Topical ambroxol possible treatment of neuropathic pain


Recent research from Europe indicates the potent cough syrup ingredient ambroxol could be effective in alleviating neuropathic pain when used as a cream applied to the skin.

The German scientists concluded that, “[Ambroxol] is therefore considered to be a useful, simple concept for pain management with few side effects. In the case reports presented in this article, this concept was successfully implemented, for the first time, in the form of topical ambroxol 20 % cream in patients with severe neuropathic pain.”

However the European Medicines Agency published an advisory regarding possible complications in the use of ambroxol. They note that, “The risk of anaphylactic reactions and SCARs with ambroxol or bromhexine is low. Frequencies of these side effects are unknown.”

They go on to caution, “Anaphylactic reactions and severe cutaneous adverse reactions (SCARs), including erythema multiforme, Stevens-Johnson syndrome/toxic epidermal necrolysis and acute generalised exanthematous pustulosis, have been reported in patients receiving ambroxol.”

With those warnings out of way, the researchers made these claims based on findings on five of the people they treated, “Four patients with no improvement after lidocaine 5 % and one patient with no response to capsaicin 8 % nevertheless experienced a pain reduction with topical ambroxol.”

Widely available in tablet form, the 20% cream was prepared exclusively for this study by combining the following ingredients, “ambroxol cream 20 %, 50.0 g: ambroxol 10.0 g, dimethyl sulfoxide 5.0 g, made up to 50.0 g with Linola cream.”

Ambroxol is the active ingredient of medications marketed commercially as Mucosolvan, Mucobrox, Mucol, Lasolvan, Mucoangin, Surbronc, Ambolar, and Lysopain. Not available as a cream, it’s sold as a cough syrup, in tablets, pastilles, dry powder sachets, inhalation solutions, drops, ampules as well as effervescent tablets.

As noted in Wikipedia, “Many state-of-the-art clinical studies have demonstrated the efficacy of ambroxol in relieving pain in acute sore throat, with a rapid onset of action, with its effect lasting at least three hours. Ambroxol is also anti-inflammatory, reducing redness in a sore throat.”

Though known as a pain reliever since the 1970’s, it’s use in a topical (locally through the skin) form could offer promise for people where other methods have not been effective.


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