Bromhexine hydrochloride is a well-established mucolytic agent indicated for the management of productive cough and bronchial congestion associated with various respiratory conditions. As a derivative of the natural compound vasicine, it works by depolymerizing mucopolysaccharide fibers, thereby reducing the viscosity of bronchial secretions. This action facilitates expectoration, improves airway clearance, and supports overall respiratory function. It is available in various formulations, including tablets, syrups, and solutions for oral or inhalation use, making it a versatile option in both acute and chronic respiratory care.

Features

• Active ingredient: Bromhexine hydrochloride
• Mechanism: Mucolytic action through depolymerization of acid mucopolysaccharides
• Formulations: Tablets (4 mg, 8 mg), syrups, oral solutions, and nebulizer solutions
• Onset of action: Noticeable within 2–4 hours of administration
• Half-life: Approximately 1.5 hours, with metabolic conversion to ambroxol
• Administration: Oral or via inhalation, depending on formulation

Benefits

• Reduces viscosity of thick, tenacious mucus, easing expectoration
• Improves bronchial secretion clearance, supporting lung hygiene
• Enhances antibiotic penetration into bronchial tissues in infectious cases
• Alleviates symptoms of productive cough, reducing discomfort and respiratory effort
• Supports management of chronic respiratory conditions such as chronic bronchitis and bronchiectasis
• Available in pediatric and adult formulations for tailored dosing

Common use

Bromhexine is commonly prescribed for acute and chronic respiratory conditions characterized by excessive, viscous mucus. These include acute bronchitis, chronic obstructive pulmonary disease (COPD), bronchiectasis, bronchial asthma with mucus hypersecretion, and tracheobronchitis. It is also used as adjunctive therapy in respiratory tract infections to improve the efficacy of antibiotics by enhancing their distribution in bronchial secretions. In some clinical settings, it is administered pre- and post-operatively to prevent pulmonary complications.

Dosage and direction

Dosage varies based on age, severity of condition, and formulation. Adults typically receive 8–16 mg three times daily. For children aged 5–10 years, a common dose is 4 mg three times daily; for those under 5, dosing is weight-based or as per pediatric syrup recommendations. Oral solutions and syrups should be measured accurately using provided devices. Inhalation solutions are generally administered via nebulizer, with dosing guided by a healthcare provider. It is advisable to take bromhexine with a full glass of water to aid hydration and mucus clearance. Always follow specific prescribing information or medical advice.

Precautions

Use with caution in patients with a history of gastric ulceration, as bromhexine may increase gastric secretions. Hepatic or renal impairment requires dosage adjustment or avoidance. Patients with compromised cough reflex or risk of aspiration should be monitored closely. Pregnancy and lactation: use only if clearly needed and under medical supervision, as safety data are limited. Avoid in individuals with known hypersensitivity to bromhexine or related compounds.

Contraindications

Hypersensitivity to bromhexine hydrochloride or any component of the formulation. Not recommended in cases of severe hepatic impairment or acute peptic ulcer disease. Contraindicated in patients with a history of bronchospasm induced by mucolytic agents.

Possible side effect

Common side effects are generally mild and may include gastrointestinal disturbances such as nausea, vomiting, epigastric pain, and diarrhea. Less frequently, dizziness, headache, sweating, and rash have been reported. Elevated liver enzymes may occur transiently. Inhaled formulations can occasionally cause local irritation or bronchospasm, particularly in asthmatic patients.

Drug interaction

No clinically significant interactions with common drugs are widely documented, though bromhexine may enhance the penetration of antibiotics like amoxicillin and erythromycin into bronchial tissues, potentially increasing their efficacy. Use with caution alongside other cough suppressants, as reduced cough reflex may impair mucus clearance. Always inform healthcare providers of all concomitant medications.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose to catch up. Resume the regular dosing schedule. Consistent administration supports optimal mucolytic effect.

Overdose

Symptoms of overdose may include nausea, vomiting, and gastrointestinal upset. There is no specific antidote; treatment is symptomatic and supportive. Gastric lavage or activated charcoal may be considered if ingestion was recent. Maintain hydration and monitor vital signs. Seek immediate medical attention in case of suspected overdose.

Storage

Store at room temperature (15–30°C), away from light and moisture. Keep oral solutions and syrups tightly closed. Do not freeze. Keep out of reach of children. Check expiration date and discard any unused medication appropriately.

Disclaimer

This information is for educational purposes and does not replace professional medical advice. Always consult a healthcare provider for diagnosis, treatment decisions, and personalized recommendations. Do not self-medicate. The efficacy and safety of bromhexine may vary based on individual health status and adherence to prescribed guidelines.

Reviews

Bromhexine has been widely studied and used for decades, with clinical trials and meta-analyses supporting its efficacy in reducing sputum viscosity and improving symptoms in conditions like chronic bronchitis. User reports often highlight its effectiveness in easing productive cough, though individual responses may vary. It is generally well-tolerated, with a favorable safety profile in both adult and pediatric populations when used as directed.