Pintus7.5 mg/5 ml

Established Use — Dry (Non-Productive) Cough

Pintus is indicated for the symptomatic relief of dry, irritating (non-productive) cough of various causes, including cough associated with the common cold, acute upper respiratory tract infections, and other conditions that cause an irritating cough without significant mucus or phlegm production. Pintus works by suppressing the cough reflex; it does not treat the underlying cause of the cough.

Not for Productive (Chesty) Cough

Pintus should not be used for a productive (chesty, mucus-producing) cough, where coughing is helping to clear secretions from the airways. Suppressing this type of cough with Pintus can allow mucus to build up in the lungs and airways, which may worsen breathing difficulty or increase the risk of chest infection. For this reason, Pintus should not be combined with mucolytic or expectorant medicines (see Interaction and Precautions and Warnings for the full explanation).

Guideline-Supported — Peri-Operative Use

Regulatory product information supports the use of Pintus to suppress cough before and after surgical procedures, and during diagnostic procedures such as bronchoscopy, where coughing could interfere with the procedure itself or with post-operative recovery.

Adjunct / Off-Label Use

Some regional product literature for Pintus also describes its adjunctive use for cough associated with whooping cough (pertussis) and acute inflammation of the lower respiratory tract. In these situations, Pintus is used only as an adjunct to relieve the cough symptom, alongside appropriate antimicrobial and supportive treatment of the underlying infection, and its use should be guided by a physician.

Each formulation of Butamirate Citrate contains Butamirate Citrate as its active ingredient. In Bangladesh, Butamirate Citrate is marketed as: sustained-release tablets containing Butamirate Citrate 50 mg; oral syrup containing Butamirate Citrate 7.5 mg/5 mL; and pediatric oral drops containing Butamirate Citrate 5 mg/mL.

Pintus is a non-opioid, centrally-acting cough-suppressant (antitussive) medicine used to relieve a dry, irritating cough that is not helping to clear mucus from the airways. Unlike opioid-based cough medicines, Pintus is not derived from opium and does not typically cause the marked sedation or dependence associated with opioid antitussives, although mild drowsiness can occur. Pintus is available in Bangladesh as tablets, syrup, and pediatric drops, allowing the dose to be tailored to adults, older children, and young children or infants under medical guidance. Pintus is intended only for short-term, symptomatic relief of dry cough, and is not a treatment for productive (mucus-producing) cough or for the illness causing the cough. As with any medicine, Pintus should be used strictly as directed by a doctor or pharmacist.

Antitussive (Cough Suppressant, Non-Opioid, Centrally-Acting)

Butamirate Citrate is thought to act mainly by reducing the sensitivity of the cough centre, thereby suppressing the cough reflex, without acting through opioid receptors; because it is not an opioid, Butamirate Citrate does not carry the respiratory-depressant or addictive potential associated with opioid cough suppressants. Product literature also describes mild peripheral effects of Butamirate Citrate on the airways, including anticholinergic and bronchodilating (bronchospasmolytic) activity, which may further ease breathing during a coughing episode. After oral intake, Butamirate Citrate is absorbed relatively quickly, is highly bound to plasma proteins, and is extensively broken down (hydrolysed) in the body to metabolites that are eliminated mainly via the kidneys.

• Tablets: Swallow the sustained-release Pintus tablet whole with a glass of water; do not chew or crush it, as this can alter the sustained-release effect.
• Syrup: Measure each dose of Pintus syrup using the measuring cup or spoon provided with the pack; wash and dry the measuring device after each use.
• Drops: Use the dropper supplied with the Pintus pediatric drops to measure the exact number of drops or mL prescribed; the drops may be given directly or mixed into a small amount of water or liquid for infants and young children.
• Take Pintus at evenly spaced intervals through the day, as directed on the label or by the prescriber.
• Do not exceed the dose or frequency of Pintus prescribed by the doctor, and do not use it for longer than advised.
• If a dose of Pintus is missed, take it as soon as remembered unless it is almost time for the next dose — in that case, skip the missed dose and do not double up.

• Mucolytics and expectorants (e.g., bromhexine, ambroxol, guaifenesin, acetylcysteine, carbocisteine): Pintus should not be combined with mucolytic or expectorant medicines. Because Pintus suppresses the cough reflex while mucolytics and expectorants work to loosen and increase respiratory secretions, using them together can allow mucus to accumulate in the airways instead of being cleared by coughing, increasing the risk of bronchospasm, breathing difficulty, and airway or chest infection.
• Centrally-acting/sedating medicines and alcohol: Because Pintus can cause drowsiness in some patients, caution is advised when Pintus is taken together with other sedating medicines or alcohol, as the drowsiness may be additive.
• Strong enzyme-inhibiting medicines or drugs with a narrow therapeutic index: Some product information for Pintus advises caution when it is used together with medicines described as strong enzyme inhibitors or those with a narrow therapeutic index. A doctor or pharmacist should review all other medicines being taken before starting Pintus.

Common Side Effects

Reported adverse effects of Pintus include drowsiness, dizziness, nausea, diarrhoea, and itchy skin rash or urticaria. These are generally described as occurring in a small proportion of patients and often improve with dose reduction or discontinuation of Pintus.

Serious Side Effects — Seek Medical Attention

Seek prompt medical attention if signs of a serious allergic reaction to Pintus occur, such as swelling of the face, lips, tongue, or throat, severe skin rash, or difficulty breathing, or if severe dizziness, loss of balance, or a marked drop in blood pressure develops.

Pregnancy

Pintus is contraindicated during the first trimester of pregnancy. In the second and third trimesters, Pintus should be used only if a doctor considers it clearly necessary, after weighing the potential benefit against the risk, as safety data for this period remain limited.

Breastfeeding

Use of Pintus during breastfeeding is not recommended, as there is insufficient data on its excretion into breast milk and its effect on the nursing infant; some product information specifically advises against its use while breastfeeding. A doctor should be consulted before using Pintus during breastfeeding.

• Do not use for a productive (mucus-producing) cough: Pintus suppresses the cough reflex and should not be used when a cough is productively clearing mucus from the airways, because doing so can cause mucus retention, worsening breathing difficulty, and a higher risk of chest infection; for the same reason, Pintus should not be combined with mucolytic or expectorant medicines (see Interaction).
• Cough persisting beyond about a week: If a cough being treated with Pintus lasts more than about 7 days in adults, or more than about 3 days in children, or is accompanied by fever, rash, persistent headache, or breathing difficulty, medical advice should be sought rather than continuing Pintus without review.
• Drowsiness, driving, and operating machinery: Because Pintus can cause drowsiness or dizziness in some patients, caution is advised when driving or operating machinery until it is known how Pintus affects the individual.
• Sugar/excipient content of some formulations: Some Pintus syrup formulations contain sorbitol, fructose, or colourants; patients with hereditary fructose intolerance or known sensitivity to these excipients should check the label and consult a doctor or pharmacist before use.
• Limited data in renal or hepatic impairment and in elderly patients: Specific safety data for Pintus in these groups are limited, so it should be used with caution and under medical supervision.
• Use the age-appropriate formulation in children: Pintus should be given to a child only in the formulation and dose appropriate for that child's age, confirmed by a doctor or pharmacist, since not every approved Pintus product is licensed for use in young children.

Reported symptoms of Pintus overdose include drowsiness, nausea, vomiting, diarrhoea, loss of balance or dizziness, and low blood pressure (hypotension). There is no specific antidote for Pintus overdose. If an overdose of Pintus is suspected, do not induce vomiting unless specifically directed to do so by a doctor or a poison control service, and seek emergency medical attention or contact a poison control centre immediately. Management of Pintus overdose is supportive and should be carried out by medical professionals in a hospital setting.

Store Pintus below 30°C in a cool, dry place, protected from light and moisture, and out of the reach and sight of children. Because storage conditions can vary slightly between different brands and formulations (tablet, syrup, drops) of Pintus, always store according to the specific instructions printed on the product label and pack, and discard any unused syrup or drops after the period stated on the label once the pack has been opened.

Children: Age-appropriate formulations and doses of Pintus exist — pediatric drops for infants from about 2 months to 3 years of age, and syrup for children from about 3 years upward — but the exact minimum age and dose depend on the specific approved product, and some Pintus products are approved for adults and adolescents only. A doctor should confirm the correct formulation and dose of Pintus for a child.

Elderly: Specific data on the use of Pintus in elderly patients are limited; Pintus should be used with caution and under medical supervision, with attention to drowsiness.

Renal impairment: Specific data on Pintus in patients with renal impairment are limited; use with caution and under medical supervision.

Hepatic impairment: Specific data on Pintus in patients with hepatic impairment are limited; use with caution and under medical supervision.

Other: Patients with hereditary fructose intolerance should check the excipients of the specific Pintus syrup formulation, as some contain sorbitol or fructose.

Pintus is intended for short-term, symptomatic treatment of dry cough, generally for the duration prescribed by a doctor, often up to about one week. If the cough being treated with Pintus persists for more than about 7 days in adults, or more than about 3 days in children, or is accompanied by fever, rash, persistent headache, or difficulty breathing, medical advice should be sought rather than continuing Pintus without review, as a prolonged, unexplained cough may indicate an underlying condition that needs separate evaluation.

Antitussive; Non-opioid cough suppressant; Centrally-acting cough-reflex inhibitor

Butamirate Citrate acts primarily by reducing the sensitivity of the cough centre, thereby suppressing the cough reflex, without acting through opioid receptors. It also exhibits mild peripheral anticholinergic and bronchodilating (bronchospasmolytic) activity on the airways, which can help ease breathing during a coughing episode.

Pintus is available in pediatric-specific formulations in Bangladesh — oral drops (5 mg/mL) and syrup (7.5 mg/5 mL) — that allow dosing to be tailored to a child's age. Per regional product information, drops are typically used in infants from about 2 months to 3 years of age, and syrup in children from about 3 years upward, with the specific dose depending on age (see the Dosage table). However, not every approved Pintus product is licensed for pediatric use in every country — some are approved for adults and adolescents 18 years and above only — so the age-appropriateness of a given Pintus product should always be confirmed from its specific label or by a doctor or pharmacist before use in a child.