Bromhexine hydrochloride is a well-established mucolytic agent indicated for the management of productive cough and respiratory conditions characterized by viscous, tenacious mucus. As a derivative of the vasicine alkaloid, it works by depolymerizing mucopolysaccharide fibers, reducing sputum viscosity, and facilitating expectoration. This mechanism enhances the clearance of bronchial secretions, improves lung function, and supports airway hygiene. It is commonly prescribed both as monotherapy and as an adjunct in comprehensive respiratory treatment protocols.

Features

• Active ingredient: Bromhexine hydrochloride
• Available in tablet, syrup, and solution formulations
• Demonstrated mucolytic and secretolytic properties
• Suitable for adult and pediatric populations (age-dependent formulations)
• Compatible with many common respiratory therapeutics

Benefits

• Reduces sputum viscosity, enabling easier expectoration
• Improves bronchial clearance and lung function parameters
• Decreases coughing effort and respiratory discomfort
• Supports faster recovery from acute respiratory exacerbations
• Enhances antibiotic penetration into bronchial secretions
• May reduce frequency of respiratory infections in chronic conditions

Common use

Bromhexine is primarily indicated for respiratory conditions associated with abnormal mucus secretion and impaired mucociliary clearance. These include acute and chronic bronchitis, bronchiectasis, tracheobronchitis, bronchial asthma, emphysema, cystic fibrosis, and chronic obstructive pulmonary disease (COPD). It is also used pre- and post-operatively to prevent pulmonary complications and following thoracic surgery to maintain airway patency. The medication may be prescribed as part of a comprehensive management strategy that includes bronchodilators, antibiotics, and chest physiotherapy.

Dosage and direction

Adults and children over 10 years: 8-16 mg three times daily
Children 5-10 years: 4-8 mg three times daily
Children 2-5 years: 4 mg two to three times daily
Syrup formulation: Use measuring device provided; shake well before use
Tablets should be swallowed whole with water, preferably after meals to minimize gastric discomfort. Treatment duration typically ranges from 7-14 days for acute conditions, though chronic conditions may require longer therapy under medical supervision. Dosage adjustments may be necessary in hepatic impairment.

Precautions

Use with caution in patients with gastric ulceration or a history of peptic ulcer disease due to potential gastric irritation. Hepatic impairment requires careful monitoring and possible dose reduction. Patients with renal impairment should be monitored closely. Not recommended during first trimester of pregnancy unless clearly needed. Use in pediatric populations requires strict adherence to age-specific dosing guidelines. Patients should maintain adequate hydration to support mucolytic action.

Contraindications

Hypersensitivity to bromhexine or any component of the formulation. Severe hepatic impairment. History of severe peptic ulcer disease. Not recommended for use in children under 2 years of age due to limited safety data. Avoid in patients with known phenylketonuria (some formulations may contain phenylalanine).

Possible side effect

Common side effects (≥1/100 to <1/10) include gastrointestinal disturbances such as nausea, vomiting, epigastric pain, and diarrhea. Uncommon side effects (≥1/1,000 to <1/100) may include dizziness, headache, sweating, and rash. Rare cases (<1/1,000) of hypersensitivity reactions including angioedema, urticaria, and bronchospasm have been reported. Transient elevations in liver enzymes may occur but typically resolve with discontinuation.

Drug interaction

No clinically significant interactions with most commonly prescribed medications. Theoretical potential for increased gastric toxicity when combined with NSAIDs or corticosteroids. May enhance penetration of antibiotics (particularly amoxicillin and erythromycin) into bronchial secretions. No known interactions with theophylline or beta-agonists. Monitor patients on concurrent CYP3A4 substrates, though clinical significance remains uncertain.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed one. Maintain regular dosing schedule to ensure consistent mucolytic effect. If multiple doses are missed, consult healthcare provider for guidance on resuming therapy.

Overdose

Symptoms may include nausea, vomiting, and gastrointestinal distress. No specific antidote exists. Treatment should be symptomatic and supportive. Gastric lavage may be considered if ingestion occurred within 1-2 hours. Maintain adequate hydration and electrolyte balance. Monitor respiratory function and provide supportive care as needed. Contact poison control center for latest management recommendations.

Storage

Store at room temperature (15-30°C) in original container. Protect from light and moisture. Keep syrup formulation tightly closed and do not freeze. Keep all medications out of reach of children and pets. Do not use after expiration date printed on packaging. Do not transfer tablets to other containers as this may affect stability.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting any new medication or treatment regimen. Dosage and administration should be determined by a physician based on individual patient characteristics and medical history. The manufacturer’s prescribing information should be consulted for complete details.

Reviews

Clinical studies demonstrate bromhexine’s efficacy in reducing sputum viscosity and improving expectoration. A meta-analysis of 16 randomized controlled trials showed significant improvement in symptom scores and pulmonary function tests compared to placebo. Patients report improved breathing comfort and reduced coughing effort. Healthcare providers note its good tolerability profile and utility in complex respiratory cases. Long-term studies support its safety profile in chronic management of respiratory conditions.