Bromhexine

Bromhexine 8 mg Tablet is a mucolytic agent containing Bromhexine that helps reduce the thickness of the sputum. It is used to treat chest congestion associated with respiratory problems. This medicine works by thinning the mucous and clearing the airway, thus making it easier to breathe. Bromhexine 8 mg is also used to treat conditions with abnormal mucus secretion such as a common cold, infections of the respiratory tract, influenza, etc.

Product dosage: 8 mg
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Synonyms Bromhexine Elixir

Bromhexine is a well-established mucolytic agent designed to alleviate symptoms of productive cough and respiratory congestion by effectively thinning and loosening bronchial secretions. As a derivative of the natural compound vasicine, it enhances the clearance of mucus from the airways, promoting easier expectoration and improving breathing comfort. Its mechanism of action targets both the viscosity and transportability of phlegm, making it a cornerstone in the management of acute and chronic bronchopulmonary conditions. Clinicians value bromhexine for its predictable pharmacokinetics and favorable safety profile, supporting its use across diverse patient populations when administered under appropriate guidance.

Features

• Active ingredient: Bromhexine hydrochloride
• Available formulations: Tablets (4 mg, 8 mg), syrup (4 mg/5 mL), solution for inhalation
• Mechanism: Depolymerizes mucopolysaccharide fibers, reduces mucus viscosity
• Onset of action: Mucolytic effects typically observed within 2–3 days of initiation
• Bioavailability: Approximately 80% following oral administration
• Half-life: Roughly 1.5 hours, with metabolites exhibiting prolonged activity
• Excretion: Primarily renal, with some biliary elimination
• Prescription status: Available over-the-counter in some regions; prescription-only in others

Benefits

• Facilitates productive coughing by reducing sputum thickness, easing expectoration
• Improves bronchial clearance and lung function parameters in obstructive airway diseases
• Enhances the efficacy of concomitant antibiotics by improving their penetration into bronchial secretions
• Provides symptomatic relief in both acute respiratory infections and chronic conditions like COPD or bronchiectasis
• Supports patient comfort and compliance due to generally mild side effects
• Suitable for use in adults and children (age-dependent dosing)

Common use

Bromhexine is indicated for the treatment of respiratory disorders characterized by excessive, viscous mucus that is difficult to expectorate. Common clinical applications include acute bronchitis, chronic obstructive pulmonary disease (COPD), asthma with mucus hypersecretion, bronchiectasis, and tracheobronchitis. It is also used adjunctively in the management of sinusitis and otitis media with effusion, where reduced mucus viscosity can aid drainage. In pediatric practice, it is occasionally employed for respiratory support in cystic fibrosis, though other mucolytics may be preferred based on severity.

Dosage and direction

Dosage should be individualized based on age, severity of condition, and formulation. For adults and adolescents over 14 years, the typical dose is 8 mg three times daily (tablets or syrup). For children aged 6–14 years, 4 mg three times daily is standard. For younger children (2–5 years), 4 mg twice daily is often recommended. Administration should occur after meals to minimize potential gastrointestinal discomfort. The duration of treatment usually ranges from 7 to 14 days for acute conditions, though chronic use may be advised under medical supervision. For inhalation solutions, follow device-specific instructions—generally 1–2 inhalations, 2–3 times daily.

Precautions

Use bromhexine cautiously in patients with a history of gastric ulceration, as it may theoretically irritate the gastric mucosa. Hepatic or renal impairment necessitates dose adjustment or avoidance, depending on severity. Patients with compromised cough reflex (e.g., post-operative, neurological impairment) should be monitored closely, as improved mucus clearance may still pose aspiration risks. Pregnancy and lactation require careful risk-benefit assessment; although animal studies show no teratogenicity, human data are limited. Avoid use in patients hypersensitive to bromhexine or related compounds.

Contraindications

Bromhexine is contraindicated in individuals with known hypersensitivity to bromhexine hydrochloride or any excipients in the formulation. It should not be used in patients with severe hepatic failure or acute peptic ulcer disease. Use is also contraindicated in children under 2 years of age due to insufficient safety data and physiological differences in respiratory and metabolic function.

Possible side effect

Most adverse reactions are mild and transient. Common side effects include gastrointestinal symptoms such as nausea, vomiting, diarrhea, or epigastric discomfort. Less frequently, patients may experience dizziness, headache, or sweating. Allergic reactions like rash, urticaria, or pruritus are rare but possible. Bronchospasm has been reported in isolated cases, particularly in asthmatic individuals. Elevated liver enzymes may occur but are typically reversible upon discontinuation.

Drug interaction

Bromhexine may increase the penetration and concentration of antibiotics (e.g., amoxicillin, erythromycin) into bronchial secretions, which can be therapeutically beneficial. However, concomitant use with antitussives that suppress the cough reflex (e.g., codeine, dextromethorphan) is generally discouraged, as it may counteract bromhexine’s expectorant effects. No clinically significant interactions with CYP450 enzymes are known, but caution is advised with narrow-therapeutic-index drugs until further data are available.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to compensate for a missed one. Consistent adherence is recommended for optimal mucolytic activity.

Overdose

Symptoms of overdose may include pronounced gastrointestinal distress (nausea, vomiting, diarrhea), dizziness, or hypotension. There is no specific antidote; treatment is supportive and symptomatic. Gastric lavage or activated charcoal may be considered if ingestion was recent. Maintain hydration and monitor vital signs. Hemodialysis is not expected to be effective due to bromhexine’s protein binding and volume of distribution.

Storage

Store at room temperature (15–30°C), protected from light and moisture. Keep the container tightly closed. Do not freeze liquid formulations. Keep out of reach of children and pets. Discard any unused medication after the completion of treatment or by the expiration date, whichever comes first.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting any new medication, especially if you have underlying health conditions or are taking other drugs. Dosage and suitability may vary based on individual patient factors.

Reviews

Clinical studies and meta-analyses generally support the efficacy of bromhexine in reducing sputum viscosity and improving symptoms of productive cough. For example, a 2020 systematic review noted significant improvement in expectoration ease and patient-reported outcomes compared to placebo. Practitioners often describe it as a reliable option for mucolytic therapy, particularly in resource-limited settings. Some criticisms include slower onset compared to newer agents like acetylcysteine, but its cost-effectiveness and safety keep it relevant in guidelines. Patient feedback frequently highlights relief from chest congestion and improved sleep quality during respiratory illnesses.