IMMUSIM lozenge

IMMUSIM Lozenges by Simorgh Darou

Dosage Form and Packaging

• 30 lozenges per pack, arranged in 3 blister packs of 10 lozenges each.

Composition

Each lozenge contains:

• Vitamin C (as Ascorbic Acid): 150 mg
• Zinc (equivalent to 83.637 mg Zinc Gluconate): 12 mg
• Black Elderberry Extract (Sambucus nigra): 100 mg
• Echinacea Root Powder (Echinacea purpurea): 25 mg
• Slippery Elm Bark Powder (Ulmus rubra): 25 mg
• Propolis (Bee Propolis): 25 mg

Other Ingredients: Magnesium stearate, sorbitol, mannitol, fructose, raspberry flavoring.

Indications

• Strengthening the immune system.
• Sore throat relief.
• Assisting in the prevention and treatment of common colds.

Dosage and Administration

• Adults: Take 1 lozenge, 1–3 times daily, or as directed by a physician.
• Allow the lozenge to dissolve completely in the mouth.

Pharmacological Effects and Mechanism of Action

• Echinacea purpurea: Effective in managing upper respiratory tract infections, such as the common cold and influenza, due to its antiviral properties. It stimulates the immune response via various bioactive compounds, including:
  • Polysaccharides (e.g., heteroxylan, arabinogalactan) for nonspecific immune activation.
  • Alkylamides, chicoric acid, and echinacoside, which enhance immunomodulatory effects.
  • Polyacetylenes (e.g., ketoalkenes and ketoalkynes) with antifungal activity.
• Sambucus nigra (Black Elderberry): Rich in flavonoids, such as anthocyanins, known for their antiviral activity and immune-enhancing effects.
• Bee Propolis: Contains flavonoids such as pinocembrin, galangin, and pinobanksin with antiviral, antibacterial, and antifungal properties.
• Vitamin C: Essential for physiological processes, including redox reactions, cellular respiration, and immune function. Known to reduce the duration of cold symptoms and support immune defense.
• Zinc: Plays a critical role in protein synthesis and immune function. Zinc supplementation has shown to significantly reduce the duration of colds in various studies.

Adverse Effects

• Common side effects:
  • Echinacea: Nausea, abdominal pain, diarrhea, vomiting.
  • Vitamin C and Zinc: May cause esophagitis, heartburn, abdominal cramps, gastrointestinal obstruction, fatigue, flushing, headache, and somnolence. Zinc gluconate may lead to indigestion.
• Propolis: May cause allergic reactions (e.g., oral ulcers, inflammation) in individuals sensitive to bee products.

Drug Interactions

• Propolis: May interact with anticoagulants.
• Echinacea: Interacts with:
  • Immunosuppressants (e.g., prednisone, cyclosporine).
  • Antiviral agents such as darunavir (Prezista), warfarin, and docetaxel.
• Vitamin C: May interfere with drugs like aspirin, acetaminophen, warfarin, desferrioxamine, chlorpromazine, and fluphenazine.
• Zinc:
  • Reduced absorption with iron, tetracyclines, or phytate-rich foods.
  • Zinc reduces the absorption of copper, fluoroquinolones (e.g., ciprofloxacin), and tetracyclines. Maintain a minimum 2-hour gap between zinc supplements and tetracycline administration.

Contraindications and Precautions

• Pregnancy and Lactation: Use under medical supervision.
• Medical Conditions: Consult a physician before use in cases of kidney stones, diabetes, or cancer.
• Autoimmune diseases: Avoid in conditions such as multiple sclerosis, lupus, or rheumatoid arthritis, due to potential immune stimulation by echinacea and elderberry.
• Allergic Reactions: Individuals with atopy (predisposition to allergies) or bee product sensitivity should avoid use.
• Pre-surgical use: Discontinue at least 2 weeks before surgery.

Storage Conditions

• Store below 30°C, away from light and moisture.
• Keep out of reach of children.