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Bromhexine has mucolytic (secretolytic) and expectorant effects. The mucolytic effect is associated with the depolymerization and liquefaction of mucoprotein and mucopolysaccharide fibers. Bromhexine has a weak antitussive effect. Stimulates the production of endogenous surfactant, ensuring the stability of alveolar cells during respiration. The clinical effect is manifested after 2-5 days from the start of treatment with the drug.
When ingested, Bromhexine is almost completely (99%) absorbed within 30 minutes. Bioavailability is 20-25% (the effect of "first pass" through the liver). In plasma, Bromhexine strongly binds to proteins of 95%, penetrates the hematoencephalic and placental barriers. In the liver, Bromhexine undergoes demethylation and oxidation. The half-life is 15 hours due to slow reverse diffusion from tissues. Excreted by the kidneys. In chronic renal failure, the release of Bromhexine metabolites is impaired. With repeated use, Bromhexine may accumulate.
Chronic inflammatory lung diseases (bronchial asthma, cystic fibrosis, tuberculosis, tracheobronchitis, spastic bronchitis, bronchiectasis, pulmonary emphysema, pneumoconiosis), chest injuries, pre- and postoperative period.
5 ml of syrup contain:
Active substance: Bromhexine hydrochloride - 4 mg.
Bromhexine is marketed under different brands and generic names, and comes in different dosage forms:
|Brand name||Manufacturer||Country||Dosage form|
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Dosage and Administration
Bromhexine ingested regardless of the meal.
Adults are prescribed 8-16 mg (10-20 ml) 3-4 times a day.
- from 2 years old - 2 mg (2.5 ml) 2-3 times a day;
- from 3 to 6 years - 2-4 mg (2.5-5 ml) 3 times a day;
- from 6 to 14 years - 4-8 mg (5-10 ml) 3 times a day.
The course of treatment is from 4 to 28 days.
In the course of treatment, it is recommended to use a sufficient amount of liquid, which supports the secretolytic action of Bromhexine.
In children, treatment should be combined with postural drainage or vibration massage of the chest, which facilitates the evacuation of secretions from the bronchi.
From the digestive system: dyspeptic phenomena, transient increase in the activity of liver transaminases in serum.
From the side of the central nervous system: headache, dizziness.
Dermatological reactions: increased sweating, skin rash.
On the part of the respiratory system: cough, bronchospasm.
Pregnancy (I-st trimester), children's age (up to 3 years).
Bromhexine can be administered simultaneously with other drugs used in the treatment of bronchopulmonary diseases.
Bromhexine is not prescribed simultaneously with antitussives (including those containing codeine), because they may make coughing of sputum diluted with bromhexine difficult.
Bromhexine contributes to the penetration of antibiotics (amoxicillin, erythromycin, cephalexin, oxytetracycline), sulfa drugs into the bronchial secretion in the first 4-5 days of antimicrobial therapy.
Bromhexine is not compatible with alkaline solutions.
Pregnancy and Lactation
During pregnancy and lactation, Bromhexine is used in cases where the intended benefit to the mother outweighs the potential risk to the fetus or child.
With gastric ulcer, as well as indications of a history of gastric bleeding, Bromhexine should be used under medical supervision.
Use with caution in patients with asthma.
Bromhexine is not used simultaneously with drugs containing codeine, because this makes it difficult to cough up a liquefied sputum.
Used as part of combined preparations of plant origin with essential oils (including with eucalyptus oil, anise oil, peppermint oil, menthol).
Symptoms: nausea, vomiting, diarrhea, dyspeptic disorders.
Treatment: artificial vomiting, gastric lavage (in the first 1-2 hours after ingestion).
- Brand name: Bromhexin-Akrikhin
- Active ingredient: Bromhexine
- Dosage form: Syrup
- Manufacturer: Akrikhin
- Country of Origin: Russia
- Bioavailability of bromhexine tablets and preliminary pharmacokinetics in humans
- Selected ion monitoring assay for bromhexine in biological fluids
- Tritium labelling of bromhexine via amide reduction with LiB3H4
- GLC trace analysis of dextromethorphan and bromhexine salts in pharmaceutical preparations
- Electron-capture GLC determination of bromhexine in human plasma
- RETRACTED: Bromhexine-Selective PVC Membrane Electrode Based on Bromhexinium Tetraphenylborate
- Studies on the formation of cyclohexylamine and n-methylcyclohexylamine from bromhexine in animals and man, and simultaneous determination of cyclohexylamine and n-methylcyclohexylamine by gas chromatography
- The role of micellar catalysis from kinetic and thermodynamic investigations of the reaction between bromhexine drug with para-dimethylaminobenzaldehyde
- Characterization of bromhexine and ambroxol in equine urine: Effect of furosemide on identification and confirmation
- Automatic determination of amylocaine and bromhexine by atomic absorption spectrometry
- Flow-injection extraction-spectrophotometric determination of bromhexine with orange IV
- Simultaneous determination of bromhexine hydrochloride and methyl and propyl p-hydroxybenzoate and determination of dextromethorphan hydrobromide in cough-cold syrup by high-performance liquid chromatography
- Simultaneous determination of salbutamol sulphate, bromhexine hydrochloride and etofylline in pharmaceutical formulations with the use of four rapid derivative spectrophotometric methods
- Bioequivalence study of bromhexine by liquid chromatography–electrospray ionization-mass spectrometry after oral administration of bromhexine hydrochloride tablets
- Quantification of the major metabolites of bromhexine in human plasma using RRLC–MS/MS and its application to pharmacokinetics
- Retraction notice to “Bromhexine-Selective PVC Membrane Electrode Based on Bromhexinium Tetraphenylborate” [Microchem. J. 62/2 (1999) 237–243]
- Multi-pumping flow system for spectrophotometric determination of bromhexine
- Determination of bromhexine hydrochloride in pharmaceutical preparations by reversed-phase ion-pair high-performance liquid chromatography
- Determination of bromhexine as its trifluoroacetyl derivative by gas-liquid chromatography with electron-capture detection
- Assay of bromhexine in human plasma by capillary gas—liquid chromatography with nitrogen-selective detection and selected ion monitoring
- Determination of bromhexine in human plasma and urine by high-performance liquid chromatography
- Determination of bromhexine in plasma by reversed-phase liquid chromatography : Interference of lipoproteins on extraction
- Determination of bromhexine and ambroxol in pharmaceutical dosage forms, urine and blood serum
- Determination of the minor component bromhexine in cotrimoxazole-containing tablets by absorption spectrophotometry and partial least-squares (PLS-1) multivariate calibration