohol content.

The liquid and syrup come in bottles containing 250mg of carbocisteine in 5ml. The liquid also comes in sachets containing 750mg of carbocisteine in 10ml.

Talk to your doctor or pharmacist about which type will be best for you or your child.

The usual dose for adults is:

• capsules – two 375mg capsules, taken 3 times a day. When your symptoms improve, your doctor may recommend one 375mg capsule, taken 4 times a day
• syrup – 15ml, taken 3 times a day. When your symptoms improve, your doctor may recommend 10ml, taken 3 times a day
• liquid in sachets – 1 sachet, taken 3 times a day. When your symptoms improve, your doctor may recommend 1 sachet taken twice a day
• liquid in bottles – 15ml, taken 3 times a day. When your symptoms improve, your doctor may recommend 10ml taken 3 times a day

The usual dose for children is:

• 2 to 4 years – 1.25ml to 2.5ml of syrup or liquid from a bottle, given 4 times a day
• 5 to 11 years – 5ml of syrup or liquid from a bottle, given 3 times a day
• 12 to 17 years – 15ml of syrup or liquid from a bottle, given 3 times a day. When your symptoms improve, your doctor may recommend 10ml, taken 3 times a day

How to take it

You can take carbocisteine with or without food.

Swallow carbocisteine capsules whole.

The liquid in a bottle and the syrup will both come with a plastic syringe or spoon to help you measure out the right dose. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

How long to take it for

Usually, treatment with carbocisteine is for life.

However, your doctor may recommend that you stop taking it if carbocisteine does not seem to be helping your symptoms after a month or so.

If you forget to take it

If you forget a dose of carbocisteine, take it as soon as you remember, unless your next dose is due in less than 2 hours. In this case, skip the missed dose and take your next one at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking too much carbocisteine is unlikely to harm you or your child. In most cases you will not have any symptoms.

you take more than your prescribed dose of carbocisteine and you:

• have an upset stomach
• are vomiting

Go to 111.nhs.uk or call 111 . Call 111 if you're asking about a child under the age of 5 years.

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the carbocisteine packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

These common side effects of carbocisteine can happen to 1 in 10 people. There are things you can do to help cope with them:

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

Serious side effects of carbocisteine are rare.

Call 111 for advice now if:

• you have blood in your vomit
• your poo is black and tarry

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to carbocisteine.

These are not all the side effects of carbocisteine. For a full list see the leaflet inside your medicine packet.

Carbocisteine and pregnancy

Carbocisteine is not generally recommended during the first trimester of pregnancy. This is because there is very little information to say whether it might affect your baby's development.

Depending on why you need a mucolytic, your doctor might recommend an alternative medicine.

Carbocisteine and breastfeeding

If your doctor or health visitor says your baby is healthy, it's usually OK to take carbocisteine while breastfeeding.

It's not known how much carbocisteine passes into breast milk, although your baby will not be able to absorb a lot into their body from any that does pass into your breast milk. This means it's unlikely to cause any side effects in your baby.

However, depending on why you need a mucolytic, you may be advised to take other treatments instead where more is known about their use in breastfeeding.

If you do take carbocisteine while breastfeeding, talk to your midwife, health visitor, pharmacist or doctor if you have any concerns, including if your baby:

• is not feeding as well as usual
• has an upset stomach, such as being sick or having diarrhoea
• has a rash

Carbocisteine and fertility

There is no evidence that carbocisteine affects fertility in either men or women.

Cautions with other medicines

Carbocisteine does not mix well with some medicines.

Tell your doctor or a pharmacist it you're taking any medicines that can cause bleeding or ulcers in your stomach. These include:

• NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen, naproxen, diclofenac or high-dose aspirin
• steroids (also called corticosteroids)
• antiplatelet medicines that help to prevent blood clots, such as clopidogrel, low-dose aspirin or ticagrelor

Mixing carbocisteine with herbal remedies and supplements

There's not enough information to say that complementary medicines and herbal remedies are safe to take with carbocisteine. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Related links

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