Bromhexine hydrochloride is a well-established mucolytic agent indicated for the management of productive cough and respiratory conditions characterized by excessive, viscous mucus. As a derivative of the vasicine alkaloid, it works by depolymerizing mucopolysaccharide fibers, thereby reducing sputum viscosity and facilitating expectoration. This pharmacological action supports airway clearance, improves bronchial secretion transport, and enhances the efficacy of concomitant respiratory therapies. Clinically, bromhexine is valued for its targeted mechanism and favorable safety profile, making it a staple in both acute and chronic respiratory care protocols.

Features

• Active ingredient: Bromhexine hydrochloride
• Available in 8 mg tablets, oral solution, and syrup formulations
• Mucolytic action through hydrolysis of acid mucopolysaccharide fibers
• Increases lysosomal activity to break down thick sputum
• Enhances pulmonary penetration of antibiotics like amoxicillin
• Compatible with bronchodilators and corticosteroids

Benefits

• Rapid reduction in sputum viscosity for easier expectoration
• Decreased frequency and severity of productive coughing episodes
• Improved bronchial airflow and oxygen exchange
• Enhanced efficacy of co-administered antibiotics in respiratory infections
• Supports faster recovery in acute bronchitis and COPD exacerbations
• Minimizes mucus plugging in chronic conditions like bronchiectasis

Common use

Bromhexine is primarily indicated for respiratory conditions where thick, tenacious mucus impairs airway function. This includes acute and chronic bronchitis, bronchiectasis, tracheobronchitis, and chronic obstructive pulmonary disease (COPD). It is also used as adjunctive therapy in pneumonia, sinusitis, and otitis media to improve mucus drainage. In pediatric practice, it may be prescribed for respiratory complications of cystic fibrosis or childhood bronchiolitis, though dosing requires careful adjustment.

Dosage and direction

Adults and children over 10 years: 8 mg (one tablet or 10 ml syrup) three times daily.
Children 5–10 years: 4 mg (half tablet or 5 ml syrup) three times daily.
Children 2–5 years: 2 mg (quarter tablet or 2.5 ml syrup) three times daily.
Tablets should be swallowed whole with water; syrup should be measured using the provided dosing cup. For optimal effect, administer after meals to minimize gastric irritation. Therapy typically continues for 7–14 days in acute conditions, though chronic use may be advised under medical supervision.

Precautions

Use with caution in patients with a history of gastric ulceration, as bromhexine may mildly increase gastric secretions. Hepatic or renal impairment necessitates dose adjustment—monitor transaminases and creatinine in prolonged use. Avoid in patients with poor cough reflex or compromised respiratory drive, as increased sputum volume without effective clearance may cause aspiration risk. Pregnancy Category B: use only if clearly needed; limited human data available. Not recommended during breastfeeding due to secretion in milk.

Contraindications

Hypersensitivity to bromhexine or any component of the formulation. Severe hepatic failure (Child-Pugh C). Acute peptic ulcer disease. Concomitant use with antitussives that suppress cough reflex. Not recommended in children under 2 years due to immaturity of respiratory and metabolic systems.

Possible side effect

Common (≥1/100): gastrointestinal discomfort, mild nausea, transient elevation of liver enzymes.
Uncommon (≥1/1000): diarrhea, headache, dizziness, rash.
Rare (<1/1000): allergic reactions including angioedema, anaphylaxis (discontinue immediately), Stevens-Johnson syndrome.
Most side effects are mild and resolve with continued use or dose reduction.

Drug interaction

May increase penetration and serum levels of amoxicillin, erythromycin, and cephalexin—monitor for antibiotic-related effects. No significant interactions with bronchodilators, corticosteroids, or anticoagulants. Theoretical increased risk of gastric erosion with NSAIDs; avoid concurrent use in susceptible patients. Does not affect CYP450 metabolism.

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 make up for a missed one. Maintain regular intervals to ensure consistent mucolytic action.

Overdose

No specific antidote exists. Symptoms may include nausea, vomiting, and gastritis. Gastric lavage is not routinely recommended; provide symptomatic treatment. Hemodialysis is ineffective due to high protein binding. Contact a poison control center for management guidance.

Storage

Store below 25°C in the original container, protected from light and moisture. Keep oral solution tightly closed. Do not freeze. Keep out of reach of children. Discard any unused portion 6 months after opening.

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 dosing. Do not self-medicate.

Reviews

“Prescribed bromhexine for chronic bronchitis—noticeable improvement in mucus clearance within 3 days. Coughed productively without strain.” — Maria K., 54
“Used in pediatric cystic fibrosis care as adjunct. Helps reduce chest physiotherapy duration. Well tolerated.” — Dr. A. Reynolds, Pulmonologist
“Effective but caused mild heartburn. Taken with food resolved the issue.” — James L., 61