Green (Solution, Spray) Instructions for Use
ATC Code
A01AD02 (Benzydamine)
Active Substance
Benzydamine (Rec.INN registered by WHO)
Clinical-Pharmacological Group
A drug with local anesthetic, antimicrobial, and anti-inflammatory action for topical application in dentistry
Pharmacotherapeutic Group
NSAID
Pharmacological Action
NSAID, an indazole derivative, without a carboxyl group. The absence of a carboxyl group imparts the following features: Benzydamine is a weak base (whereas most NSAIDs are weak acids), has high lipophilicity, and penetrates well into the site of inflammation (where pH is lower) along the pH gradient and accumulates in therapeutic concentrations.
It has an anti-inflammatory and local analgesic effect, and has an antiseptic (against a wide range of microorganisms), as well as an antifungal effect.
The anti-inflammatory effect is due to a decrease in capillary permeability, stabilization of cell membranes due to inhibition of synthesis and inactivation of prostaglandins, histamine, bradykinin, cytokines, complement factors and other nonspecific endogenous damaging factors.
Benzydamine suppresses the production of pro-inflammatory cytokines, especially TNFα, and to a lesser extent IL-1β. The main feature of benzydamine is that, being a weak inhibitor of prostaglandin synthesis, it demonstrates potent inhibition of pro-inflammatory cytokines. For this reason, Benzydamine can be classified as a cytokine-suppressing anti-inflammatory drug.
The local anesthetic effect of benzydamine is associated with the structural features of its molecule, similar to local anesthetics. The analgesic effect is due to an indirect decrease in the concentration of biogenic amines with algogenic properties and an increase in the pain sensitivity threshold of the receptor apparatus; Benzydamine also blocks the interaction of bradykinin with tissue receptors, restores microcirculation and reduces pain sensitivity at the site of inflammation.
Benzydamine has an antibacterial effect due to rapid penetration through the membranes of microorganisms with subsequent damage to cellular structures, disruption of metabolic processes and the function of cell lysosomes.
It has an antifungal effect against 20 strains of Candida albicans and Candida non-albicans, causing structural modifications of the fungal cell wall and their metabolic chains, thus preventing their reproduction.
Pharmacokinetics
When applied topically, it is well absorbed through the mucous membranes and quickly penetrates into inflamed tissues. It is detected in the blood plasma in an amount insufficient to obtain systemic effects. It is excreted mainly by the kidneys and through the intestines in the form of metabolites or conjugation products.
Indications
Symptomatic therapy of pain syndrome in inflammatory diseases of the oral cavity and ENT organs (of various etiologies): pharyngitis, laryngitis, tonsillitis; gingivitis, glossitis, periodontosis, stomatitis (including after radiation and chemotherapy); calculous inflammation of the salivary glands; after dental treatment or extraction; after surgical interventions and injuries (tonsillectomy, jaw fractures); candidiasis of the oral mucosa (as part of combination therapy).
ICD codes
| ICD-10 code | Indication |
| B37.0 | Candidal stomatitis |
| J02 | Acute pharyngitis |
| J03 | Acute tonsillitis |
| J04.0 | Acute laryngitis |
| J31.2 | Chronic pharyngitis |
| J35.0 | Chronic tonsillitis |
| J37.0 | Chronic laryngitis |
| K05 | Gingivitis and periodontal diseases |
| K08.8 | Other specified disorders of teeth and supporting structures (including toothache) |
| K11.5 | Sialolithiasis |
| K12 | Stomatitis and related lesions |
| K14.0 | Glossitis |
| R07.0 | Pain in throat |
| T79.3 | Posttraumatic wound infection, not elsewhere classified |
| ICD-11 code | Indication |
| 1F23.0 | Candidiasis of the lips or oral mucosa |
| CA02.Z | Acute pharyngitis, unspecified |
| CA03.Z | Acute tonsillitis, unspecified |
| CA05.0 | Acute laryngitis |
| CA09.2 | Chronic pharyngitis |
| CA0F.Y | Other specified chronic diseases of the palatine tonsils and adenoids |
| CA0G | Chronic laryngitis or laryngotracheitis |
| DA01.Z | Diseases of the oral mucosa, unspecified |
| DA03.0 | Glossitis |
| DA04.4 | Sialolithiasis |
| DA0A.Z | Diseases of teeth and supporting structures, unspecified |
| DA0B.Z | Gingival diseases, unspecified |
| DA0C.Z | Periodontal diseases, unspecified |
| DA0Z | Diseases or disorders of the orofacial complex, unspecified |
| LA30.5Z | Anomalies of tooth resorption or loss, unspecified |
| MD36.0 | Pain in throat |
| NF0A.3 | Posttraumatic wound infection, not elsewhere classified |
Dosage Regimen
| The method of application and dosage regimen for a specific drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly adhere to the compliance of the dosage form of a specific drug with the indications for use and dosage regimen. |
For oropharyngeal spray, administer the solution directly to the affected area.
For adults and children 12 years and older, use 4-8 sprays, 2-6 times daily.
For children 6 to 12 years old, use 4 sprays, 2-6 times daily.
For children 3 to 6 years old, the dose is 1 spray per 4 kg of body weight, with a maximum single dose of 4 sprays; administer 2-6 times daily.
For all patients, individualize the frequency of administration based on the severity of pain and inflammation.
For oral rinse solution, use 15 mL undiluted.
Rinse the mouth thoroughly for 30 seconds to 2 minutes, then expectorate the solution completely.
Repeat the rinse procedure 2-3 times daily, or as directed by a physician.
The maximum duration of continuous use without medical consultation is 7 days.
If symptoms persist beyond this period, discontinue use and consult a physician.
Avoid contact with eyes. In case of accidental contact, rinse thoroughly with water.
Adverse Reactions
Local reactions: rarely – dry mouth, burning sensation in the oral cavity; frequency unknown – numbness in the oral cavity.
Allergic reactions: infrequently – photosensitivity; rarely – sensitivity reactions, skin rash, skin itching; very rarely – angioedema, laryngospasm; frequency unknown – anaphylactic reactions.
Contraindications
Children under 3 years of age; children over 3 years of age (depending on the dosage form used); hypersensitivity to benzydamine.
With caution
Hypersensitivity to acetylsalicylic acid or other NSAIDs; bronchial asthma (including history).
Use in Pregnancy and Lactation
Should not be used during pregnancy and breastfeeding.
Pediatric Use
Contraindicated in children under 3 years of age; in children over 3 years of age – depending on the dosage form used.
Geriatric Use
There are no special instructions for limiting use in elderly patients.
Special Precautions
If there is an ulcerative lesion of the oropharyngeal mucosa, the patient should consult a doctor if symptoms persist for more than 3 days.
Not recommended for use in patients with hypersensitivity to acetylsalicylic acid or other NSAIDs.
Use with caution in patients with bronchial asthma, as bronchospasm may develop.
Storage Conditions
Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.
Dispensing Status
Over-the-Counter
Important Safety Information
This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.
Medical DisclaimerBrand (or Active Substance), Marketing Authorisation Holder, Dosage Form
Dosed topical spray 0.255 mg/1 dose: 30 ml (160 doses) bottle
Marketing Authorization Holder
Belupo, Pharmaceuticals & Cosmetics d.d. (Croatia)
Dosage Form
| Green Brin® | Dosed topical spray 0.255 mg/1 dose: 30 ml (160 doses) bottle |
Dosage Form, Packaging, and Composition
Metered-dose topical spray in the form of a colorless, transparent to slightly opalescent liquid, with a characteristic minty odor.
| 1 dose1 | |
| Benzydamine hydrochloride | 0.255 mg |
Excipients: ethanol (96%) – 13.6 mg, glycerol – 8.5 mg, sodium saccharin – 0.119 mg, methylparahydroxybenzoate – 0.17 mg, polysorbate 20 – 0.34 mg, mint flavor2 – 0.085 mg, sodium bicarbonate – 0.002 mg, purified water – up to 0.17 ml.
11 dose of spray contains 0.17 ml of solution.
2Qualitative composition of mint flavor: flavoring substances, natural flavoring substances.
30 ml (160 doses) – HDPE bottles (1) with a pump and dispenser with a folding cannula – cardboard packs (1).
Metered-dose topical spray 0.51 mg/dose: 15 ml bottle (76 doses)
Marketing Authorization Holder
Belupo, Pharmaceuticals & Cosmetics d.d. (Croatia)
Dosage Form
| Green Brine® Forte | Metered-dose topical spray 0.51 mg/dose: 15 ml bottle (76 doses) |
Dosage Form, Packaging, and Composition
Metered-dose topical spray colorless, transparent to slightly opalescent with a characteristic minty odor.
| 1 dose* | 1 ml | |
| Benzydamine hydrochloride | 0.51 mg | 3 mg |
Excipients: ethanol 96%, glycerol, sodium saccharin, methylparahydroxybenzoate, macrogol glyceryl hydroxystearate (Kolliphor® RH 40), mint flavor**, sodium bicarbonate, purified water.
* 1 dose of spray contains 0.17 ml of solution.
** qualitative composition of mint flavor: flavoring substances, natural flavoring substances.
15 ml (76 doses) – bottles with a pump dispenser (1) – cardboard packs.
Solution for topical application 1.5 mg/ml: bottle 120 ml 1 pc.
Marketing Authorization Holder
Belupo, Pharmaceuticals & Cosmetics d.d. (Croatia)
Dosage Form
| Green Brine® | Solution for topical application 1.5 mg/ml: bottle 120 ml 1 pc. |
Dosage Form, Packaging, and Composition
Solution for topical application in the form of a transparent or slightly opalescent green liquid with a characteristic minty odor.
| 1 ml | |
| Benzydamine hydrochloride | 1.5 mg |
Excipients: glycerol – 50 mg, ethanol 96% – 80 mg, sodium saccharin dihydrate – 0.7 mg, methylparahydroxybenzoate – 1 mg, polysorbate 20 – 2 mg, mint flavor – 0.5 mg, sodium bicarbonate – 0.009 mg, quinoline yellow dye (E104) – 0.027 mg, patent blue dye (E131) – 0.003 mg, purified water – up to 1 ml.
120 ml – colorless glass bottles (1) with a measuring cup – cardboard packs.
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