Interactions
Capval® should not be administered together with an expectorant, as this prevents the mucus formed from being coughed up and can lead to a congestion of secretion. In addition, combination with medications that have a central attenuating effect (such as sedatives, sleeping pills, antidepressants, neuroleptics, opioids or alcohol) is not recommended. An interaction with the vitamin K antagonist warfarin (Coumadin) has been described, which is probably based on the fact that Capval® inhibits the enzyme CYP2C9.
Warfarin is a substrate of CYP2C9, which means that warfarin is metabolised via CYP2C9. If Capval® now inhibits CYP2C9, warfarin can accumulate in the body and this can lead to an overdose of warfarin as it can no longer be metabolized. This inhibition of CYP2C9 could therefore also be relevant for other drugs that are metabolised via CYP2C9: These include the drugs phenprocoumon, phenytoin and losartan.
Capval® must not be taken in the case of a known hypersensitivity reaction to the active substance noscapine. In addition, Capval® juice contains the components methyl or propyl 4-hydroxybenzoate, so it should also not be taken if there is an allergy to one of these components. Capval® juice and sugar-coated tablets also contain different types of sugar (sugar-coated tablets contain lactose and sucrose; juice contains the sugar sorbitol).
If you have an intolerance to one of these types of sugar, the product should only be taken after consulting a doctor. In the case of severe mucus formation, Capval® is counterproductive as it prevents the mucus from being expectorated. Children under six months of age should not take Capval®.
For children under two years of age, Capval® should only be used when prescribed by a doctor. Some sources state that Capval® is contraindicated during pregnancy only in the first trimester. Others advise against taking Capval® during the entire pregnancy.
To be on the safe side, Capval® should not be used during pregnancy as there is not yet sufficient data available. If Capval® is taken during breastfeeding, the baby is unlikely to be at risk because only small quantities of noscapine pass into breast milk. Nevertheless, Capval® should not be taken for more than 2-3 days during the breastfeeding period.
Roadworthiness and the operation of machinery
After taking Capval®, we strongly advise against driving a car or other vehicles. Nor should you operate electrical tools or heavy machinery, as Capval® can impair your attention and ability to react. You cannot react quickly enough to sudden events. This can be the case especially at the start of treatment and when the dose is increased.
Products
Capval® is available in the form of lozenges, drops, capsules, suppositories and as syrup.
Dosage
Capval® coated tablets usually contain 25 mg noscapine per one tablet. Capval® juice contains 25 mg noscapine in 5 g (which corresponds to about 5 ml). In adults, Capval® in a dosage of 50-100 mg is cough-relieving.