T h e r a p e u t i c I n d e x 123 Children 3 to 12 years: ½ to 1 teaspoonful (2.5 to 5 mL) three to four times daily. To be prescribed in children younger than 3 years as per the physician’s discretion. Adverse Effects No adverse effects have been reported. Contraindications No known contraindications. Special Precautions • Continuous use for > 4 weeks is not advisable. • The safety of Koflet-EX linctus during pregnancy is not established, and hence, is not recommended. Drug Interactions No clinically significant drug interactions have been reported. Presentation Pilfer-proof bottles of 100 mL and 200 mL with measuring cups. Pharmacological Actions of Principal Ingredients 1. Expectorant action: Glycyrrhiza glabra root is extensively used in traditional medicine for the treatment of sore throat, cough, and bronchial catarrh, as it has demulcent and expectorant properties. Adhatoda vasica leaf and Achillea millefolium have bronchodilatory effect. They help relax the tracheal and bronchial smooth muscles, which is mediated through the stimulation of β-adrenergic receptors and/or inhibition of histamine H1 receptors. Zingiber officinale attenuates airway hyperresponsiveness and relaxes airway smooth muscles, in part, by altering Ca++ regulation and stimulating β-adrenergic receptors. 2. Mucolytic action: Peppermint satva (Mentha spp) stimulates the mucus-secreting cells in the respiratory tract, augments the soluble mucus content, and lowers the specific gravity of the respiratory tract fluid. This facilitates easy expectoration. 3. Anti-inflammatory action: Glycyrrhiza glabra is known to exert potent anti-inflammatory effect through different mechanisms: (i) suppression of prostaglandin (PG) synthesis (by inhibiting arachidonic acid cascade pathway–related enzymes) and (ii) neutrophil-mediated inhibition of reactive oxygen species (neutrophils are the most potent inflammatory mediators at the site of inflammation). Several studies involving different models have observed the ability of glycyrrhizin, a key constituent of Glycyrrhiza glabra, to downregulate proinflammatory cytokines (tumor necrosis factor [TNF]-α, interleukin [IL]-1β, IL-3, IL-5, IL-6, IL-10, IL-12 (p40), IL-12 (p70), and IL-13) and chemokines (IL-8 and eotaxin-1). Adhatoda vasica leaf extract exerts significant anti-inflammatory activity. Vasicine, an active constituent of Adhatoda vasica, was observed to inhibit the free radical damage induced by ovalbumin and aluminum Koflet®-EX (linctus)
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