"Bromhexin" is a drug that is used for the treatment of acute, chronic diseases accompanied by difficult to separate sputum. The main form of drug release is tablets.
The drug "Bromhexin" (tablets). Instruction: description, pharmacokinetics
The preparation contains the active substance bromhexine. Auxiliary components: lactose monohydrate, sugar, calcium stearate, starch.
The drug is well absorbed in the stomach, intestines, and then undergoes metabolic transformation in the liver. The drug is distributed throughout all body tissues. It is excreted by the kidneys as inactivated compounds. The half-life of the drug components reaches two hours. The drug is able to penetrate into the brain tissue through a small part of it can enter the fetus through the placenta. The release of the components of the drug may be slowed down in case of impaired renal function.
Medicinal product "Bromhexin" (tablets). Instructions for use: pharmacodynamics
The drug has a pronounced expectorant and weak antitussive effect. Mucolytic effects are associated with liquefaction and depolymerization of mucopolysaccharide, mucoprotein fibers. One of the most important features of the drug's action is the stimulation of the synthesis of endogenous surfactant. It also increases the activity of the ciliated epithelium.
The drug "Bromhexine Berlin-Chemie" (tablets). Instructions: method of application, dosage
Ingestion is the only way to use this drug. It is consumed regardless of food intake. For adults, the dose is four tablets three times in one day. In the course of therapy, it is recommended to consume a sufficient amount of water, which supports the secretolytic activity of the drug. The maximum treatment period is four weeks.
Medicinal product "Bromhexin" (tablets). Instructions: side effects
Among the many side effects most often there is an increase in the activity of liver transaminases, which is of a transient nature, headache, increased sweating, cough, skin rash, bronchospasm.
The drug "Bromhexin" (tablets). Instructions: contraindications, drug interactions
The drug should not be used in the presence of hypersensitivity to the components, peptic ulcer (exacerbation stage), in pregnancy. It is also contraindicated for children under six years of age.
It is allowed to prescribe this drug in combination with drugs of other groups that are used to treat bronchopulmonary diseases. It promotes the penetration of antibiotics into the lung tissue. The use in conjunction with codeine is unacceptable, this leads to difficulty in coughing up sputum. The drug is used in combination with herbal preparations, essential oils. Use in conjunction with alkaline solutions is also unacceptable.
Medicinal product "Bromhexin" (tablets). Instruction: special instructions, overdose
Patients with impaired renal function this drug it is prescribed in slightly smaller doses. With weak bronchial motility, a significant amount of secreted sputum, the use of the drug requires special care, this can cause a delay in the contents in the bronchi. Bronchial, asthma, stomach ulcer - diseases in which the drug should be used under medical supervision. The drug during periods of lactation, pregnancy is used only in rare cases.
Overdose symptoms: vomiting, nausea, bowel disorders. To date, no specific antidote for this drug has been developed. Therefore, all therapy in case of an overdose is reduced to gastric lavage, which should be carried out within the first two hours after taking the drug.
Bromhexine tablets are a mucolytic drug that is designed to improve the motility of the glands of the bronchial tree and synthesize the lung's own secretions, which reduces the viscosity of thick sputum that clogs the bronchial space. The drug has a pronounced expectorant effect, facilitates the excretion of mucus outside the lungs, softens a strong dry cough and promotes its transition to a productive form. This drug belongs to the category of low toxic drugs, therefore, it is well absorbed by the body of patients of different age groups. Bromhexine tablets practically do not affect blood circulation in the area of the respiratory system and have a minimum set of side properties.
The cost of this plate of Bromhexin tablets is 45-55 rubles. This package contains 10 tablets coated with a special coating so that the dissolution and absorption of the drug does not take place in the stomach, but in the intestines. This increases the therapeutic effect, and the active components of the drug in a larger volume enter the bloodstream, and with it directly into the lung tissue. The medicine is dispensed without special recipe attending physician, and can be purchased at almost every pharmacy that sells medicines.
Bromhexine tablets are intended for the treatment of severe dry cough of an infectious and cold origin. The drug is able to translate dry cough into its productive form due to the fact that it can liquefy thick phlegm to the limit until it begins to leave the lungs on its own during the next bronchial spasm. Due to the expansion of the bronchial space, the patient feels that his breathing has become much cleaner and easier, gas exchange improves, and the bloodstream is saturated with a large volume of oxygen. The latter physiological factor plays a key role in enhancing immunity and body resistance to infectious agents of pulmonary disease.
Contraindications
Bromhexine tablets do not have a large list of contraindications. The drug is well absorbed and practically does not provoke atypical reactions of the body. Still, you should refrain from taking this medication in the following cases, namely:
- In the first trimester of pregnancy. At this stage of fetal development in the body of the unborn child, the foundations for the stable functioning of all vital organs and systems are laid. Taking Bromhexine tablets by a pregnant woman can negatively affect the health of the child's respiratory system.
- Peptic ulcer disease. The drug slightly increases the general acidity of gastric juice, therefore, if the patient initially already has a predisposition to peptic ulcer disease and inflammatory processes in the digestive tract, then you should not carry out therapy with Bromhexine. Exacerbation of gastric ulcer threatens with serious consequences for the patient's health and may result in emergency hospitalization.
- Allergy. Individual susceptibility to allergic reactions to the active components of Bromhexine manifests itself in the form of urticaria, pruritus, profuse rashes on the abdomen, chest, neck and upper limbs... Particularly severe forms of allergies can manifest as bronchial spasm and swelling of the nasopharyngeal mucosa.
- Lactation. Breastfeeding a baby is the circumstance that prohibits the simultaneous administration of Bromhexine tablets. The active substances of the medication can enter the mother's milk, and with it into the baby's body. The child's reactions to this drug can be very different, but they are all negative and not conducive to strengthening the child's body.
- Stomach bleeding. There is a certain category of people who have congenital weakness of the capillary vessels of the stomach. Such patients suffer from periodic discharge of blood into the digestive organ. Bromhexine tablets are capable of activating this pathological process and provoking a larger release of blood. The latter condition of the body can lead to a sharp decrease in blood pressure and surgery to eliminate blood loss.
The attending physician, after examining the patient, can establish the presence of additional limiting factors that exclude the intake of Bromhexine tablets in view of the fact that this drug will not be advisable to use in a specific therapeutic case.
Indications for use
Bromhexin tablets are prescribed by the attending physician, a pulmonologist, if the following pulmonary diseases are detected in a patient, namely:
The attending physician may prescribe Bromhexine tablets as an independent drug, or as part of complex therapy to achieve maximum therapeutic effect in a short period of time.
Instructions for the use of Bromhexine tablets
The procedure for taking this medicinal product for patients of the adult age category and children is established individually. Accordingly, the therapeutic dosage is also determined as follows, namely:
For kids
A child whose age is from 1 to 2 years is indicated for taking 2 mg. the drug 3 times a day. Children aged 2 to 6 years receive a dosage of 4 mg. medicines 3 times a day. A child of the age category from 6 to 10 years old should take 6-8 mg. medication 3 times a day. Children over 10 years old already receive adult dosage which is in the range of 8 mg. 3-4 times a day.
For adults
Therapy for adult men and women involves taking Bromhexine in a dose of 8 to 16 mg. 4 times a day. This is the optimal amount of the drug, which allows you to effectively fight inflammation in the organs of the respiratory system, activate the secretory function of the bronchi and accelerate the outflow of sputum until complete recovery. The duration of one therapeutic course is from 10 to 15 days.
In most cases, in adults and children, the first signs of a therapeutic effect appear as early as 4-6 days from the start of taking Bromhexine tablets. At the insistence of the doctor, taking the medication may last longer than the period recommended in the instructions. Also, the drug is allowed to be used for the prevention of stagnation in the postoperative period, when the respiratory organs, and especially the lungs, have undergone surgery.
Side effects
Bromhexine tablets do not have a pronounced toxic effect, but despite this, the drug has a number of side effects. They appear in the form of the following atypical reactions of the body:
- Disorder of the gastrointestinal tract. Irritation of the gastric mucosa by the active components of Bromhexine tablets can lead to the patient beginning to experience nausea, abdominal pain, heaviness in the right hypochondrium, lack of appetite. The development of diarrhea and vomiting with dehydration is not excluded.
- Dizziness. Bromhexine practically does not affect blood circulation, but patients with weak cerebral vessels may experience moderate pain in the temples and the back of the head. In such cases, it is recommended that you stop taking the pills and take a pain reliever. You also need to measure your blood pressure. If it is increased, then you need to immediately call ambulance to stabilize the state of health.
- Allergy. Patients prone to allergic reactions may experience itchy skin, a red rash on various parts of the body (most often the rash is formed on the abdomen), urticaria, bronchial spasm, or swelling of the nasopharyngeal mucosa.
This is an exhaustive list of possible side effects that have been documented in multiple clinical trials. Also, do not discount the individual factor of each patient's organism. Other indirect manifestations of non-perception of the drug are not excluded. Therefore, in the process of treating pulmonological diseases with Bromhexin tablets, accompanied by a strong dry cough, it is necessary to listen to the behavior of your body.
Gross formula
C 14 H 20 Br 2 N 2Pharmacological group of the substance Bromhexine
Nosological classification (ICD-10)
CAS code
3572-43-8Characteristics of the substance Bromhexine
White crystalline powder. Let's slightly dissolve in water and alcohol.
Pharmacology
pharmachologic effect- expectorant, mucolytic, antitussive.Causes depolymerization of mucoprotein and mucopolysaccharide polymer molecules (mucolytic effect). Stimulates the production of endogenous surfactant, which ensures the stability of alveolar cells during respiration, their protection from adverse factors, improving the rheological properties of bronchopulmonary secretion, its sliding along the epithelium and the release of sputum from respiratory tract.
When taken orally within 30 minutes, it is almost completely (99%) absorbed into the gastrointestinal tract. Bioavailability is 80% due to the "first pass" effect through the liver. In plasma, it binds to proteins. Penetrates the BBB and placental barriers. In the liver, it undergoes demethylation and oxidation. Some of the metabolites formed remain active. T 1/2 - 1 hour, however, terminal T 1/2 reaches 15 hours due to slow reverse diffusion from tissues. Excreted by the kidneys. In severe hepatic failure, the clearance of bromhexine decreases, and in chronic renal failure, the excretion of its metabolites is impaired. May cumulate with repeated use.
Application of the substance Bromhexine
Acute and chronic bronchopulmonary diseases, accompanied by the formation of sputum of increased viscosity (bronchial asthma, pneumonia, tracheobronchitis, obstructive bronchitis, bronchiectasis, pulmonary emphysema, cystic fibrosis, tuberculosis, pneumoconiosis).
Contraindications
Hypersensitivity, peptic ulcer (in the acute stage), pregnancy (especially the first trimester), breast-feeding.
Restrictions on use
Diseases of the respiratory tract, accompanied by excessive accumulation of secretions; history of gastric bleeding; renal and / or hepatic impairment.
Application during pregnancy and lactation
In pregnancy, use is possible after a careful assessment of the risk / benefit ratio.
At the time of treatment, breastfeeding should be discontinued (it passes into breast milk).
Side effects of the substance Bromhexine
From the nervous system and sensory organs: dizziness, headache.
From the digestive tract: nausea, vomiting, dyspeptic disorders, abdominal pain, exacerbation of gastric ulcer and duodenal ulcer, increased activity of hepatic transaminases.
Allergic reactions: skin rashes, itching, urticaria, rhinitis, angioedema.
Others: shortness of breath, fever and chills.
Interaction
Bromhexine is not prescribed simultaneously with drugs that suppress the cough center (including codeine-containing drugs), because this can make it difficult for the liquefied sputum to pass. Bromhexine promotes the penetration of antibiotics (erythromycin, cephalexin, oxytetracycline, amoxicillin) and sulfa drugs into the lung tissue. Incompatible with alkaline solutions.
Overdose
Symptoms: increased side reactions.
Treatment: artificial vomiting, fluid intake (milk or water) in the first 1-2 hours after administration, symptomatic therapy.
Route of administration
Inside.
Precautions for the substance Bromhexine
In the course of treatment, it is recommended to consume a sufficient amount of liquid, which supports the secretolytic effect of bromhexine. In cases of impaired bronchial motility or with a significant amount of sputum secreted, the use of bromhexine requires caution due to the risk of delayed secretions in the airways.
The occurrence of Stevens-Johnson and Lyell syndromes has been reported very rarely. If changes occur on the skin or mucous membranes, the drug should be discontinued.
Interaction with other active ingredients
Trade names
| Name | The value of the Vyshkovsky Index ® |
| 0.0186 | |
| 0.0152 | |
| 0.0052 | |
| 0.0034 | |
| 0.0032 | |
| 0.0017 | |
| 0.0006 | |
| 0.0005 | |
| 0.0005 | |
| 0.0005 | |
Bromhexine Berlin Chemie refers to the instruction for use as a means of stimulating the motor function of the respiratory tract and secretolytics. Tablets 4 mg and 8 mg, syrup, solution have mucolytic, expectorant and bronchodilator effects. Reviews of patients and recommendations of doctors indicate that this drug helps in the treatment of cough, including dry cough, with bronchitis and asthma.
Release form and composition
Bromhexine is available in the following dosage forms:
- Tablets 8 mg (in cell packs and cans of various packaging).
- Syrup 4 mg / 5 ml (in bottles of 60 and 100 ml).
- Tablets for children 4 mg (in blisters of 10 pieces).
- Oral solution 4 mg / 5 ml (in 100 ml vials).
The active ingredient of the drug is bromhexine hydrochloride.
pharmachologic effect
Bromhexine reduces the viscosity of bronchial secretions, as it depolarizes the acidic polysaccharides contained in it and stimulates the secretory cells of the bronchial mucosa, which produce secretions containing neutral polysaccharides.
The main active ingredient, bromhexine hydrochloride, provides a weak antitussive effect. The drug liquefies phlegm, increases its volume and stimulates discharge. It also improves the formation of surfactant, which stabilizes alveolar cells during the respiratory process.
The effect of taking the medication becomes noticeable 2-5 days after the start of the medication. Taking Bromhexine tablets and other forms of drug release does not lead to its accumulation in the body, it is excreted mainly by the kidneys in the urine, mainly in the form of metabolites.
What helps Bromhexine Berlin Chemie?
Indications for the use of the drug include diseases of the respiratory tract, the course of which is associated with the formation of a viscous secretion that is difficult to separate:
- Cystic fibrosis.
- Chronic bronchitis with a broncho-obstructive component.
- Tracheobronchitis.
- Chronic pneumonia.
- Bronchial asthma.
Instructions for use
Bromhexine tablets and solution are taken orally:
- adults and children over 10 years old - 8 mg 3-4 times a day;
- children under the age of 2 years - 2 mg 3 times a day;
- at the age of 2 to 6 years - 4 mg 3 times a day;
- at the age of 6 to 10 years - 6-8 mg 3 times a day.
If necessary, the dose can be increased for adults up to 16 mg 4 times a day, for children - up to 16 mg 2 times a 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 - 2 mg each. At the age of 6 years - used in doses up to 2 mg. Inhalations are carried out 2 times a day. The therapeutic effect may appear on the 4th-6th day of treatment.
Parenteral administration is recommended for treatment in severe cases, as well as in the postoperative period to prevent the accumulation of thick mucus in the bronchi. Enter 2 mg subcutaneously, intramuscularly or intravenously 2-3 times a day slowly for 2-3 minutes.
Contraindications
Before taking Bromhexine in tablets or syrup, you should familiarize yourself with the contraindications to its use. Absolute contraindications include:
- personal hypersensitivity;
- lactation;
- peptic ulcer of the gastrointestinal tract in the period of exacerbation;
- pregnancy in the first trimester;
- sugar intolerance;
- children up to 2 years old for syrup and up to 6 years old for tablets.
Side effects
Usually Bromhexine is well tolerated. However, in rare cases, some unwanted effects may occur: 
- angioedema;
- dizziness;
- anaphylactic reactions;
- Stevens-Johnson syndrome;
- increased cough;
- diarrhea;
- hives;
- Lyell's syndrome;
- an increase in the activity of aminotransferases in the blood;
- dyspeptic disorders;
- nausea;
- exacerbation of peptic ulcer of the duodenum and stomach;
- bronchospasm;
- vomit;
- breathing disorder;
- increased sweating;
- stomach pain;
- skin rashes;
- itchy skin;
- headache;
- chills;
- anaphylactic shock.
Children, during pregnancy and breastfeeding
It is prescribed if the expected benefit to the mother outweighs the expected risk to the fetus or child.
Syrup and tablets are contraindicated in children under 2 years of age. For children under 6 years old, in view of the dosage characteristics, it is advisable to take syrup, over 6 years old - syrup and tablets for children.
special instructions
In the treatment of patients suffering from gastric ulcer, as well as those with a history of gastric bleeding, the use of the drug should be carried out under the supervision of a physician. Patients diagnosed with bronchial asthma are prescribed Bromhexine with caution.
It is not recommended to take the medicine at the same time as drugs that contain codeine, which is explained by the difficulty in coughing up liquefied sputum. Bromhexine can be used in combined herbal preparations containing essential oils(including menthol, eucalyptus oil, peppermint oil, anise).
Drug interactions
Do not prescribe in parallel with antitussive drugs (for example, codeine-containing drugs), due to the difficulty in the discharge of bronchial secretions.
A combined intake with NSAIDs can irritate the gastrointestinal mucosa and even lead to the formation of erosions and ulcers.
The use of Bromhexine favors the penetration of sulfonamide drugs and antibiotics (Oxytetracycline, Erythromycin, Amoxicillin, Cephalexin) into the bronchial secretions, in the first 4-5 days of antibiotic therapy.
Analogues of the drug Bromhexin
By structure, analogs are determined:
- Vero-Bromhexine.
- Phlegamin.
- Bromhexine Berlin-Chemie (MS; Grindeks; Nycomed; -Ruspharm; -Acri; -Egis;).
- Solvin.
- Flekoxin.
- Bronchotil.
Analogues in action include:
- Acestin.
- Acetylcysteine.
- Fluditek.
- Fluimucil
- Ascoril.
- AmbroHexal.
- Libeksin.
- Bronhosan.
- Flavamed.
- Bronchoxol.
Vacation conditions and price
The average price of Bromhexine (8 mg tablets No. 50) in Moscow is 30 rubles.
Available without a prescription. Store in a dry, dark place at a temperature not exceeding 25 ° C. The shelf life is 5 years.
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I N S T R U K C I Z
on the medical use of the drug
Bromhexine
Composition of the medicinal product.
Active substance: bromhexine;
1 tablet contains bromhexine hydrochloride 8 mg;
lactose, sugar, ruberosum, potato starch, calcium stearate.
Dosage form. Tablets.
The tablets are pink.
Pharmacotherapeutic group.
Mucolytic agents. ATC code R05C B02.
Pharmacological properties.
Bromhexine has mucolytic (secretolytic) and expectorant effects. It determines where is the polymerization of mucoprotein and mucopolysaccharide polymer molecules (mucolytic effect). Stimulates the production of endogenous surfactant, which ensures the stability of alveolar cells during respiration, their protection from adverse factors, improves the rheological properties of bronchopulmonary secretion, promotes its flow through the epithelium and the elimination of sputum from the respiratory tract.
When taken orally within 30 minutes, it is almost completely (99%) absorbed. Bioavailability is 80% due to the "first pass" effect through the liver. In plasma, it binds to proteins. Penetrates the blood-brain and placental barriers. In the liver, it is subject to demethylation and oxidation. Some of the metabolites formed retain their pharmacological activity. The elimination half-life is 1 hour, but the final elimination half-life reaches 15 hours due to slow reverse diffusion from tissues. Excreted by the kidneys. In severe hepatic failure, the clearance of bromhexine decreases, and in chronic renal failure, the release of its metabolites is impaired. May cumulate with repeated use.
INDICATIONS
Sharp and chronic diseases bronchi and lungs, accompanied by a violation of the formation and passage of sputum.
Contraindications
Hypersensitivity to the components of the drug, pregnancy (especially in the first trimester), breastfeeding. Childhood up to 6 years old. Relative contraindications: peptic ulcer of the stomach and duodenum, diseases of the respiratory system, the course of which is accompanied by education a large number liquid sputum, impaired renal and liver function.
Necessary safety measures during application.
Use with caution in patients with bronchial asthma. During treatment, it is necessary to take a sufficient amount of liquid, which increases the expectorant effect of bromhexine. The drug should be used with caution if the patient has a violation of bronchial motility, accompanied by the formation of a large amount of bronchial secretions (primary ciliary dyskinesia).
With gastric ulcer, as well as with indications for gastric bleeding in history, Bromhexine should be used under the supervision of a physician.
In case of impaired renal function and severe liver disease, the drug should be used with great caution (lengthen the time intervals of drugs or reduce their dose).
In acute renal failure, the possibility of accumulation of bromhexine metabolites in the liver should be considered.
When any disorders of the skin or mucous membranes appear for the first time when using bromhexine hydrochloride, the drug should be discontinued immediately (this may be the beginning of the development of such severe complications as Stevens-Johnson syndrome or Lyell's syndrome).
Application during pregnancy or lactation.
The drug is not used during pregnancy. During treatment with the drug, breastfeeding should be discontinued.
The ability to influence the reaction rate when driving a car or when working with other mechanisms.
During the period of drug treatment, one should refrain from driving vehicles and working with other mechanisms.
Children. The drug in this dosage form children under 6 years of age are not used. In children over 6 years of age, it is recommended to combine the treatment with vibration massage of the chest, which facilitates the removal of secretions from the bronchi.
Method of administration and dosage
The drug is taken orally after meals with plenty of liquid. Adults and adolescents over 14 years old: 8-16 mg (1-2 tablets) 3 times a day. Children from 6 to 14 years old, as well as patients weighing less than 50 kg: 8 mg (1 tablet) 3 times a day. The duration of treatment is determined individually, according to the indications and dynamics of the development of the disease, but it should not exceed 4-5 days without the appropriate doctor's recommendation. In the presence of impaired renal function or severe liver disease, the dose of the drug should be reduced accordingly.
Overdose.
Symptoms: dyspeptic disorders, nausea, vomiting, diarrhea. Dizziness, headache, ataxia, diplopia, metabolic acidosis, rapid breathing. Treatments. In case of significant overdose, monitoring should be carried out of cardio-vascular system and, if necessary, prescribe symptomatic therapy. Due to a high degree of binding to plasma proteins, a large volume of distribution and a slow reverse distribution of bromhexine from tissues into the blood, one should not expect an acceleration of drug excretion during hemodialysis or forced diuresis.
Side effects.
From the side of the digestive system: stomach pain, dyspeptic disorders, nausea, vomiting, diarrhea, exacerbation of gastric ulcer and duodenal ulcer, a transient increase in the activity of aminotransfer ases in the blood serum.
From the side of the central nervous system: headache (like a migraine), dizziness, chills.
On the part of the skin: increased sweating.
From the respiratory system: increased cough, bronchospasm, respiratory distress.
From the immune system: urticaria, skin rashes, pruritus, angio-neurotic edema, anaphylactic reactions, including anaphylactic shock, Stevens-Johnson syndrome and Lyell's syndrome.
Interaction with other medicinal products and other types of interactions.
Bromhexine can be prescribed in combination with bronchodilators, antibacterial drugs, drugs that are used in cardiology.
Bromhexine is not used with agents that irritate the gastric mucosa. They are also not used simultaneously with drugs containing codeine, since this prevents the expectoration of diluted sputum.
Bromhexine promotes the penetration of antibiotics (amoxicillin, erythromycin, cephalexin, oxytetracycline), sulfa drugs into bronchial secretions in the first 4-5 days of antimicrobial therapy.
Best before date. 3 years.
Storage conditions. Store in a dry place at a temperature not exceeding 25 ° C.
Package. There are 20 tablets in a blister.