Indications
• Productive and unproductive cough
• Cough associated with Upper Respiratory Tract Infections
• Cough due to active and passive smoking
• Allergy
• Asthma

Contraindications
• Known hypersensitivity
• During pregnancy and lactation
• In patients with pre-existing ischaemic heart disease or those patients with significant risk factors for ischaemic heart disease
• It is also contraindicated in patients with gastric ulceration

Precautions & Warnings 
The most common adverse reactions to terbutaline are tremor, headache, tachycardia, palpitations, muscle spasms and hypokalaemia. Side effects resulting from guaifenesin and ambroxol administration are very rare.

Terbutaline: Due to the positive inotropic effect of beta2-agonists, these drugs should not be used in patients with hypertrophic cardiomyopathy.
Tocolysis: Terbutaline in Azecof (Ambroxol 15 mg, Terbultaline 1.50 mg, Guaiphenesin 50 mg & Menthol 2.5 mg) should be used with caution in tocolysis and supervision of cardiorespiratory function, including ECG monitoring, should be considered. Treatment should be discontinued if signs of myocardial ischaemia (such as chest pain or ECG changes) develop. Terbutaline in Azecof (Ambroxol 15 mg, Terbultaline 1.50 mg, Guaiphenesin 50 mg & Menthol 2.5 mg) suspension should not be used as a tocolytic agent in patients with significant risk factors for pre-existing heart disease. During infusion treatment in pregnant women with beta2-stimulants in combination with corticosteroids a rare complication with a pathological picture resembling pulmonary oedema, has been reported.

Respiratory indications: Patients with underlying severe heart disease (e.g. ischaemic heart disease, arrhythmia or severe heart failure) who are receiving Terbutaline should be warned to seek medical advice if they experience chest pain or other symptoms of worsening heart disease. Attention should be paid to assessment of symptoms such as dyspnoea and chest pain, as they may be of either respiratory or cardiac origin.
Due to the hyperglycaemic effects of beta2-agonists, additional blood glucose controls are recommended initially in diabetic patients.
Potentially serious hypokalaemia may result from beta2-agonist therapy. Particular caution is recommended in acute severe asthma as the associated risk may be augmented by hypoxia. The hypokalaemic effect may be potentiated by concomitant treatments. It is recommended that serum potassium levels are monitored in such situations.

Ambroxol: Care to be taken to avoid contact with eye, skin, serious ingestion or inhalation.

Guaiphenesin: Guaiphenesin should be not used for persistent or chronic cough, such as occurs with asthma, or where cough is accompanied by excessive secretions, unless directed by a physician. Caution should be exercised in the presence of severe renal or severe hepatic impairment. The concomitant use of cough suppressants is not recommended. Patients with rare hereditary problems of fructose intolerance should not take this medicine. Not more than 4 doses should be given in any 24 hours. Avoid with any other cough and cold medicine. Consult a pharmacist or other healthcare professional before use in children under 6 years.

Dosage
As prescribed by the physician

Presentation
Azecof Suspension: 100 ml bottle