Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Promixin 1 million International Units (IU) Powder for Nebuliser Solution
⚠ This medicine appears to have been discontinued
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Colistimethate sodium may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
What it is and what it is used for
FOR Promixin contains the active substance colistimethate sodium, and is given as an inhalation to treat chronic chest infections in patients with cystic fibrosis. Promixin is used when these infections are caused by specific bacteria called Pseudomonas aeruginosa. This is a very common bacteria that infects the lungs of nearly all patients with cystic fibrosis at some time during their lives. If the infection is not properly controlled it will continue to damage the lungs, causing further problems. In order to administer Promixin the powder contained in its vial should be dissolved with appropriate diluent solution, in sterile saline (salt water) or sterile water and then breathed (inhaled) into the lungs using a suitable nebuliser device so that more of the antibiotic can target the bacteria causing the infection.
What you need to know before you take it
E PROMIXIN In certain circumstances your doctor may decide not to prescribe Promixin. Do not use Promixin if:
- you are allergic (hypersensitive) to colistimethate sodium, colistin or other polymyxins; If this applies to you, see your doctor before you start taking Promixin. Warnings and precautions with Promixin:
- you have or have had kidney problems;
Page 1 of 8 Promixin 1 million International Units (IU) Powder for Nebuliser Solution UK Leaflet Text V20b Tracked – SE/H/1877/II/042/G – EU EoP 29/06/2022 National Phase
• • •
you suffer from myasthenia gravis (a rare disease where your muscles are extremely weak and get tired very quickly); you suffer from porphyria (a rare metabolic disease that some people are born with); you suffer from asthma.
If any of these apply to you, tell your doctor. In premature and new-born babies, special care should be taken when using Promixin as the kidneys are not yet fully developed. Other medicines and Promixin Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines. These medicines may interfere with the effect of Promixin. •
medicines which can affect how your kidneys function. Taking such medicines at the same time as Promixin can increase the risk of damage to the kidneys.
•
medicines which can affect your nervous system. Taking such medicines at the same time as Promixin can increase the risk of side effects in your nervous system.
•
medicines called muscle relaxants, often used during general anaesthesia. Promixin can increase the effects of these medicines. If you have a general anaesthetic, let your anaesthetist know that you are having Promixin.
If you suffer from myasthenia gravis and are also taking other antibiotics called macrolides (such as azithromycin, clarithromycin or erythromycin) or antibiotics called fluoroquinolones (such as ofloxacin, norfloxacin and ciprofloxacin), taking Promixin further increases the risk of muscle weakness and breathing difficulties. Having colistimethate sodium as an infusion at the same time as receiving Promixin as inhalation can increase your risk of side effects. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine. There is no information about the safety of Promixin in pregnant women. Your doctor should advise you before using Promixin where benefits of the medicine exceed the risk.
Colistimethate sodium may be secreted in the breast milk. Please discuss the use of Promixin with your doctor. Driving and using machines Promixin may make you feel dizzy, confused or have problems with your sight, such as blurred vision. If this happens to you, do not drive or use any tools or machines.
How to take it
PROMIXIN Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. Tell your doctor if you have problems with your kidneys as you may need to take a lower dose of Promixin.
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You should take your first dose of Promixin when you are with your doctor or nurse. Take your Promixin after physiotherapy (if you have physiotherapy). This will ensure that your lungs are clear so that Promixin can work effectively. If you also take other inhaled medicines, your doctor will tell you which order to taken them in. The recommended dose for adults, adolescents and children aged 2 years or older is 1-2 vials (1-2 million units) two or three times a day (maximum 6 million units per day). The recommended dose for children less than 2 years old is half to 1 vial (0.5-1 million units) twice daily (maximum 2 million units per day). Your doctor may decide to adjust the dose depending on your circumstances. Promixin is inhaled from a device called a nebuliser. Promixin can be taken using any nebuliser system that can be used to deliver antibiotics to the lungs in the form of a mist. In countries where the I-neb AAD is available Promixin comes with a Promixin Disc so that it can be used with the I-neb AAD System. To find out how to use Promixin with the I-neb, see the detailed instructions which come with the device. If you use a different nebuliser you should make sure the room is well ventilated. How to prepare Promixin Your doctor or nurse will show you how to prepare and use Promixin with your nebuliser. Before Promixin can be placed into the nebuliser and inhaled it must first be dissolved with sterile water, sterile 0.9% saline (salt water) or a half and half mixture of sterile water and sterile 0.9% saline (salt water) as directed below. Your doctor or nurse will tell you the correct volume of liquid to add to each Promixin vial and how many Promixin vials you need to prepare and use for each dose with your nebuliser. 1) Locate the lip on the red plastic top near the arrow marked "FLIP UP". Then holding the vial in one hand and the plastic top with the other hand, turn the top a small amount anti-clockwise. Place a thumb under the lip and push the top up to about 90° (see diagram 1).
2) Grasp the plastic top as shown in diagram 2 and pull open slowly, like a hinge, to almost 180°.
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3) Turn the vial around so that the plastic top is pointing towards you. Holding the centre of the top as shown, pull it downwards and twist slightly to either the right (diagram 3a) or the left so that the metal seal is broken on one side only (diagram 3b).
4) Once the seal is broken, hold the vial firmly and peel off the metal seal to reveal the whole of the rubber stopper (diagram 4).
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5) Remove the rubber stopper from the vial of Promixin by holding the outside edge of the stopper only and place it upside-down on a clean surface. Slowly add sterile water, sterile 0.9% saline, or sterile water and sterile 0.9% saline to the vial, adding the volume of liquid your doctor or nurse has told you. 6)
Replace the rubber stopper and gently turn the vial upside down twice (diagram 6).
7) Roll the vial gently between both hands to dissolve all the Promixin powder visible on the base and side of the vial (diagram 7). Do not shake the vial too hard as this may make the solution foam.
8) Once most of the powder is dissolved leave the vial to stand for 5-10 minutes to let any foam disappear and to allow any remaining powder to dissolve.
Page 5 of 8 Promixin 1 million International Units (IU) Powder for Nebuliser Solution PIL-Promixin-INH-UK-V20b Tracked – SE/H/1877/II/042/G – EU EoP 29/06/2022 National Phase
Pour the solution into the nebuliser and inhale immediately. If it is not possible to use the solution immediately replace the stopper in the vial and store for no longer than 24 hours in a refrigerator. Do not use any solutions that have been prepared for more than 24 hours. See section 5 'How to store Promixin' for instructions on how to store or dispose of any unused Promixin. If you take more Promixin than you should If you realise that you have taken more Promixin than your doctor has recommended (or if someone else has taken some of your Promixin), contact your doctor straight away. The symptoms of taking too much Promixin can include:
- tingling or numbness around the lips and face
- dizziness and spinning sensation (vertigo)
- slurred speech
- visual disturbance
- confusion
- mental disturbance
- flushing (reddening of the face) If you forget to take Promixin Take the dose as soon as you remember, unless it is near the time for your next dose. Do not take a double dose to make up for a forgotten dose. If you stop taking Promixin Do not stop your treatment early unless your doctor says that you can. Your doctor will tell you how long your treatment will last. If you have any further questions on the use of this medicine ask your doctor or nurse.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. Promixin can sometimes cause allergic reactions like skin rash. If this happens you should stop taking Promixin and tell your doctor immediately. Breathing in Promixin through a nebuliser can make some people notice tightness in their chest, feel wheezy, cough or become breathless (sometimes described as chocking sensation). For this reason the first dose should be taken when you are with your doctor or
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nurse. Your doctor may also advise you to take a medicine to help prevent any breathlessness. Your doctor may check your breathing at your clinic visits. Promixin might also affect your kidneys, usually if the dose is high or you are taking other medicines that may affect your kidneys. Promixin may sometimes cause you to have a sore mouth or sore throat. Reporting of side effects If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly (see details below). By reporting side effects you can help provide more information on the safety of this medicine. United Kingdom Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard Ireland HPRA Pharmacovigilance Earlsfort Terrace IRL – Dublin 2 Tel: +353 1 6764971 Fax: +353 1 6762517 Website: www.hpra.ie E-mail: [email protected]
How to store it
PROMIXIN Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the vial and carton. The expiry date refers to the last day of that month. Unopened Promixin vials do not require any special storage conditions. Promixin contains no preservatives. Once prepared, Promixin solutions should preferably be used immediately. If this is not possible, solutions should be stored for no longer than 24 hours in a refrigerator. Do not use any solutions that have been prepared for more than 24 hours. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
6.
Contents of the pack and other information
What Promixin contains The active substance is colistimethate sodium. Each vial contains 1 million International Units (IU) of colistimethate sodium, which weighs about 80 milligrams (mg). There are no other ingredients. What Promixin looks like and contents of the pack Page 7 of 8 Promixin 1 million International Units (IU) Powder for Nebuliser Solution PIL-Promixin-INH-UK-V20b Tracked – SE/H/1877/II/042/G – EU EoP 29/06/2022 National Phase
Promixin is a powder for nebuliser solution, supplied as a white to off-white powder in a glass vial. Promixin is supplied in packs containing 30 vials. In countries where the I-neb AAD is available, each pack also contains a Promixin Disc for use with the I-neb AAD system. Marketing Authorisation Holder Zambon S.p.A. Via Lillo del Duca 10 20091 Bresso (MI) – Italy Tel: +39 02 665241 Email: [email protected] Manufacturer Xellia Pharmaceuticals ApS Dalslandsgade 11 DK- 2300, Copenhagen S Denmark Distributor Zambon UK Limited UK Tel: +44 (0) 800 0288 942 Other formats: To listen to or request a copy of this leaflet in Braille, large print or audio please call, free of charge: 0800 198 5000 (UK Only) Please be ready to give the following information: Product name: Reference number:
Promixin 1 million international unit powder for nebuliser solution. 31654/0008
This is a service provided by the Royal National Institute of Blind People. PA 1441/003/001 (Ireland) This medicine is authorised in the Member States of the European Economic Area and in the United Kingdom (Northern Ireland) under the following names: Austria, Netherlands, Sweden, France: Tadim Germany, Denmark, Norway, United Kingdom (Northern Ireland), Italy, Spain, Portugal: Promixin This leaflet was last revised in June 2022
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Frequently asked questions about Promixin 1 million International Units (IU) Powder for Nebuliser Solution
How do I take Promixin 1 million International Units (IU) Powder for Nebuliser Solution?
Promixin 1 million International Units (IU) Powder for Nebuliser Solution comes as inhaler. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
What is the active substance in Promixin 1 million International Units (IU) Powder for Nebuliser Solution?
The active substance in Promixin 1 million International Units (IU) Powder for Nebuliser Solution is colistimethate sodium.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Promixin 1 million International Units (IU) Powder for Nebuliser Solution, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Promixin 1 million International Units (IU) Powder for Nebuliser Solution without a prescription?
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: colistimethate sodium
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
Promixin is indicated for the management in adult and paediatric of chronic pulmonary infections due to Pseudomonas aeruginosa in patients with cystic fibrosis (see section 5.1).
Consideration should be given to official guidance on the appropriate use of antibacterial agents.
4.2. Posology and method of administration
It is recommended that colistimethate sodium (CMS) should be administered under the supervision of physicians with appropriate experience in its use.
Posology
The dosage can be adjusted depending on the severity of the condition and clinical response.
Recommended dose range:
Administration via inhalation
Adults, adolescents and children ≥ 2 years
1-2 MIU two to three times per day (max 6 MIU/day)
Children < 2 years
0.5-1 MIU twice daily (max 2 MIU/ day)
Relevant clinical guidance on treatment regimens, including duration of treatment, periodicity and co-administration of other antibacterial agents should be adhered to.
Older people
Dose adjustment is not considered necessary.
Renal impairment
Dose adjustment is not considered necessary; however, caution is advised in patients with renal impairment (see sections 4.4 and 5.2).
Hepatic impairment
Dose adjustment is not considered necessary.
Method of administration
Promixin for nebulisation is reconstituted with a diluent solution and administered by nebulisation using a suitable nebuliser.
Drug delivery characteristics from in vitro studies with different nebuliser systems are detailed below;
Characteristic
Nebuliser system
Respironics I-neb AAD with 0.3mL (grey) medication chamber
Pari eflow rapid
Pari LC Sprint with Pari Boy SX compressor
Promixin dose placed in nebuliser system
1 million IU in 1mL
1 million IU in 3mL
1 million IU in 3mL
(a)
Droplet Size Distribution;
Median Particle Size: d50
(µm)
4.34
4.56
4.37
(b)
Total Drug Delivered from Nebuliser mouthpiece #
(Million IU)
0.333
0.277
0.385
(c)
Fine Particle Fraction
(% < 5µm)
59.55
58.19
57.73
(d)
Fine Particle Dose Delivered from Nebuliser mouthpiece #
(Million IU < 5 µm)
0.198
0.161
0.222
(e)
Delivery Time #
3 minutes, 36 seconds
5 minutes, 0 seconds
6 minutes, 40 seconds
(f)
Drug Delivery Rate from Nebuliser mouthpiece #
(Million IU/minute)
0.055
0.032
0.033
# Measured using a simulated inhalation: exhalation (I:E) ratio of 1:1, a tidal volume of 500mL and 15 breathes per minute.
• All Promixin reconstituted with a 50:50 mixture of WFI and 0.9% saline to the recommended volume for each nebuliser system.
• Pari Boy SX operated at 1.6 bar pressure, 5.1L/min flow rate.
• (d) is calculated from (b) / 100 x (c)
• (f) = (d) / (e)
Characteristic
Nebuliser system
Respironics I-neb AAD with 0.5mL
(lilac) medication chamber
Pari eflow rapid
Pari LC Sprint with Pari Boy SX compressor
Promixin dose placed in nebuliser system
1 million IU in 1mL
2 million IU in 4mL
2 million IU in 4mL
(a)
Droplet Size Distribution;
Median Particle Size: d50
(µm)
4.81
4.31
4.35
(b)
Total Drug Delivered from Nebuliser mouthpiece #
(Million IU)
0.579
0.601
0.861
(c)
Fine Particle Fraction
(% < 5µm)
53.01
63.11
57.73
(d)
Fine Particle Dose Delivered from Nebuliser mouthpiece #
(Million IU < 5 µm)
0.307
0.379
0.497
(e)
Delivery Time #
8 minutes, 29 seconds
6 minutes, 38 seconds
11 minutes, 32 seconds
(f)
Drug Delivery Rate from Nebuliser mouthpiece #
(Million IU/minute)
0.036
0.057
0.043
# Measured using a simulated inhalation: exhalation (I:E) ratio of 1:1, a tidal volume of 500mL and 15 breathes per minute.
• All Promixin reconstituted with a 50:50 mixture of WFI and 0.9% saline to the recommended volume for each nebuliser system.
• Pari Boy SX operated at 1.6 bar pressure, 5.1L/min flow rate.
• (d) is calculated from (b) / 100 x (c)
• (f) = (d) / (e)
Colistimethate sodium undergoes hydrolysis to the active substance colistin in aqueous solution.
For special precautions for disposal and handling of reconstituted solutions, see Section 6.6
If other treatments are being taken, they should be taken in the order recommended by the physician.
Dose conversion table:
In the EU, the dose of colistimethate sodium (CMS) must be prescribed and administered only as International Units (IU). The product label states the number of IU per vial.
Confusion and medication errors have occurred because of the different expressions of dose in terms of potency. The dose is expressed in the US, and other parts of the world, as milligrams of colistin base activity (mg CBA).
The following conversion table is prepared for information and the values must be considered nominal and approximate only.
CMS conversion table
Potency
≈ mass of CMS (mg)*
IU
≈ mg CBA
12,500
0.4
1
150,000
5
12
1,000,000
34
80
4,500,000
150
360
9,000,000
300
720
* Nominal potency of the drug substance = 12.500 IU/mg
4.3. Contraindications
Promixin is contraindicated in patients with known hypersensitivity to colistimethate sodium or other polymyxins.
4.4. Special warnings and precautions for use
Bronchospasm
Nebulisation of colistimethate sodium may induce coughing or bronchospasm. A choking sensation has been reported in some cases. It is advisable to administer the first dose under medical supervision. Pre-dosing with a bronchodilator is recommended and should be routine, especially if this is part of the patient's current therapeutic regimen. FEV1 should be evaluated pre and post dosing. If there is evidence of colistimethate sodium induced bronchial hyperreactivity in a patient not receiving pre-treatment bronchodilators the test should be repeated on a separate occasion using a bronchodilator. Evidence of bronchial hyperreactivity in the presence of a bronchodilator may indicate an allergic response and colistimethate sodium should be discontinued. Bronchospasm that occurs should be treated as medically indicated.
Bronchial hyperreactivity in response to colistimethate sodium may develop with continued use over time and it is recommended that pre and post treatment FEV1s are evaluated at regular clinic visits.
Renal impairment
Colistimethate sodium is renally excreted and is nephrotoxic if high serum concentrations are achieved. Whilst this is unlikely during inhalation therapy, serum concentration estimations are recommended especially in patients with renal impairment.
Nephrotoxicity
Impairment of renal function has been reported, usually following use of higher than recommended intravenous or intramuscular doses in patients with normal renal function, or failure to reduce the intravenous or intramuscular dosage in patients with renal impairment or when used concomitantly with other nephrotoxic drugs. The effect is usually reversible on discontinuation of therapy.
Neurotoxicity
High serum concentrations of colistimethate sodium after intravenous or intramuscular administration may be associated with overdosage or failure to reduce the dosage in patients with renal impairment, and this may lead to neurotoxicity. Concomitant use with either non-depolarising muscle relaxants or antibiotics with similar neurotoxic effects can also lead to neurotoxicity. Dose reduction of colistimethate sodium may relieve symptoms. Neurotoxic effects that have been reported include: vertigo, transient facial paraesthesia, slurred speech, vasomotor instability, visual disturbances, confusion, psychosis and apnoea. (see also Section 4.5)
Porphyria
Use with extreme caution in patients with porphyria.
Microbial Resistance
Colistimethate sodium acquired resistance in mucoid Pseudomonas aeruginosa during clinical use has been reported. Susceptibility testing should be performed on patients who are treated on a long term basis, at regular clinic visits, and whenever a patient experiences an exacerbation (see Section 5.1).
Other
Colistimethate sodium is known to reduce the presynaptic release of acetylcholine at the neuromuscular junction and should be used in patients with myasthenia gravis with the greatest caution and only if clearly needed.
4.5. Interaction with other medicinal products and other forms of interaction
Due to the effects of colistimethate sodium on the release of acetylcholine, non-depolarising muscle relaxants should be used with extreme caution in patients receiving Promixin as their effects could be prolonged (see Section 4.4).
Concomitant use of inhaled colistimethate sodium with other medications that are nephrotoxic or neurotoxic (e.g. cephalothin sodium, aminoglycosides, non-depolarising muscle relaxants) including those which are administered by the i.v. or i.m. routes should only be undertaken with the greatest caution (see Section 4.4).
Co-treatment with colistimethate sodium and macrolides such as azithromycin and clarithromycin, or fluoroquinolones such as norfloxacin and ciprofloxacin should be undertaken with caution in patients with myasthenia gravis (see section 4.4).
4.6. Fertility, pregnancy and lactation
Pregnancy
Safety in human pregnancy has not been established. Animal studies do not indicate a teratogenic potential. However, there is evidence that colistimethate sodium crosses the placenta and consequently there is potential for foetal toxicity if administered during pregnancy. Promixin should only be given during pregnancy if the benefits outweigh any potential risk.
Breast-feeding
Colistimethate sodium is excreted in breast milk; breast feeding is not recommended during therapy.
Fertility
There are no data on the effects of colistimethate sodium on human fertility. Animal studies with colistimethate do not indicate adverse effects on fertility (see section 5.3).
4.7. Effects on ability to drive and use machines
Neurotoxicity, characterised by dizziness, confusion or visual disturbances have been reported following parenteral administration of colistimethate sodium. If these effects occur patients should be warned against driving or operating machinery.
4.8. Undesirable effects
The commonest undesirable effects following nebulisation of colistimethate sodium are coughing and bronchospasm (indicated by chest tightness which may be detected by a decrease in FEV1) in approximately 10% of patients. (See also Section 4.4)
Adverse reactions are tabulated below by system organ class and frequency. Frequencies are defined as Very common (≥1/10): common (≥1/100 to <1/10): uncommon (≥1/1,000 to <1/100): rare (≥1/10,000 to <1/1,000) and very rare (<1/10,000), not known (cannot be estimated from the available data)
Body System
Frequency
Reported adverse reaction
Immune system disorders
Not known
Hypersensitivity reactions such as skin rash
Respiratory, thoracic and mediastinal disorders
Very common
Cough, chest tightness, bronchoconstriction or bronchospasm
General disorders and administration site conditions
Not known
Sore throat and sore mouth.
Should hypersensitivity reactions such as skin rash occur treatment with colistimethate sodium should be withdrawn.
Cases of sore throat or sore mouth may be due to hypersensitivity or superinfection with Candida species.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via;
Yellow Card Scheme
Website: www.mhra.gov.uk/yellowcard
4.9. Overdose
Overdosage may cause apnoea, muscle weakness, vertigo, transient facial paraesthesia, slurred speech, vasomotor instability, visual disturbances, confusion, psychosis and renal insufficiency.
No antidote is available. Management of overdose is by means of supportive treatment and measures designed to increase clearance of colistimethate sodium such as inducing an osmotic diuresis with mannitol, peritoneal dialysis or prolonged haemodialysis.
🇷🇴 Known in Romania as
Medicines sold in Romania with the same active substance: Cunoscut în România ca
⚠ Same active substance, but a different pharmaceutical form (for example a gel instead of a tablet). Not interchangeable — ask a pharmacist.
- COLOBREATHE prescriptionCOLISTIMETHATUM NATRICUM · inhaler / nebuliser
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Romanian medicines in the UK →
🇵🇱 Known in Poland as
Medicines sold in Poland with the same active substance: W Polsce znany jako
⚠ Same active substance, but a different pharmaceutical form (for example a gel instead of a tablet). Not interchangeable — ask a pharmacist.
- Colistin TZFColistimethatum natricum · inhaler / nebuliser
- ColobreatheColistimethatum natricum · inhaler / nebuliser
- Colistimethatum natricum NoridemColistimethatum natricum · inhaler / nebuliser
- ColiviaColistimethatum natricum · injection / infusion
- Colistimethate AccordColistimethatum natricum · injection / infusion
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
💬 Ask about this leaflet
Ask anything about Promixin 1 million International Units (IU) Powder for Nebuliser Solution. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.