Causes the depolymerization of mucoprotein and mucopolysaccharide polymer molecules (mucolytic effect). Stimulates the production of endogenous surfactant, which ensures the stability of alveolar cells in the process of respiration, their protection against adverse factors, the improvement of the rheological properties of broncho-pulmonary secretions, its sliding along the epithelium and the release of sputum from the respiratory tract.
When ingested within 30 minutes, almost completely (99%) is absorbed in the gastrointestinal tract. Bioavailability is 80% due to the "first pass" effect through the liver. In plasma binds to proteins. It penetrates the BBB and placental barriers. In the liver undergoes demethylation and oxidation. Some of the metabolites formed remain active. T1/2 - 1 h, however, the terminal T1/2 reaches 15 h due to slow reverse diffusion from tissues. Excreted by the kidneys. In severe hepatic failure, clearance of bromhexine is reduced, and in chronic renal failure, the excretion of its metabolites is impaired. With repeated use may accumulate.
Side Effects of Bromhexine
From the nervous system and sense organs: dizziness, headache.
On the part of the digestive tract: nausea, vomiting, dyspeptic disorders, abdominal pain, aggravation of gastric ulcer and duodenal ulcer, increased activity of hepatic transaminases.
Allergic reactions: skin rash, itching, urticaria, rhinitis, angioedema.
Other: shortness of breath, fever and chills.
Bromhexine is not prescribed simultaneously with drugs that suppress the cough center (including codeine-containing drugs), because this may make it difficult for the sputum to discharge. Bromhexin contributes to the penetration of antibiotics (erythromycin, cefalexin, oxytetracycline, amoxicillin) and sulfa drugs in the lung tissue. Incompatible with alkaline solutions.
Warnings for substance Bromhexine
In the process of treatment, it is recommended to use a sufficient amount of liquid, which supports the secretolytic action of Bromhexine. In cases of impaired motility of the bronchi or with a significant amount of sputum, the use of bromhexine requires caution because of the risk of delayed discharge in the respiratory tract.
The occurrence of Stevens-Johnson and Lyell syndromes has been very rarely reported. If changes occur on the skin or mucous membranes, the drug should be stopped.
Hypersensitivity, peptic ulcer and 12 duodenal ulcers in the acute phase, pregnancy (I term), lactation period, children's age (up to 3 years).
Bromhexine should be used with caution in a weakened patient, as well as in patients with mechanical narrowing of the bronchi (difficult expectoration of bronchial secretions) or bronchial diseases accompanied by excessive accumulation of secretions, as well as in the case of renal and / or hepatic insufficiency and gastric bleeding in history.
When treatment is necessary to take a sufficient amount of fluid, which increases the expectorant effect of Bromhexine.
In children, treatment should be combined with postural drainage or vibration massage of the chest, facilitating the excretion of secretions from the bronchi.
With gastric ulcer, as well as indications of a history of gastric bleeding, Bromhexine should be used under medical supervision.
Influence on the ability to drive vehicles and maintain mechanisms: There is no evidence of the negative impact of Bromhexine on the ability to drive vehicles and other mechanisms.
Pharmacodynamics and pharmacokinetics
The therapeutic agent Bromhexin is characterized secretolytic(mucolytic) and expectorant properties, from which the tablets and the syrup of the drug is used for dry cough in adults and children. Secretolytic efficacy bromhexinemanifested due to his ability to diluteand depolymerizemucoprotein and mucopolysaccharide fibers bronchial secretions. Also important in the productivity of treatment bromhexinehas stimulated their education surfactant, substances of surfactant nature that lines the inside lung alveoli, thereby enhancing the protective function of the pulmonary system. In addition to its main effects, the drug has a weak antitussive impact.
Oral administration bromhexineleads to its almost complete absorption (99%) of the gastrointestinal tract for 30 minutes. Due to the effect of "first pass»Through the liver, the drug has a low bioavailability (about 20%). Plasma protein binding is quite high. Able to penetrate placentaland blood brain barriers. Hepatic metabolic transformations take place thanks to oxidationand demethylation. T1 / 2 due to slow reverse tissue diffusion averages 15 hours. Excretion is carried out mostly by the kidneys. Has the ability to cumulationin the body. With pathologies of the kidneys excretion of products metabolism is broken.
Indications for use
The indications for Bromhexine are painful conditions of the bronchopulmonary system in the presence of difficult outgoing viscous sputum (tracheobronchitis, pulmonary emphysema, bronchial asthmapneumoconiosis cystic fibrosis, bronchiectasis, tuberculosis, obstructive bronchitis, pneumonia).
Also, the drug is used in the preoperative period for sanation(recovery) bronchial tree, in the postoperative period for prophylacticsputum removal in the bronchi, when conducting diagnostic and therapeutic clinical intra bronchial manipulations.
For absolute contraindications include:
- peptic ulcer Gastrointestinal tract in the period of exacerbation,
- pregnancy in the first trimester
- children's age up to 2 years for syrup and up to 6 years for tablets,
- personal hypersensitivity,
- sugar intolerance.
- liver pathology/kidney,
- propensity to GI bleeding,
- bronchopulmonary painful conditions with congestion excessive amount of secret,
- pregnancy in the second and third trimester.
Bromhexine tablets, instructions for use
Bromhexine tablets are intended for oral (oral) administration. Tablets can be taken regardless of the meal, with 100-200 ml of water. Adults are shown a single dose of 8-16 mg of the drug 3-4 times at 24 hours. From 6 to 14 years old, they practice 3 times daily intake of 8 mg. The effect of therapy can develop only at 4-6 days.
Bromhexine syrup, instructions for use
The syrup of the drug is mainly intended for use in pediatrics, although it does not exclude the use of the drug by adult patients in the same dosages and frequency of administration as prescribed for tablets (8–16 mg 3–4 times a day).
Children's syrup is produced with a mass content of the active ingredient 4mg / 5ml and often for convenience of dosing it is supplied with a measuring beaker, such as syrup Bromhexine Nycomed, measuring cup or spoon.
Instructions for use Bromhexinefor children, it recommends that patients of 2-6 years of age take 2.5-5 ml (2-4 mg), 6-10 years - 5-10 ml (4-8 mg), after 10 years - 10 ml (8 mg) of syrup for children three times a day.
Applying children's Bromhexin, recommend parallel usevibration massage chest baby or procedure postural drainage, for the purpose of additional relief secret secretions.
The course of treatment of any of the pharmacological forms of the drug can last from 4 to 28 days. In the course of therapy, the patient should be provided with the use of a sufficient volume of fluid in order to maintain a productive secretive action.
Symptoms of overdose may occur nauseafollowed vomitor without it diarrhea and other disorders dyspepticcharacter
If overdose events are detected in the first 60-120 minutes, the patient should be called vomitingand wash the stomach. Subsequent symptomatic treatment is indicated.
Most often, tablets and syrup (closed bottle) can be stored for 3 years.
In the case when for any reason the use of Bromhexine is not possible, the doctor may recommend the following analogues:
Instructions to the drug prohibits taking tablets up to 6 years and taking syrup up to 2 years.
Basic prescribed dosage form Bromhexinefor children from 2 to 6 years old, due to the possibility of more accurate dosing (measuring spoon or beaker) and ease of swallowing, is the oral syrup for children used in the above dosages. Bulk part bromhexinein tablets for children makes 4 mg and is appointed to the children who reached 6 summer age in the doses corresponding to their age category.
Bromhexine during pregnancy and lactation
The drug in any form is contraindicated in of pregnancy in the first trimester. In the second and third trimester, his appointment is possible only in extreme cases, consistent with the principle - the benefit / risk for the mother / fetus.
If necessary, treatment with Bromhexine lactation need to pause.
As a rule, reviews of Bromhexine in adult patients who understand what exactly the pills of the drug are for, namely, for liquefaction of viscous sputum with a view to its early removal, are positive. In most cases, the drug does an excellent job with its task and practically, with rare exceptions, does not lead to side effects. The situation is a bit more complicated when the question concerns young patients and their mothers who want to cure their child’s cough as soon as possible, and in the case that this does not happen quickly, are ready to respond negatively to any drug. Recall once again that Bromhexin syrup for children is designed to solve the problem softening of bronchial secretionsand various bronchopulmonary diseases may require treatment with different drugs from many medicinal groups and often in combination. Therefore, before giving your child any medicine, you just need to seek qualified advice from a pediatrician and strictly follow his instructions.
Price Bromgeksina where to buy
The price of the drug, depending on the manufacturer and the number of pills or the volume of the bottle, is somewhat different, but remains within the limits accessible to virtually every consumer.
So the price of Bromhexine in tablets 8 mg No. 50 varies from 25 to 50 rubles, the price of Bromhexin syrup 8 mg / 5 ml 150 ml is within 150 rubles, and syrup for children 4 mg / 5 ml 100 ml can be bought for 60-80 rubles.
The mechanism of action of the drug Bromhexine consists in its pronounced expectorant, secretomotor and secretolytic action on the mucous membrane of the respiratory system, which has a stimulating effect on the cells of the glands of the mucous membrane of the respiratory tract, increasing the secretion of mucous secretion in the bronchi and alveoli, and stimulates the ciliary activity of the respiratory epithelial system of the body. The basis of the mechanism of action of this drug is the activation of hydrolyzing enzymes of cells of the bronchial glands and alveoli, and with the dilution of mucopolysaccharide and mucoprotein and fibers and their depolymerization, as a result, the viscosity of sputum decreases and this leads to a decrease in cough of any etiology.
Bromhexine is perfectly absorbed from the gastrointestinal tract and has a high absorption capacity when taking any form of the drug - syrup or tablets. The effect of the drug begins to manifest itself usually one day after the start of taking the drug. A pronounced therapeutic effect is manifested within two days from the start of treatment. The metabolism of this drug in most cases occurs in the liver, and is excreted mainly by the kidneys. With long-term use may accumulate in the body.
Bromhexine administration method
This drug has the following forms of release: in the form of syrup for children and adults and tablets produced by various companies: Berlin-Chemie, Grindeks, Nikomed, Ratiopharm, Ruspharm, Ferein, Egis.
Bromhexine has the following forms of release - 4, 8 and 16 mg tablets each, a syrup consisting of the corresponding substance Bromhexine in 5 ml - 4 mg and 10 mg, as well as a solution for oral administration having 10 ml of Bromhexine in 5 ml.
The dosage for children and adults is: for adults and children over ten years old - eight milligrams three to four times daily. Children under two years old - two milligrams three times daily. Children aged two to six years - four milligrams three times daily, and children from six to ten years old - six to eight milligrams three times daily. If necessary, the daily dose can be increased in adults up to sixteen milligrams four times a day, and children up to sixteen milligrams twice a day.
Special instructions and interaction with other drugs
With caution, this drug should be taken during pregnancy and lactation. Taking this drug during pregnancy and lactation is possible only with a doctor's prescription and with its constant monitoring.
It is not recommended to take Bromhexine for liver or kidney failure.
This drug is prescribed with caution in case of gastric ulcer, as well as with the threat of gastric bleeding, its history. In such cases, Bromhexine should be used only under the supervision of a physician. Bromhexine is not used simultaneously with true antitussive drugs containing codeine and depressing the cough reflex, due to the fact that this can cause difficulty in coughing up of liquefied sputum and its accumulation in the bronchopulmonary system.
Bromhexine use during lactation and pregnancy
Taking this drug during pregnancy, like any drug, is contraindicated in the first three months of pregnancy and is not recommended for pregnant women in the second and third trimester of pregnancy and during lactation. It must be remembered that there is always a risk of adverse effects of the drug on the embryo in early pregnancy or on the developing fetus at a later date. In any case, the use of this drug for pregnant women and lactation is possible only with constant medical supervision and with a doctor's prescription.
Also, when breastfeeding a child, taking Bromhexine is not recommended.
This is a drug that belongs to the pharmacotherapeutic group - expectorant and mucolytic agents.
And it has the following forms of release: Bromhexin 4 Berlin-Chemie in syrup in bottles of sixty and one hundred milliliters and having five milligrams of bromhexine in the composition of 5 ml of syrup and considered to be the infant dosage of the medicinal product.
And dragee Bromhexin 8 Berlin-Chemie twenty-five dragees in a blister.
Bromhexin 4 Berlin-Chemie is used on the basis that a measuring spoon contains 5 ml of syrup - the dosage for adults and adolescents over fourteen years is two to four measuring spoons three times a day, which corresponds to 24-48 mg of the active substance Bromhexine per day.
Children from six to fourteen years old, as well as patients weighing less than fifty kilograms: two measuring spoons three times a day, which corresponds to 24 mg of bromhexine per day. Children from two to six years: one measuring spoon three times a day, which corresponds to 12 mg of bromhexine per day. And children up to the age of two: half a measuring spoon 3 times a day, which corresponds to 6 mg of bromhexine per day.
If kidney function is abnormal or liver damage, bromhexine is taken in a reduced dose or with long intervals between doses.
In the course of treatment, an adequate drinking regimen is recommended to maintain the secretolytic action of bromhexine.
Bromhexin 8 Berlin - Chemie
The drug Bromhexine prescribed inside, after eating, without chewing pills and drinking plenty of fluids.
The dosage for adults and adolescents over fourteen years old is: one to two tablets three times a day, which corresponds to 24-48 mg per day.
Children from six to fourteen years old and patients weighing less than fifty kilograms take one tablet three times, which corresponds to 24 mg per day.
In case of impaired renal and / or liver function, it is recommended to increase the intervals between taking the drug or reduce the dose with the mandatory consultation of the attending physician.
Bromhexine for children
The drug Bromhexine is currently one of the safest mucolytic drugs with expectorant for children, which is used from an early age. Convenient dosage, pleasant aroma and taste of this medicinal product is considered to be a distinctive feature of the use of bromhexine in children. Важными характеристиками для применения этого лекарственного препарата для детей является и то, что он способен оказывать не только прекрасное отхаркивающее, мукорегуляторное и муколитическое воздействие на слизистую оболочку дыхательных путей ребенка, что способствует разжижению мокроты, но и дополнительно обладает противокашлевым эффектом.Bromhexine also has an excellent effect as a mucoregulator, which speeds up and improves discharge, by activating ciliated ciliated epithelium.
Bromhexine is a drug that actively acts on the consistency of sputum, while regulating the ratio of its constituent components, as a result, the viscosity of sputum decreases and leads to an improvement in its discharge and elimination from the respiratory tract of a child, which leads to a moist cough.
Bromhexin is also used in pediatric practice for the complex treatment of a complicated course of childhood infectious diseases: measles, rubella, mumps, scarlet fever or chicken pox when nasopharyngitis, laryngitis, tracheitis or bronchitis develops in a child.
In pediatric practice, it is used as a syrup and tablets in appropriate dosages.
Practical use of the drug Bromhexin for the treatment of cough
The drug Bromhexin, is currently considered to be quite effective, popular and safe for expectorant and mucolytic drugs, which is widely used in medical practice for the treatment of cough in all age categories.
Bromhexine in any form of its use in its antitussive action, based on its emollient, expectorant, secretomotor, secretolytic effects, has excellent efficacy, both in children and adults, diluting mucous secretions accumulating in the trachea, bronchi, and alveoli of the lungs and thick , viscous mucus that accumulates in the larynx and nasopharynx.
Bromhexine is widely used in therapeutic and pediatric and practice for the treatment of cough, which causes inflammatory diseases mainly upper and lower respiratory tract - laryngitis, pharyngitis, laryngotracheitis, tracheitis, bronchitis and pneumonia. In addition, by potentiating the antibacterial and anti-inflammatory effect of antibiotics, it has additional positive effects and is widely prescribed for inflammatory diseases of the lower respiratory tract of infectious and inflammatory genesis, which are accompanied by a pronounced wet cough.
Additional positive characteristics of this drug is its excellent tolerability.
According to the classification adopted in medicine, Bromhexin is a mucolytic agent against cough and bronchial diseases. The active ingredient in the composition of the substance is Bromhexine hydrochloride, a synthetic derivative of vasicin, which is a biologically active component of plant origin in the form of fibers. The substance acts on the bronchi of the lungs, providing a secretolytic effect.
Composition and release form
Bromhexine Nycomed against lung diseases is available in the form of tablets, syrup and oral solution. Detailed composition and description of the funds:
White Flat Cylinder Pills
Colorless viscous liquid with raspberry flavor
Apricot flavored liquid
Bromhexine hydrochloride concentration, mg
4 or 8 per 1 pc.
Calcium stearate, lactose, potato starch
Food flavor raspberry, sorbitol, water, propylene glycol, methyl and propyl paraben
Water, propylene glycol, hydrochloric acid, apricot flavor concentrate, sorbitol
Contoured cell packs of 10 tablets, 5 packs per pack
100 ml bottles in a carton box with instructions for use
60 ml bottles
Dosing and Administration
Instructions for use Bromgeksina indicates the method of its use and the possible dosage. These indicators depend on the form of release of the drug and the course of the disease. The solution can be administered orally, by inhalation or parenterally. The last injection is expected in the treatment of severe cases and in the postoperative period. Subcutaneously, intravenously or intramuscularly injected with 2 mg 2-3 times / day slowly (2-3 minutes).
For oral administration with the aim of removing sputum intended cough tablets Bromhexin. Adults and children over 10 years old according to the instructions should be taken 8 mg 3-4 times / day, 6-10 years - 6-8 mg 3 times / day, 2-6 years - 4 mg each, up to two years - 2 mg. If necessary and in severe cases, the dosage is increased to 16 mg 4 times / day for adults and up to 16 mg twice / day for children. Doctors note that the therapeutic effect of the drug appears on the 4-6 days of treatment.
Bromhexine syrup is available for use by children. According to the instructions, children under six years old receive a measuring spoon three times / day (12 mg of the active substance). Infants and children under two years of age should take the medicine only as directed and controlled by the pediatrician. Children 6-14 years of age or patients weighing less than 50 kg consume two measuring spoons three times / day (24 mg), and adults and adolescents over 14 years old use 2-4 measuring spoons three times / day (24-48 mg of bromhexine) . The duration of therapy is no more than 4-5 days.
Bromhexine solution can be used for inhalation using a special nebulizer device. To do this, it is poured 8 mg of medication for adults, 4 mg - for children over 10 years old or 2 mg for babies 6-10 years old and younger. The device very finely disperses the fluid, allowing it to penetrate as deeply as possible into the lungs and act on the cause of the cough more quickly. Inhalation do twice / day.
In addition, the solution can be used for oral administration, similar to a syrup. Instructions for use indicates the dose: adults and children over 14 years old - three times / day, 2-4 scoops, children 6-14 years or patients with a weight of less than 50 kg - 1-2 scoops, up to six years - one . It is not recommended to use the solution for more than 4-5 days without a special permission of the doctor.
According to the instructions, the doctor can prescribe the use of Bromhexine only if the expected benefit to the mother exceeds the potential risk to the fetus. The active ingredient of the composition penetrates the placental barrier and is found in breast milk. Therefore, when breastfeeding, the use of drugs is prohibited due to the high risk of damage to the child's body.
Medication treatment suggests that it will be combined with other drugs. Some combinations are risky or banned, indicated in the instructions for use:
- It is forbidden to combine medicine with codeine-containing drugs - this makes it difficult for sputum to discharge,
- can be taken simultaneously with the combination of herbal preparations containing the essential oils of eucalyptus, anise, peppermint, menthol,
- incompatible with alkaline solutions,
- when taken with antibiotics and sulfonamides, their concentration in bronchopulmonary secretion and penetration of antibiotics increases,
- nonsteroidal anti-inflammatory drugs can mutually enhance the effect of irritation of the gastric mucosa,
- allowed combination with bronchodilators, antibacterial and drugs used in cardiology.
What is Bromhexin used for?
The use of Bromhexine is advisable in the treatment of respiratory diseases, the course of which is associated with the formation of a viscous secretion difficult to separate:
- Bronchial asthma,
- Chronic pneumonia,
- Chronic bronchitis with broncho-obstructive component,
- Cystic fibrosis.
In addition, the drug is used for diagnostic and therapeutic intrabronchial manipulations and in the preoperative period for the rehabilitation of the bronchial tree, as well as for the prevention of accumulation of thick viscous sputum in the bronchi after surgery.
The drug Bromhexin contributes to the provision of a secretolytic (mucolytic) effect, has an expectorant and weak antitussive effect. The use of this drug can reduce the viscosity of sputum, increase its volume and facilitate the process of its removal. The therapeutic effect of the drug Bromhexin develops after 2-5 days of use.
The use of the drug Bromhexin (tablets including) contributes to the production of acid neutral polysaccharides, which destroy acidic ones. In addition, the active ingredient of the drug increases the activity of the bronchi, which contributes to the expectorant effect. As the viscous sputum evacuates, the microflora of the bronchi is restored.
Instructions for use
According to the instructions for use, the therapeutic effect of the use of Bromhexine appears after about 2-5 days. The duration of treatment is 4-28 days, depending on the severity of the disease.
- Tablets for adults and children over 10 years old - 8 mg 3-4 times / day. Children under 2 years of age - 2 mg 3 times / day, from 2 to 6 years old - 4 mg 3 times / day, and from 6 to 10 years old - 6-8 mg 3 times / day. If necessary, the dose can be increased to adults up to 16 mg 4 times / day, children - up to 16 mg 2 times / day.
- In the form of inhalation for adults - 8 mg each, for children over 10 years old - 4 mg each, at the age of 6-10 years old - 2 mg each. At the age of 6 years - used in doses up to 2 mg. Inhalation spend 2 times / day.
Parenteral administration is recommended for treatment in severe cases, as well as in the postoperative period to prevent the accumulation of thick sputum in the bronchi. Enter 2 mg p / c, in / m or / in 2-3 times / day slowly over 2-3 minutes.
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Pharmacy sales terms
My good old Bromhexine. I also remember him from childhood, it helps well when coughing! I saw it myself and give it to my baby when they cough. All the same, the German quality of pharmaceuticals speaks for itself!
In addition, how many took never noticed any adverse reactions! And for me this is an incredible plus to take the medicine! Also among the advantages would be a sin not to single out the price of the drug!
The drug is absolutely nothing. Took for two weeks with bronchitis. Together with antibiotics in the second week, the cough did not get any better; nothing was expectorated. I had to take a picture, which revealed pneumonia and was then treated at the hospital with painful injections, then the doctors said that all these garbage pills needed a normal antibiotic to treat severe bronchitis. So it goes. So I would think about the effectiveness of bromhexine.
a strong cough for 2 months have done all kinds of pills with antibiotics does not help advise can anyone faced with such a sore
Try co-trimoxazole, cheap pills and the effect is good. I work in the cold and coughing tortured, now it is not