Other Brands/Names

OBH Nellco, OBH Molex, OB Combi Batuk Pilek.

How It Works

Ammonium chloride increases systemic acidity by increasing the concentration of hydrogen ions (H+) in the body. In addition, it is commonly included as an expectorant in cough medicines because its mild irritant effect on the bronchial mucosa promotes the secretion of respiratory fluids, helping to trigger a more effective cough and facilitating the sputum to be coughed.

Indications

Expectorant component in cough medicines for productive (phlegmy) cough. Management of metabolic alkalosis (blood pH > 7.45), often associated with severe vomiting and dehydration.

Contraindication

• Severe renal diseases and liver disorders.

• Do not administer when metabolic alkalosis is accompanied by sodium loss (urinary excretion of sodium bicarbonate).

Side Effects

• Significant reactions: ammonia toxicity or poisoning (signs may include pallor, cold sweats, irregular heart rhythm, vomiting).

• Injection-site reactions: pain, irritation, phlebitis (inflammation of a vein), venous thrombosis (clot formation in a vein), infection.

• Metabolic/nutritional disorders: hyperglycemia (high blood sugar levels).

• Nervous system disorders: headache, hyperreflexia (exaggerated reflexes).

• Psychiatric/respiratory disorders: hyperventilation (rapid breathing), confusion.

• Renal/urinary tract disorders: glycosuria (glucose present in urine).

• Skin/subcutaneous disorders: rash.

Types

Ammonium chloride is available as syrup (as an expectorant in cough formulations) and injection medicine (to treat metabolic alkalosis).

Dosage

• Expectorant in cough medicines: follow the recommended dosage on the product label.

• Metabolic alkalosis: dose is individualized according to severity and patient tolerance; calculation may consider the combined deficits of carbon dioxide and chloride.

Safety

• Monitor patients periodically for manifestations of ammonia toxicity (pallor, cold sweats, vomiting, disordered breathing, cardiac rhythm disturbances, seizures).

• Administer intravenous injections slowly to reduce local irritation and toxic effects.

• Pregnancy category C: animal studies show fetal risk, and adequate human data are lacking; use in pregnancy only if clearly needed.

Drug Interactions

• May increase adverse effects when used with potassium-sparing diuretics.

• May increase serum concentrations of chlorpropamide and salicylates.

• May decrease serum concentrations of amantadine, amphetamines, mecamylamine, and α/β-agonists.

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