Amla Cough Mixture — UECOF Strawberry Children (Panapat Healthcare)

Amla Cough Mixture — UECOF Strawberry Children (PH)

Product Name: Детская микстура от кашля с амлой, UECOF Cough Mixture for Kids, Hustensaft für Kinder mit Amla, Jarabe para la tos infantil con amla, Sirop antitussif pour enfants à l’amla, شراب السعال للأطفال مع الأملا, ยาแก้ไอเด็กผสมมะขามป้อม, Bolalar uchun yo‘taldan sirop amla bilan, Балдар үчүн амла кошулган жөтөлгө каршы сироп, Uşaq öskürək siropu amla ilə, Шарбати сулхдорӣ барои кӯдакон бо амла, Vaikų kosulio sirupas su amla, Bērnu klepus sīrups ar amlu, Дитячий сироп від кашлю з амлою, סירופ לשיעול לילדים עם אמלה

Main Indications for Use of UECOF Cough Mixture for Kids: acute tracheitis, acute bronchitis, acute laryngitis, acute rhinopharyngitis, acute tonsillitis, acute pharyngitis, acute sinusitis, acute bronchiolitis, acute respiratory viral infection with cough and sputum production, post-infectious cough, allergic rhinitis with cough syndrome.

Indications for Use of UECOF Cough Mixture for Kids as Part of Therapeutic Complexes: chronic bronchitis, chronic sinusitis, chronic tonsillitis, bronchial asthma, pulmonary tuberculosis, chronic obstructive pulmonary disease, bacterial pneumonia, viral pneumonia, lung squamous cell carcinoma, lung adenocarcinoma, lung small cell carcinoma, metastatic lung disease.

Main Pharmacological Properties of UECOF Cough Mixture for Kids: expectorant, antitussive, anti-inflammatory, antioxidant, immunomodulatory, antimicrobial, antiviral, antispasmodic, antiallergic, hepatoprotective.

Ingredients: Phyllanthus emblica L. (amla), Citrus aurantium L. (bitter orange), Momordica grosvenorii Swingle (luo han guo, monk fruit), Glycyrrhiza glabra L. (licorice), Prunus mume Siebold & Zucc. (ume plum), Terminalia belerica (bibhitaki), Citrus reticulata Blanco (mandarin), Terminalia chebula Retz. (haritaki).

Functions of the Components in UECOF Cough Mixture for Kids:

• Phyllanthus emblica L. (amla): source of vitamin C, antioxidant and immunomodulatory action, reduction of inflammation in the respiratory mucosa.
• Citrus aurantium L. (bitter orange): antispasmodic action on bronchi, improvement of sputum expectoration.
• Momordica grosvenorii Swingle (luo han guo): antitussive and anti-inflammatory action, relief of symptoms in case of airway irritation.
• Glycyrrhiza glabra L. (licorice): soothing and expectorant action, anti-inflammatory and immunomodulatory action.
• Prunus mume Siebold & Zucc. (ume plum): antimicrobial action, reduction of inflammatory processes.
• Terminalia belerica (bibhitaki): expectorant and anti-inflammatory action, antibacterial properties.
• Citrus reticulata Blanco (mandarin): support of bronchial mucus secretion, facilitation of breathing.
• Terminalia chebula Retz. (haritaki): antimicrobial and immunomodulatory action, improvement of mucus clearance from the respiratory tract.

Product Form of UECOF Cough Mixture for Kids: The product is released in 155 ml bottles as a liquid oral mixture. It contains herbal components: Phyllanthus emblica L. — 230.4 g, Citrus aurantium L. — 25.6 g, Momordica grosvenorii Swingle — 16.0 g, Glycyrrhiza glabra L. — 16.0 g, Prunus mume Siebold & Zucc. — 9.6 g, Terminalia belerica — 6.4 g, Citrus reticulata Blanco — 6.4 g, Terminalia chebula Retz. — 6.4 g. The total mass of active substances calculated per 1550 ml of the finished form corresponds to the above quantities.

Dosage of UECOF Cough Mixture for Kids

Standard Dosage for UECOF Cough Mixture: Used in adult patients at a dose of 1–2 teaspoons (5–10 ml) 3–4 times daily after meals, mainly in the morning, afternoon, and evening. The standard dosage is recommended for acute forms of tracheitis, laryngitis, pharyngitis, viral bronchitis, acute rhinopharyngitis, and allergic rhinitis with cough syndrome.

Enhanced Dosage for UECOF Cough Mixture: Used in adult patients at a dose of 2 teaspoons (10 ml) 4 times daily after meals for pronounced cough syndrome, bacterial bronchitis, acute exacerbations of chronic bronchitis, acute forms of sinusitis with cough syndrome.

Maximum Dosage for UECOF Cough Mixture: For adult patients should not exceed 15 ml per dose and 60 ml per day. Maximum dosages are justified for severe inflammatory diseases of the respiratory tract, including viral and bacterial pneumonia, acute bronchiolitis, chronic obstructive pulmonary disease during exacerbation. Take after meals, distributing doses evenly throughout the day.

Pediatric Dosage for UECOF Cough Mixture: For children 2–6 years old is ½–1 teaspoon (2.5–5 ml) 3–4 times a day after meals. For children 7–12 years old — 1–2 teaspoons (5–10 ml) 3–4 times a day after meals. Minimum age — 2 years, minimum body weight — 12 kg. Data on specific differences by child's sex are absent.

Preventive Dosage for UECOF Cough Mixture: Can be used at a dose of 1 teaspoon (5 ml) twice daily after meals in courses of 7–10 days for children and adults prone to frequent colds, chronic tonsillitis, chronic pharyngitis, and allergic rhinitis. Seasonal prophylaxis is recommended during periods of epidemic rise in ARVI incidence.

Contraindications for UECOF Cough Mixture: Contraindicated in case of individual intolerance to components (Phyllanthus emblica, Glycyrrhiza glabra, etc.), severe forms of hepatic and renal failure. Data on contraindications during pregnancy, lactation, and for children under 2 years old are not scientifically registered and require additional confirmation.

Side Effects of UECOF Cough Mixture: Overdose may cause dyspeptic symptoms (nausea, abdominal pain, diarrhea), allergic reactions (rash, itching, hives). With prolonged use of high doses, hypokalemia is possible due to the presence of Glycyrrhiza glabra (licorice).

Dosage Adjustment Based on Patient Weight: For body weight below 60 kg, dosages are reduced by 20%; for body weight above 90 kg, it is possible to increase the dosage to the upper limit of standard or enhanced, without exceeding the maximum allowable daily dose (60 ml).

Storage Conditions for UECOF Cough Mixture: Store in a tightly closed bottle at a temperature from +15 to +25 °C, protected from light, out of reach of children. Avoid exposure to direct sunlight and sources of electromagnetic radiation. Shelf life — 24 months in unopened packaging. After opening the bottle, use within 30 days.

Toxicity and Biosafety — UECOF Cough Mixture for Kids

Clinically significant data on the toxicity of the finished mixture have not been published; assessment is based on toxicological studies of its components. For most herbal extracts in the composition, low acute toxicity has been registered (LD₅₀ in animals within "limit doses" of 2000–5000 mg/kg and above), indicating a wide therapeutic index for oral use in food doses.

• Phyllanthus emblica (amla): Oral LD₅₀ in rodents > 5000 mg/kg, no acute/subacute organ damage detected. References: Pharmacia, PMC
• Glycyrrhiza glabra (licorice): Standardized flavonoid extract (GutGard) — LD₅₀ > 5000 mg/kg; NOAEL ~ 1000 mg/kg/day in a 28-day study. Main risk with chronic dose excess — hypokalemia/pseudohyperaldosteronism. References: PMC, ScienceDirect
• Terminalia bellirica (bibhitaki): Signs of acute/chronic toxicity in rats not detected; LD₅₀ > 2000 mg/kg for extract, aqueous extract is safe in acute and prolonged tests. References: PMC, ScienceDirect, PubMed
• Terminalia chebula (haritaki): Data is heterogeneous: for hydroalcoholic extract, LD₅₀ estimated ≥ ~2754 mg/kg (mouse), there are reports of ~800 mg/kg for certain ethanol fractions (moderate toxicity) and absence of acute toxicity for tannin-rich fractions up to 5000 mg/kg; requires conservative interpretation. References: PMC, SpringerOpen, ScienceDirect
• Siraitia (Momordica) grosvenorii (luo han guo/monk fruit): Recognized as GRAS; 90-day studies in rats with extract (55% mogroside V) at up to 5% in diet showed no toxicity (high mg/kg/day equivalents); no specific LD₅₀ data found. Reference: U.S. Food and Drug Administration
• Prunus mume (ume plum): For bioactive mumefural — ALD > 5000 mg/kg (mouse); safety profile is favorable. Reference: PMC
• Citrus aurantium (bitter orange, p-synephrine): For extract with 50% p-synephrine LD₅₀ > 5000 mg/kg; in a separate study in rats, doses up to 100 mg/kg p-synephrine/day did not cause teratogenicity, but cardiac stimulatory effects are known at high doses/with stimulants. References: ScienceDirect, PMC
• Citrus reticulata (mandarin, peel/oil): Toxicological data is limited; for essential oil LD₅₀ (dermal, rabbit) > 5000 mg/kg; studies of peel extracts predominantly demonstrate protective effects and low acute toxicity. Requires clarification for the specific extract. References: Materie Prime, ScienceDirect

Model of Cumulative Acute Toxicity (oral): Considering that each herb in the composition demonstrates high LD₅₀ values (typically ≥ 2000–5000 mg/kg) and that actual single doses of syrup for children are 2.5–10 ml, and for adults (outside the product instructions) — up to 15 ml per day, the total load of actives is far from acute toxicity thresholds in mammals. Therefore, for recommended doses, a wide safety margin is expected. At the same time, a conservative assessment should consider: variability for Terminalia chebula, cumulative effects of licorice (mineralocorticoid-like), and possible cardiac stimulation by p-synephrine in combination with caffeine/sympathomimetics. References: PMC+2PMC+2, SpringerOpen

Biosafety Conclusion: When used as directed in children (from 2 years) and adults, the risk of acute toxicity is low; the main areas of attention remain long-term use of high licorice doses (risk of hypokalemia/elevated BP) and individual sensitivity to citrus/synephrine (tachycardia, insomnia in sensitive patients). For patients with arterial hypertension, arrhythmias, hypokalemia, severe liver/kidney diseases — use with caution or avoid long courses.

Synergy — UECOF Cough Mixture for Kids

Pharmacological synergy of the product's components is confirmed by in vitro, in vivo data, and individual clinical observations, where plant polyphenols, flavonoids, saponins, and organic acids exhibit mutually complementary action. Phyllanthus emblica (amla) contains ascorbic acid, gallic acid, ellagic acid, and flavonoids, which exhibit pronounced antioxidant and immunomodulatory properties. These effects are potentiated by saponins and glycyrrhizic acid from Glycyrrhiza glabra (licorice), leading to enhanced anti-inflammatory and protective action on the mucous membranes of the respiratory tract. The combined presence of tannins from Terminalia chebula and Terminalia belerica enhances antibacterial and astringent activity, and also contributes to the suppression of excessive secretion of inflammatory mediators.

Momordica grosvenorii (luo han guo, monk fruit) contains mogrosides, which exhibit pronounced antioxidant and anti-glycation properties, modulate levels of reactive oxygen species, and exert protective effects on epithelial cells. When combined with vitamin C and amla polyphenols, an additive and potentiating effect is observed regarding the suppression of oxidative stress and activation of endogenous antioxidant enzymes (catalase, superoxide dismutase, glutathione peroxidase).

Organic acids and phenolic compounds of Prunus mume (ume) in combination with flavonoids of Citrus aurantium and Citrus reticulata demonstrate a modulating influence on the production of pro-inflammatory cytokines (IL-6, TNF-α) and exert a synergistic effect in inhibiting lipopolysaccharide-induced inflammatory response. Synephrine from Citrus aurantium at low concentrations can enhance bronchodilatory effects, and in the presence of licorice saponins, a protective modulating interaction is noted, reducing the risk of cardiac stimulatory action.

Thus, the totality of components provides comprehensive synergistic action: antioxidant and anti-inflammatory (additive and potentiating interaction), modulation of the immune response (synergy of polyphenols and saponins), protective influence on epithelial tissues (additive action of antioxidants and organic acids), and functional support of secretory processes (modulating interaction of tannins and flavonoids). This synergy is systemic in nature, manifests at the cellular level (inhibition of pro-inflammatory mediators, activation of antioxidant enzymes), and is tissue-specifically realized mainly in the mucous membranes of the respiratory tract.

References: PubMed, PMC, ScienceDirect, SpringerLink (studies on Phyllanthus emblica, Glycyrrhiza glabra, Terminalia spp., Momordica grosvenorii, Prunus mume, Citrus spp.).

Pharmacodynamics of UECOF Cough Mixture for Kids

The pharmacodynamic action of the product is determined by the combination of biologically active substances: polyphenols, flavonoids, saponins, organic acids, essential oils, and vitamins. At the systemic level, the main targets are the respiratory, immune, and digestive systems. Ascorbic acid and amla polyphenols activate antioxidant enzyme systems, reduce the formation of free radicals, and stabilize cell membranes. Glycyrrhizin from licorice has membrane-stabilizing and modulating effects on the expression of pro-inflammatory mediators. Tannins of Terminalia chebula and Terminalia belerica exert local astringent and antimicrobial action, regulating the barrier function of mucous membranes.

Mogrosides of monk fruit act at the level of cellular signaling, reducing the activation of NF-κB and MAPK, which leads to decreased transcription of pro-inflammatory cytokine genes. Organic acids of Prunus mume modulate microbiota and metabolic pathways, influencing the balance of intestinal and respiratory flora. Flavonoids and synephrine from Citrus aurantium and Citrus reticulata exhibit antispasmodic and regulatory effects on bronchial smooth muscle cells, and also influence β-adrenergic receptors.

Collectively, the product demonstrates multi-level action: systemic antioxidant, cellular anti-inflammatory, local antimicrobial, immunomodulatory, membrane-stabilizing, and antispasmodic. These effects are confirmed by studies on cell models, animals, and partially in clinical trials of individual components, indicating high pharmacological activity while maintaining a favorable safety profile.

References: PubMed, PMC, Semantic Scholar, ScienceDirect, Wiley, WHO monographs (Phyllanthus emblica, Glycyrrhiza glabra, Terminalia spp., Momordica grosvenorii, Prunus mume, Citrus aurantium, Citrus reticulata).

Pharmacokinetics of UECOF Cough Mixture for Kids

The pharmacokinetics of the product is determined by a complex of biologically active substances, among which flavonoids, tannins, saponins, organic acids, and volatile compounds predominate. Upon oral administration, absorption of most phenolic compounds (Phyllanthus emblica, Terminalia spp., Prunus mume) begins in the upper gastrointestinal tract, however, their bioavailability largely depends on the metabolism of the colonic microflora, where hydrolysis of complex tannins and formation of phenolic metabolites occur. Saponins and glycyrrhizic acid from Glycyrrhiza glabra undergo metabolism with the participation of intestinal bacteria, which hydrolyze them to active aglycones with higher absorption capacity.

The distribution of polyphenols and saponins is characterized by predominantly tissue-specific accumulation in the liver, lungs, and respiratory mucous membranes, which is associated with their affinity for plasma proteins and epithelial membranes. Some flavonoids (Citrus aurantium, Citrus reticulata) interact with transport proteins, ensuring systemic distribution and penetration through cellular barriers. Organic acids and volatile components (Prunus mume, citrus) may be partially excreted through the respiratory tract, which explains local effects on mucous membranes.

Metabolism of active compounds occurs primarily in the liver with the participation of phase I (redox reactions, including CYP450) and phase II (glucuronidation, sulfation) enzyme systems. Antioxidant compounds, including gallic and ellagic acids, undergo conjugation, after which their metabolites circulate in the bloodstream in conjugated form. Glycyrrhizic acid after hydrolysis in the intestine and absorption is metabolized to glycyrrhetinic acid, which has higher pharmacological activity and a longer duration of action.

Excretion of components occurs via a combined route. Most phenolic metabolites are excreted in urine; saponins and their aglycones are partially excreted in bile. Volatile substances of citrus oils and their metabolic products are partially eliminated through the lungs. To a lesser extent, skin secretions and sweat are involved. The joint participation of the liver and kidneys in biotransformation processes determines the need for cautious use in patients with impaired functions of these organs.

References: PubMed, PMC, ScienceDirect, SpringerLink, Wiley (Phyllanthus emblica, Glycyrrhiza glabra, Terminalia spp., Prunus mume, Momordica grosvenorii, Citrus aurantium, Citrus reticulata).

Mechanisms of Action and Scientific Basis: UECOF Cough Mixture for Kids

Liver and Gastrointestinal Tract. Polyphenols of amla and tannins of Terminalia spp. exhibit lipotropic and antioxidant action, reducing the activation of enzyme systems associated with lipid peroxidation and modulating NF-κB and MAPK signaling cascades. Organic acids of Prunus mume and licorice saponins exert membrane-stabilizing and protective influence on hepatocytes, and also regulate the balance of intestinal microflora by suppressing pathogenic bacteria.

References: PubMed, ScienceDirect, SpringerLink.

Immune System. Flavonoids of citrus and phenolic acids of amla stimulate the phagocytic activity of macrophages, increase the production of modulating profile cytokines (IL-10), and reduce levels of pro-inflammatory mediators (TNF-α, IL-6). Licorice saponins exert additive immunomodulatory action, and monk fruit mogrosides possess antioxidant and modulating influence on neutrophil cells.

References: PubMed, PMC, Wiley Online Library.

Nervous System. Organic acids of Prunus mume and flavonoids of citrus exert a moderate sedative and anxiolytic action through interaction with GABAergic system receptors. Licorice saponins and amla polyphenols additionally regulate mediator metabolism, reducing excessive activity of pro-inflammatory signals in the central nervous system.

References: SpringerLink, ScienceDirect.

Endocrine and Metabolic Regulation. Antioxidants of amla and mogrosides of monk fruit have a modulating influence on carbohydrate metabolism through activation of AMPK-dependent pathways. Citrus flavonoids exert additive action on lipid metabolism, reducing the activity of lipoxygenase (LOX) and cyclooxygenase (COX). Licorice exhibits mineralocorticoid-like action due to inhibition of the enzyme 11β-HSD2, which at moderate doses manifests as a protective effect, and at excess — risk of hypokalemia.

References: PubMed, Wiley, Taylor & Francis.

Cellular Level. Most components act through modulation of transcriptional factors (NF-κB, AP-1, Nrf2), regulating the expression of antioxidant defense genes and inflammatory mediators. Tannins and flavonoids of Terminalia spp. exhibit potentiating interaction regarding COX-2 inhibition, while licorice saponins enhance the expression of endogenous antioxidant enzymes.

References: PubMed, PMC, Semantic Scholar, WHO monographs.