# Guaifenesin (Liquibid)



## atl74 (Feb 4, 2002)

I posted this over on the Constipation board, but poor activity has probably prevented it from showing up on the radar. Anyway, has anyone here considered the notion of using Guaifenesin to see what efficacy it has on IBS in general? For unfamiliar with Guaifenesin (Liquibid), it is a medication specifically for thinning and loosenig phlegm and mucous (thus, improving symptoms of clogged sinus, eustachian tubes, chest congestion, etc.)Follow me here, if you will, for just a moment. Now, healthy sinuses drain almost a quart(!) of mucous every day. This was a surprise to me. I've been taking 1200mg/day recently to assist with a bad sinus infection, and I've noticed a SIGNIFICANT abatement of many nagging symptoms, the least of which being IBS. Specifically, symptoms of nightly reflux have been drastically reduced, bowel movements have been very normal in consistency and frequency, my head has never felt clearer, I'm no longer borderline-dizzy, my sleep has been excellent, anxiety is greatly reduced, etc. The list goes on, but these are my initial and definitive anectdotal findings. Thoughts, ideas? I'm very intrigued by all of these positive results, and the abatement of symptoms in congruence with the introduction of Guaifenesin is too coincidental for me to ignore.


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## bonniei (Jan 25, 2001)

Could be the histamine in many cough meds and probably in yours making you feel better. Histamines play a part in controlling colon functions.


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## atl74 (Feb 4, 2002)

Actually, Guaifenesin is not a histamine, and I'm not taking anything currently that contains histamine, so I've ruled this out. Good question, however.


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## bonniei (Jan 25, 2001)

I meant an antihistamine. I think I read that it contained it. Let me see if I can find it.


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## bonniei (Jan 25, 2001)

see if any of these are there in itSome examples of antihistamines contained in these combinations are: bromodiphenhydramine (broe-moe-dye-fen-HYE-dra-meen), brompheniramine (brome-fen-EER-a-meen), carbinoxamine (kar-bi-NOX-a-meen), chlorpheniramine (klor-fen-EER-a-meen), dexchlorpheniramine (dex-klor-fen-EER-a-meen), diphenhydramine (dye-fen-HYE-dra-meen), doxylamine (dox-ILL-a-meen), phenindamine (fen-IN-da-meen), pheniramine (fen-EER-a-meen), phenyltoloxamine (fen-ill-tole-OX-a-meen), pyrilamine (peer-ILL-a-meen), promethazine (proe-METH-a-zeen), and triprolidine (trye-PROE-li-deen


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## Guest (Feb 19, 2004)

gauifenesin (spelling) thins mucous secretions but i'm not sure how. is it actually a digestive enzyme. or some kind of enzyme, b/c the only thing i can think of that acts like quaifenesin on mucous is papaya/pineapple - the too thin mucous secretions b/c their enzymes break things down. so i'm wondering if you are actually taking some sort of enzyme thats helping with stuff. OR perhaps guaifenesin add liquid making mucous flow better - this would help with constipation. if i remember correctly, you are supposed to drink a lot of water for it to work - otherwise it doesn't. you should ask your doctor how guaifenesin works.


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## Guest (Feb 19, 2004)

gauifenesin (spelling) thins mucous secretions but i'm not sure how. is it actually a digestive enzyme. or some kind of enzyme, b/c the only thing i can think of that acts like quaifenesin on mucous is papaya/pineapple - they too thin mucous secretions b/c their enzymes break things down. so i'm wondering if you are actually taking some sort of enzyme thats helping with digestion of everything. OR perhaps guaifenesin adds liquid, making mucous flow better - this would help with constipation is its adding liquid there too. if i remember correctly, you are supposed to drink a lot of water for it to work - otherwise it doesn't so it must be using water somehow. you should ask your doctor how guaifenesin works.


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## atl74 (Feb 4, 2002)

Nope. Aside from guaifenesin, it contains inactive ingredients carbomer 934P, NF; FD&C blue #1 aluminum lake; hypromellose, USP; magnesium stearate, NF; microcrystalline cellulose, NF; sodium starch glycolate, NF.So, it does not contain any antihistamine whatsoever. It appears to work clinically an expectorant to help loosen and thin the mucus, which is probably why it is helping with my sinus/ear/reflux problems (the latter, however, I cannot logically explain).


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## bonniei (Jan 25, 2001)

Then I don't know.


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## Guest (Feb 19, 2004)

check this out!Fibromyalgia and Guaifenesin by Devin J. StarlanylExcess calcium and inorganic phosphate may cause a hyper-permeability problem in the mitochondria (Savage and Reed, 1994). This may be part of what happens in FMS. Dr. R. Paul St. Amand believes FMS is caused by an abnormality in phosphate excretion, which may be due to a genetic defect. Retention of phosphates eventually interferes with energy production in affected cells. One study (Bengtsson, Henriksson, and Larsson, 1986) found a twenty-percent reduction in the level of ATP in muscle biopsies taken from people with FMS. Excess phosphate in the mitochondria, your power-generating factories, slows formation of ATP because of the presence of excess inorganic phosphate. Muscle pain after exercise is also linked with an inorganic phosphate increase (Aldridge, Cady, Jones et al. 1986).Calcium is the main buffer for phosphate. Whenever and wherever excess phosphate builds up in cells, excess calcium does too. About forty percent of a cell's energy is expended in moving calcium in and out of storage or out of the cell completely. Since energy needs are poorly met in FMS because of insufficient ATP, calcium is allowed to sit too long where it is no longer needed.Guaifenesin (guai) is usually an ingredient in cold preparations. In 1530, in its original form, a tree bark extract called guaiacum, it was in use for rheumatism. In the new PDR for Herbal Medicines [in ref] guaiacum officinale is again indicated for rheumatism. Over twenty years ago it was synthesized, named guaifenesin, and pressed into tablets. Guai is totally absorbed through the intestinal tract within two hours after you take it. There are timed-release forms.Dr. St. Amand found a sixty-percent increase in phosphate excretion and a thirty-percent increase in oxalate and calcium excretion with guai therapy. I believe the phosphoric and oxalic acids coming out in the urine (and sweat) may carry with them other excess acids which may be significant. We don't know. I believe some of the guai effects may be mechanical, by thinning thick, sticky FMS secretions.About 20 percent of Dr. St. Amand's patients go through FMS reversal relatively quickly at 300 mg twice a day. If the cyclic process hasn't started in two weeks, patients are raised to 600 mg twice a day. Seventy percent of all patients experience reversal at that dose. Another twenty percent need 1800 mg a day. The final ten percent require 2400 mg or more per day. When the first cycle begins, there is usually a period of flu-like fatigue as stored toxins and excess phosphates start releasing. Your body works hard to process chemical toxins and excess materials so that they can be excreted. For the first few months, expect to spit out mucus that has been clogging your airways. Headaches are very common during this process. You may have other symptoms, including strong smelling perspiration and urine and burning on urination (excess acid phosphates are excreted). Your urine may become very dark. You may be sore in the crease between your buttocks and in the perineal area, and need to use a protective ointment or cream.It is important to follow the guaifenesin protocol. Do not change your dosage of guai or any other medication without talking to your doctor. Keep track of what happens. Start slowly by taking 300 mg of guaifenesin twice a day. Take 300 mg twice a day for one week. If you become distinctly worse, you have found the dosage right for you. If you are especially sensitive to medications, you may want to begin with less. Take it slowly, and give your body a chance to detoxify the material that is being released. When you reach your dose, your symptoms will get worse. The signs and symptoms in reversal are not side effects of guaifenesin. They are from the chemical toxins and wastes being released by the guai and are good signs, although they won't feel like it at the time. Salicylates in medication and herbal products can block the action of guaifenesin. Blocking effects vary with the individual.Guai therapy for FMS is not simple. Doctors can't just prescribe the medication and expect symptom remission. St. Amand begins by taking a careful medical history of the patient. He examines the patient for swollen areas, which he maps. As patients progress, the symptoms tend to disappear in the reverse order in which they first appeared. Patients with reactive hypoglycemia must be on a balanced diet for the reversal to be evident. This means no excess carbohydrates. I have found that the Zone-type diet works well, although it must be tailored to individual needs. Guaifenesin therapy seems to result in remission of symptoms for many people. There may be co-existing conditions, such as myofascial TrPs, that also need attention, and you may have other perpetuating factors that must also be identified and addressed.The only double-blinded study on FMS guaifenesin therapy was done at the University of Oregon. This study of 20 women showed guaifenesin equal to placebo. The study was flawed, through no fault of the researchers, because:1. The study was started before we knew the signs of reversal are not obvious if uncontrolled reactive hypoglycemia is present. No one knew how common reactive hypoglycemia or insulin resistance is.2. All the patients in the study were given 600 mg guai twice a day. Dr. St. Amand has found that only about 50 percent of patients respond at this dosage; and even in these patients, the reversal won't be evident if they have reactive hypoglycemia and are eating excess carbohydrates. The dosage must be individually tailored.3. Dr. St. Amand did not know about the blockage of guai by some salicylate-containing herbs until September 1995. The study ended in June 1995. Each of us has a varying tolerance of salicylates. It has been my observation that when someone who is successfully cycling on guai calls me about a sudden downturn, we invariably find a blocking agent. When it is removed, the patient starts to improve once again.4. Some people say Dr. St. Amand's patients feel better because he's charismatic. He is. But how can these positive attributes cause me to have dark, smelly, acidic urine that cleans iron stains off my toilet bowl? Toilet bowls do not respond to the placebo effect.Dr. St. Amand and I agree to disagree on some issues. I don't understand how guai works, but I have seen many patients get a new lease on life with guai and have experienced it myself. If you wish to learn more about guai, read "What Your Doctor May Not Tell You About Fibromyalgia" (Reading List). Some of the data from this section is adapted from this book, with permission from the authors. There is a guai Internet support group and website and an international support group.Dr. St. Amand and I both feel that guai therapy should take place under doctor's supervision. Avoid over-the-counter forms of guaifenesin that have other ingredients in them, such as alcohol or sugar. Avoid any medications that have pseudoephedrine. Research indicates that epinephrine-like products may worsen fibromyalgia symptoms. Guai may be purchased over-the-counter through Hyrex Pharmaceuticals at 1-800-238-5282, 3494 Democrat Road, Memphis, TN 38118, and they will ship to other countries. The author has no connection with this company.Addendum: When one of my local support group members told me that the FDA was changing its stance on guaifenesin, I contacted the expert, Dr. Paul St. Amand. I found that after November 1st, 2003, guaifenesin will no longer require a prescription but will be available in over-the-counter form. Dr. St.Amand told me the following:"There is a shortage of guaifenesin developing. Adams Company, Texas, made a long-acting (12 hour) guaifenesin and proved it did indeed last for about twelve hours. They were given permission to sell it over the counter. This happened in July or so 2002. "In October 2002 the FDA instructed all other companies to stop manufacturing guaifenesin since they had never proven they were long-acting (after 25 years) though all of them are (8-12 hours). The FDA has further ordered that all guaifenesin that is not approved as long-acting must be removed from pharmacy shelves by November 1, 2003."The law is that once a drug is made non-prescriptive, all of them must be such. In other words, all of the companies must now prove they're long acting. Those who do will also be over-the-counter drugs. We think a few are trying to comply by the November date."One Company in Santa Barbara, CA, has obtained permission from Adams to sell its product "Mucinex" under a different label. After November 1st the drug will no longer be on prescription. Insurance plans will no longer pay for the medication. I suggest you stock up also while waiting to see how all of this settles."I spoke with my pharmacist, and he assured me that he will stockpile guai, since so many of the local support group people have had such a good response. It is important to avoid any products with guai that have other medications, such as epinephrine, that could be harmful. Devin J. Starlanyl


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## atl74 (Feb 4, 2002)

Whoa! Not that I read the WHOLE thing yet, but the headlines caught my attention. Great find. I'll check it out to see if I can make a correlation with the recent abatement of my symptoms, many of which are very fibro-like.Thanks!!


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## Guest (Feb 19, 2004)

http://web.mit.edu/london/www/guai.html the above is a different take on the fibro issue. but its a good read b/c it lists all sorts of effects gauifenesin has on the body.by the way, this is a great drug for sinus infections problems, b/c it actually increases but thins mucous flow - which is what you need. most docs will give you antihistamines and stuff which can make mucous dry up and thick - what you don't want!


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## bonniei (Jan 25, 2001)

Interesting article, joanDid your doc prescribe it to you, atl74?


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## bonniei (Jan 25, 2001)

"It should also be noted that guaifenesin's relaxant effect on the nervous system might be the reason for it's expectorant property. Guaifenesin was being used as an expectorant well before propanediols were discovered, as it can be derived from the bark of the guaiac tree. However, as shall be shown later, guaifenesin doesn't appear to have a direct effect on mucus. Instead, perhaps it's expectorant ability is due to it's muscle relaxant effect. Some types of expectorants are known to act due to a relaxant effect, as the effect helps to soothe spasms and allow mucous to flow easier. Two common herbal remedies that are known to act both as relaxants and expectorants are kava kava and peppermint oil. Some relaxants, like pepperment oil, are also useful for digestion problems such as Irritable Bowel Syndrome, so it's not surprising that some people have reported guaifenesin to be useful for IBS (although IBS is a multifaceted problem, so relaxants don't work for everyone.) In any event, this shows how a single effect can have widespread and diverse effects on the body. " from that article that joan posted.


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## Guest (Feb 19, 2004)

yeah and is it really avail over the counter? i'd actually like to try it again and see what happens. i hope it truly is safe.


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## Guest (Feb 19, 2004)

wow, very interesting. i didn't read the whole article myself!! i bet that is what is helping with ibs and also with fibro. its also interesting b/c ... can you have (embarrassed) spasms in your nasal passages? is that what they are saying? Sometimes i feel them and when i'm relaxed they seem to stop and mucous flows better just like they say.


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## SpAsMaN* (May 11, 2002)

a lot of people if not all the people with ibs have fibro symptoms.???


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## bonniei (Jan 25, 2001)

joan, spasms in the bronchial tract and it seems throughout the body.


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## kel1059 (Feb 28, 2003)

you can't get the high potency stuff OTC.i got a script for it last summer but only took 2 pills.i believe i got the 1200 mg time release type. it is dirt cheap.my preventative med doc told me...." oh, that is a good one" --he is a doctor that does NOT like prescribing anything.it made me a little jittery as it is a mild stimulant (i need to check on this). i don't know if i would take it at night.


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## bonniei (Jan 25, 2001)

kel you never fail to amaze me. Is there any "med" you haven't tried?


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## kel1059 (Feb 28, 2003)

http://216.239.39.104/search?q=cache:QSyFM...&hl=en&ie=UTF-8 FDA Pulls Guaifenesin Products Off Market But Keeps Ephedra On Feb. 26, the FDA announced that a long-acting tablet form of guaifenesin, a cough suppressant, will be pulled off the market by November 2003. Guaifenesin has been sold for decades as a cough medication, in both liquid and tablet form. The single ingredient extended- release products (e.g., Guaifenesin LA, Q-Bid LA™, Liquibid ï¿½ and Sinumist ï¿½ ) entered the market before the government required proof of safety and efficacy. This action by the FDA is no doubt related to the recent approval of Mucinex ™ , an extended-release guaifenesin product from Adams[something wrong here. it is not a cough suppressant. at least i don't think it is unless thinning mucus leads to less coughing.]bonniei,things were pretty bad and i tried many things. i also have a bottle of steroids but i abandoned that experiment after 1 pill gave me a big mouth ulcer.


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## bonniei (Jan 25, 2001)

Yeah I wouldn't take the med as it has not been studied for its long term effects. Which is why I am curious if atl74's doc prescribed it.


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## Guest (Feb 19, 2004)

my doc prescribed it 600 mg to be taken twice daily - for life. this was when my sinuses were at their worst. i never noticed much effect on my ibs i don't think. he said there were few side-effects and it was safe - but you never know. i agree with bonniei and would want to find out more before taking this long term and at high dosages - though i think its safe for short term use.


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## Jhouston (Nov 9, 2003)

Guaifenesin is the active ingredient in Robitussin Joann


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## atl74 (Feb 4, 2002)

Good morning.Yes; an outpatient clinic-doc prescribed it to me over the past weekend for a BAD sinus infection (stuffed-up, teeth actually hurt; everything just hurt). I checked last night, you can buy the stuff directly OTC in 600mg pill-form; it is called Mucinex. Pharmacists typically stock it behind the counter; I bought some just down the street last night.I feel pretty good again this morning as well, and I've been taking 600mg ### 6a and 6p, given that it has proven efficacy in the extended-release tablet form for 12 hours. Little, if any problems with reflux lately, my head feels clearer, my ears don't feel "stuffed-up" (which was blamed on reflux previously), and my gut feels all-around decent.Thanks to all of you guys that chimed-in with info. I'm going to continue on the prescription, and move to Mucinex (OTC) thereafter and see how things continue to go.


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## kel1059 (Feb 28, 2003)

how much are you paying for it? the script that i got filled last june costed less than $10 -- generic ethex. my insurance either paid for it or the cost was less than the copay. http://www.ibsgroup.org/cgi-local/ubbcgi/ultimatebb.cgi Adams now makes the only 600 mg. pure guaifenesin and it costs 72 cents a pill. Since it is also now over-the-counter, no insurance coverage exists to help you pay for it. We must be careful not to slander anyone here, but you are free to draw your own conclusions. No one has ever been hurt by any guaifenesin. No claims were ever made that it was not helpful or was ineffective. The price has just shot up horrifically because -- why? More of this later.


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## atl74 (Feb 4, 2002)

Aside from the Liquibid prescription ($10 co-pay for 20 1200mg tabs), I paid about $11 for a bottle of Mucinex containing 20 600mg tabs. So, about $.65 per tablet.


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## kel1059 (Feb 28, 2003)

thanks atl.why did i post the wrong link? i have never done that before -- oh well.


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## SpAsMaN* (May 11, 2002)

--------------------------------------------------------------------------------kel you never fail to amaze me. Is there any "med" you haven't tried?Do we have the choice,we are guinea pigs!


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