▴ Erdosteine is a thiol derivative developed for the treatment of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis.
▴ Erdosteine contains 2 blocked sulfhydryl groups which are released following first-pass metabolism. The 3 active metabolites exhibit mucolytic and free radical scavenging activity.
▴ Erdosteine modulates mucus production and viscosity and increases mucociliary transport, thereby improving expectoration. It also exhibits inhibitory activity against the effects of free radicals produced by cigarette smoke.
▴ Clinical studies in patients with chronic obstructive lung disease have demonstrated the efficacy and tolerability of erdosteine. Erdosteine 300mg twice daily reduced cough (both frequency and severity) and sputum viscosity more quickly and more effectively than placebo and reduced the adhesivity of sputum more effectively than ambroxol 30mg twice daily.
▴ Co-administration of erdosteine and amoxicillin in patients with acute infective exacerbation of chronic bronchitis resulted in higher concentrations of the antibiotic in the sputum, leading to earlier and more pronounced amelioration of clinical symptoms compared with placebo.
▴ Erdosteine is associated with a low incidence of adverse events, most of which are gastrointestinal and generally mild.
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Fumagalli G, Balzarotti C, Banfi P, et al. Erdostein: a new molecule with mucolytic activity. Clinical and instrumental evaluation in patients with acute and exacerbated chronic bronchopneumopathies. G Ital Mal Torace 1988; 42(4): 299–308
Scuri R, Giannetti P, Paesano A. Effect of erdosteine and its metabolites on tracheobronchial mucus production and transport. Drugs Exp Clin Res 1988; 14: 693–8
Marchioni CF, Moretti M, Muratori M, et al. Effects of erdosteine on sputum biochemical and rheologic properties: pharmacokinetics in chronic obstructive lung disease. Lung 1990 Sep–Oct; 168: 285–93
Olivieri D, Del-Donno M, Casalini A, et al. Activity of erdosteine on mucociliary transport in patients affected by chronic bronchitis. Respiration 1991; 58: 91–4
Ricevuti G, Mazzone A, Uccelli E, et al. Influence of erdosteine, a mucolytic agent, on amoxycillin penetration into sputum in patients with an infective exacerbation of chronic bronchitis. Thorax 1988 Aug; 43: 585–90
Gazzani G, Fregnan GB, Vandoni G. In vitro protection by erdosteine against oxidative inactivation of alpha-1-antitrypsin by cigarette smoke. Respiration 1989; 55: 113–8
Biagi GL, Fregnan GB, Gazzani G, et al. Erdosteine protection from cigarette smoke-induced loss of α1 -antitrypsin activity in rat lungs. Int J Clin Pharmacol Ther Toxicol 1989 May; 27: 235–7
Kaise T, Hosoe H, Sano J, et al. Effects of KW-9144 on paraquat toxicity in mice and bleomycin-induced pulmonary injury in rats [abstract]. Jpn J Pharmacol 1993; 61 Suppl. I: 81P
Inglesi M, Nicola M, Fregnan GB, et al. Synthesis and free radical scavenging properties of the enantiomers of erdosteine. Farmaco 1994 Nov; 40: 703–8
Vagliasindi M, Fregnan GB. Erdosteine protection against cigarette smoking-induced functional antiprotease deficiency in human bronchiolo-alveolar structures. Int J Clin Pharmacol Ther Toxicol 1989 May; 27: 238–41
Ciaccia A, Papi A, Tschirky B, et al. Protection of erdosteine on smoke-induced peripheral neutrophil dysfunction both in healthy and in bronchitic smokers. Fundam Clin Pharmacol 1992; 6(8-9): 375–82
Fregnan GB, Biagi G. Proconvulsive and convulsive properties of methionine, homocysteine and related compounds in mice. Acta Ther 1988; 14: 31–43
De Bernardi, Di Valserra M. Pharmacokinetics of erdosteine in fasting and unfasting healthy volunteers after single and multiple dose oral treatments. Med Prax 1992; 13(3/4): 77–98
Papalia D, Palermo A, Vandoni G, et al. The pharmacokinetics of oral erdosteine in normal geriatric volunteers. Med Prax 1992; 13(3/4): 99–107
Papalia D, Palermo A. The pharmacokinetics of oral erdosteine in normal geriatric volunteers — study no. 2. Med Prax 1992; 13(3/4): 109–32
Titti G, Iaia P, Calchi Novati G, et al. Pharmacokinetics of erdosteine and erythromycin stinoprate when administered alone or in combination to children affected by acute tracheobronchitis. Med Prax 1991; 12(4): 143–58
Papalia D, Palermo A, Vandoni G, et al. The influence of renal function on erdosteine kinetics: a single dose study in elderly patients. Med Prax 1992; 13(3/4): 133–43
Papalia D, Palermo A, Vandoni G, et al. Pharmacokinetics of erdosteine and some of its metabolites in geriatrics patients with hepatic impairment. Med Prax 1992; 13(3/4): 145–53
Marchioni CF, Polu JM, Taytard A, et al. Evaluation of efficacy and safety of erdosteine in patients affected by chronic bronchitis during an infective exacerbation phase and receiving amoxycillin as basic treatment (ECOBES, European Chronic Obstructive Bronchitis Erdosteine Study). Int J Clin Pharmacol Ther 1995 Nov; 33: 612–8
Aubier M, Berdah L. Evaluation of Vectrine® efficacy and safety versus placebo in the treatment of stabilized chronic bronchitis with hypersecretion [in French]. Negma Laboratories (Toussus-Le-Noble), 1996. (Data on file)
Ghiringhelli G, Mancini C. Cross-over clinical study of efficacy and tolerability of erdosteine in the treatment of chronic obstructive bronchial disease in stable hypersecretive phase controlled double-blind study vs placebo. Arch Med Interna 1995; XLVII(4): 113–20
Fioretti M, Bandera M. Prevention of exacerbations in chronic bronchitic patients with erdosteine. Med Prax 1991; 12(4): 219–27
De Giovanni L, Fregnan GB, Rabitti C, et al. Lack of gastric adverse effects of erdosteine in rats and man. Int J Clin Pharmacol Ther Toxicol 1991; 29(7): 269–73
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Dechant, K.L., Noble, S. Erdosteine. Drugs 52, 875–881 (1996). https://doi.org/10.2165/00003495-199652060-00009
- Adis International Limited
- Chronic Bronchitis
- Chronic Obstructive Lung Disease
- Mucociliary Transport