Bromhexine hydrochloride: Uses, dosages and side effects

The article was written by Pharmacist Nguyen Thu Giang - Clinical Pharmacist, Faculty of Pharmacy - Vinmec Times City International Hospital

Bromhexin is a widely used drug to treat cough with phlegm and is easily purchased without a prescription in pharmacies with many different brand names, both oral tablets and syrups suitable for the subjects. vary from children to adults. However, that does not mean that you can abuse the drug.

Bromhexin is a substance with expectorant effect. By activating sialomucin synthesis and breaking down mucopolysaccharide acid fibers, the drug makes sputum more fluid and less viscous. Helps sputum from the bronchi to escape effectively. When taken orally, it usually takes 2-3 days to have clinical effects.
According to the 2015 National Pharmacopoeia, the drug is indicated in the following cases: bronchial secretion disorders, especially in acute bronchitis, acute exacerbation of chronic bronchitis. Bromhexine is often used as an adjuvant to antibiotics, when severe respiratory infections are present.

According to the manufacturer's recommendations, the dosage of bromhexin is:
Children 2-5 years old: 4mg/time x 2 times/day Children over 5 years old - 12 years old: 4mg/time x 4 times/day Children over 12 Age and adults: 8mg/time x 3 times/day. Dosage can be up to 12mg / time x 4 times / day, but it is necessary to consult a doctor.

When using Bromhexin, caution should be taken:
Should be avoided in combination with other cough medicines because of the risk of sputum stagnation in the respiratory tract. When used in patients with a history of peptic ulcers, caution must be exercised because of its mucolytic effect, which can cause damage to the gastric mucosal barrier. When used in asthmatics because bromhexine can cause bronchospasm in some susceptible people. When administered to patients with severe hepatic or renal impairment: close monitoring is required because clearance of bromhexine and its metabolites may be reduced. When used for the elderly or debilitated too weak, children, especially children under 2 years old because of the inability to effectively expectorate sputum, thus increasing sputum stasis. Possible undesirable effects when using the drug are:
Gastrointestinal: Epigastric pain, nausea, vomiting, diarrhea, dry mouth, increased liver enzymes Nervous: Headache, dizziness, sweating. Skin: Skin rash, urticaria. Respiratory: Risk of stagnation of bronchial secretions in patients unable to expectorate sputum.

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Source: Vietnam National Pharmacopoeia 2015, SPC