Bromhexine tablets instructions for use. Bromhexine. Instructions for the drug, use, price, release forms. Gastrointestinal disorders

Tradename: Bromhexine.

International nonproprietary name: Bromhexine.

Release form: tablets 8 mg.

Description: pills white, flat-cylindrical, with a chamfer.

Compound: one tablet contains: active substance - bromhexine hydrochloride – 8 mg; Excipients: sucrose, lactose monohydrate, potato starch, stearic acid 95, microcrystalline cellulose type 101.

Pharmacotherapeutic group: remedies used for coughs and colds. Expectorants, excluding combinations with antitussives. Mucolytics.

ATX code: R05CB02.

Hypersensitivity to bromhexine and/or to any auxiliary component of the drug, including lactose and sucrose, peptic ulcer of the stomach and duodenum in the acute phase, pregnancy (first trimester), lactation period, children's age (up to 3 years ).

Tablets should be taken orally, after meals, with big amount liquids.

Adults and adolescents over 14 years of age are prescribed 1 - 2 tablets (8 - 16 mg) 3 times a day.

Children and adolescents from 6 to 14 years old, as well as persons weighing less than 50 kg, 1 tablet (8 mg) 3 times a day. Children under 6 years of age should take lower dosage forms.

Children under 6 years of age should take lower dosage forms of bromhexine and only on the recommendation of a doctor.

The therapeutic effect can appear on days 4-6 of treatment. The course of treatment is from 4 to 28 days (determined individually depending on the indications and course of the disease). Patients with renal failure or impaired liver function are prescribed lower doses or increase the interval between doses.

Suction: When taken orally, bromhexine is almost completely (99%) absorbed from the gastrointestinal tract within 30 minutes. Cmax in the blood is reached approximately 1 hour after taking the drug.

Distribution: bioavailability is low (about 20%) due to the “first pass” effect through the liver. Binding to blood proteins is high and amounts to 80-90% (on average 95%), penetrates the blood-brain and placental barriers. 2 hours after oral administration, the accumulation of bromhexine in the lung tissue is recorded, exceeding the level in plasma by 1.5-4.5 times.

Metabolism: in the liver, bromhexine undergoes demethylation and oxidation, and is metabolized to the pharmacologically active ambroxol.

Removal: the half-life (T ½) is 15 hours due to slow reverse diffusion from tissues. Excreted by the kidneys. After oral administration of radiolabeled bromhexine, 97.4 ± 1.9% of the dose was found in the urine, of which less than 1% was unchanged. In chronic renal failure, the excretion of metabolites is impaired. Total clearance 800 ml/min; determined solely by hepatic blood flow. In severe liver failure, the clearance of bromhexine decreases, and in chronic liver failure, the clearance of its metabolites decreases. After repeated dosing, no signs of accumulation were found. The cumulation coefficient is 1.1.

The pharmacokinetics of bromhexine in the elderly or in patients with hepatic or renal impairment have not been studied. Experience with this drug in these patient groups is limited. Due to the slower elimination of bromhexine in patients with severe liver and kidney diseases, it is recommended to increase the interval between its use.

Pharmacokinetic interactions

No interaction studies have been conducted with oral anticoagulants and digoxin. Co-administration of ampicillin, oxytetracycline or erythromycin does not affect the pharmacokinetics of bromhexine.

I N S T R U C T I O N

on 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. Pills.

Pills Pink colour.

Pharmacotherapeutic group.

Mucolytic agents. ATC code R05C B02.

Pharmacological properties.

Bromhexine has a mucolytic (secretolytic) and expectorant effect. Determines where the polymerization of mucoprotein and mucopolysaccharide polymer molecules occurs (mucolytic effect). Stimulates the production of endogenous surfactant, which ensures the stability of alveolar cells during breathing, their protection from adverse factors, improves the rheological properties of bronchopulmonary secretions, promotes its flow through the epithelium and the removal 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 through the blood-brain and placental barriers. In the liver it is subject to demethylation and oxidation. Some of the metabolites formed retain pharmacological activity. The half-life is 1 hour, but the final half-life reaches 15 hours due to slow reverse diffusion from tissues. Excreted by the kidneys. In severe liver failure, the clearance of bromhexine is reduced, and in chronic renal failure, the release of its metabolites is impaired. May accumulate with repeated use.

INDICATIONS

Acute and chronic diseases of the bronchi and lungs, accompanied by impaired formation and circulation of sputum.

Contraindications.

Hypersensitivity to the components of the drug, pregnancy (especially in the first trimester), breastfeeding. Children's age up to 6 years. Relative contraindications: gastric ulcer and duodenum, diseases of the respiratory system, the course of which is accompanied by the formation large quantity liquid sputum, impaired renal and liver function.

Necessary safety measures during use.

Use with caution in patients suffering from bronchial asthma. During treatment, it is necessary to take a sufficient amount of fluid, which increases the expectorant effect of bromhexine. The drug should be used with caution if the patient has a disorder of bronchial motility, accompanied by the formation of a large amount of bronchial secretion (primary ciliary dyskinesia).

For gastric ulcers, as well as for indications of gastric bleeding in the anamnesis, Bromhexine should be used under the supervision of a physician.

In case of impaired renal function and severe liver diseases, the drug should be used with great caution (extend the duration of the medication or reduce its dose).

In acute renal failure, the possibility of accumulation of bromhexine metabolites in the liver should be taken into account.

When any disorders of the skin or mucous membranes appear for the first time when using bromhexine hydrochloride, you should immediately stop using the drug (this may be the beginning of the development of severe complications such as Stevens-Johnson syndrome or Lyell's syndrome).

Use during pregnancy or breastfeeding.

The drug is not used during pregnancy. During treatment with the drug, breastfeeding should be stopped.

The ability to influence the reaction speed when driving a vehicle or when working with other mechanisms.

During treatment with the drug, you should refrain from driving and operating other mechanisms.

Children. The drug in this dosage form Do not use for children under 6 years of age. In children over 6 years of age, it is recommended to combine treatment with vibration massage of the chest, which facilitates the removal of secretions from the bronchi.

Directions for use and doses

The drug is taken orally after meals with plenty of liquid. Adults and adolescents over 14 years of age: 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 disease, but it should not exceed 4-5 days without appropriate doctor’s advice. 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, the cardiovascular system should be monitored and, if necessary, symptomatic therapy should be prescribed. Due to the high degree of binding to plasma proteins, large volume of distribution and slow reverse distribution of bromhexine from tissues to the blood, one should not expect accelerated elimination of the drug during hemodialysis or forced diuresis.

Side effects.

From the digestive system: stomach pain, dyspeptic disorders, nausea, vomiting, diarrhea, exacerbation of gastric and duodenal ulcers, transient increase in the activity of aminotransferases in the blood serum.

From the central nervous system: headache (migraine type), dizziness, chills.

Skin: increased sweating.

From the respiratory system: increased cough, bronchospasm, breathing disorders.

From the immune system: urticaria, skin rashes, itching, angioneurotic edema, anaphylactic reactions, including anaphylactic shock, Stevens-Johnson syndrome and Lyell's syndrome.

Interaction with other drugs and other types of interactions.

Bromhexine can be prescribed in combination with bronchodilators, antibacterial drugs, means that are used in cardiology.

Bromhexine is not used with drugs that irritate the gastric mucosa. It is also not used simultaneously with medications containing codeine, since this prevents the expectoration of thin mucus.

Bromhexine promotes the penetration of antibiotics (amoxicillin, erythromycin, cephalexin, oxytetracycline), sulfonamide 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. 20 tablets in a blister.

Bromhexine is a prominent representative of the group of mucolytics and secretomotor drugs. It is a synthetic analogue of a plant called Justitia vascularis, but with less pronounced side effects compared to the extract of this plant. Due to the special structure of the molecule, bromhexine and its metabolites are able to simplify the structure of mucopolysaccharides. In other words, the drug helps to “unwind” mucopolysaccharide molecules and thereby reduce their ability to capture water molecules. As this ability decreases, the mucus liquefies.


In addition to this effect on mucus, bromhexine can also affect the cells that produce it. The result of this effect is the production of more less viscous mucus, as well as an increase in the production of surfactant in the lungs. Surfactant is a substance necessary for the alveoli of the lungs to expand after exhalation. In the absence of surfactant, a condition called respiratory distress syndrome occurs. It is manifested by progressive shortness of breath, bluish discoloration of the skin and mucous membranes and, ultimately, the death of the patient if appropriate medical care is not provided.

The third effect of the drug is its ability to stimulate the excretion of formed liquid sputum by increasing the oscillatory movements of the villi of the respiratory epithelium. As a result, mucus accumulates in the lumen of large bronchi and the trachea, which has a large number of cough receptors. Excess sputum irritates the above-mentioned receptors and a reflex coughing up of mucus occurs, accompanied by its removal from the bronchial tree.

Bromhexine has high bioavailability. In other words, this drug is able to penetrate absolutely all tissues of the body, overcoming all biological barriers. In accordance with the above, the drug is contraindicated for pregnant women in the second and third trimester, as well as nursing mothers, since it can disrupt the process of lung formation of both the fetus and the born child. However, if the child itself is ill, the use of the drug is justified.

Types of medication, commercial names of analogues, release forms

Bromhexine is available in the following dosage forms:

• pills;
• dragee;
• elixir;
• syrup;
• drops for oral administration ( oral solution).

Tablets and dragees can be used by both adults and children aged two years and older. For younger children, it is recommended to use oral drops, syrup and elixir due to the fact that they make it easier to dose the drug as opposed to tablets. 1 ml of solution for oral administration of syrup and elixir contains 0.8 mg of the active substance.

Bromhexine is found in pharmacies under the following commercial names:

• Bromhexine Berlin-Chemie;
• Phlegamine;
• Bronchostop;
• Solvin;
• Bromhexine-ratiopharm;
• Bromhexine-Egis et al.

Manufacturers of Bromhexine

Firm manufacturer		Commercial name drug	Manufacturer country	Release form	Dosage
Berlin-Chemie		Bromhexine 4 Berlin-Chemie	Germany	Oral solution (4 mg in 1 ml solution)	INadults and children over 14 years of age the drug is prescribed in a dose of 8–16 mg ( 10 – 20 ml of mixture) 3 times a day. the drug is prescribed in a dose of 8 mg ( 10 ml) 3 times a day. Children under 6 years old the drug is prescribed in a dose of 2–4 mg ( 2.5 and 5 ml) 3 times a day.
Berlin-Chemie		Bromhexine 8 Berlin-Chemie	Germany	Dragee (8 mg/dragée)	For adults and children the drug is prescribed in an amount of 8–16 mg ( 1 – 2 dragees) 3 times a day. Children from 6 to 14 years old and patients weighing less than 50 kg the drug is indicated in an amount of 8 mg ( 1 dragee) 3 times a day. Children under 6 years old 2 – 4 mg ( half or quarter pellet) 3 times a day. However, due to the fact that the pills are inconvenient to divide into parts, children under 6 years of age are recommended to use syrups, elixirs and oral solutions.
Pharbita		Bromhexine	Netherlands	Pills (8 mg)	the drug is prescribed in a dose of 8–16 mg ( 1 – 2 tablets) 3 times a day. Children from 6 to 14 years old It is recommended to take the drug in an amount of 8 mg ( 1 tablet) 3 times a day. Children under 6 years old 2 – 4 mg ( half and quarter tablets) 3 times a day.
Pharmstandard-Leksredstva		Bromhexine	Russia
Pliva Krakow		Phlegamine	Poland	Syrup (2 – 4 mg/5 ml)	Children under 6 years old indicated from 2 to 4 mg of the drug 3 times a day. Children from 6 to 14 years old and patients weighing less than 50 kg the drug is indicated at a dose of 8 mg 3 times a day. Children over 14 years old and adults the drug is prescribed in an amount of 8–16 mg 3 times a day.
Wave International		Bromhexine elixir	India	Elixir (4 mg/5 ml)	Adults and children over 14 years old prescribed in a dose of 8 – 16 mg ( 10 – 20 ml). Children from 6 to 14 years old and patients weighing less than 50 kg – 8 mg ( 10 ml) 3 times a day. Children under 6 years old – 2 – 4 mg ( 2.5 and 5 ml).

The mechanism of therapeutic action of the drug

Once in the gastrointestinal tract, bromhexine almost completely penetrates the blood and spreads throughout the body. The maximum concentration of the drug in the blood is achieved after two hours. As bromhexine enters the liver, its gradual restructuring occurs with the formation of intermediate metabolites, which also have a pronounced mucolytic and secretomotor effect. The best known metabolite of bromhexine is a drug called ambroxol. Bromhexine is a drug that can accumulate in tissues, so its initial mild effect occurs 2–4 hours after the first use, and the maximum effect develops starting from 4–5 days of treatment.

Both bromhexine and its metabolites affect both mucus and the cells that produce it. Due to the fact that this drug is not able to selectively affect the respiratory epithelium, its effect extends to other mucous cells of the body. This feature explains some of the side effects of bromhexine, described below. In addition, the drug is able to penetrate the biological barriers of the body - blood-brain, hematoplacental, as well as into breast milk, and therefore bromhexine is contraindicated for pregnant women in the second and third trimester during normal pregnancy, as well as for nursing mothers. In the first trimester, the use of the drug is allowed, since the intensive development of fetal lung tissue begins approximately only from the fifth month of intrauterine development. If there is an urgent need to prescribe drugs from this group to a nursing mother, the child must be transferred to artificial feeding for the duration of her treatment.

Upon contact with mucus, bromhexine acts on the mucopolysaccharides that make up its composition and “unwinds” them, simplifying the structure of the latter. As the structure becomes simpler, the ability of mucopolysaccharides to bind water molecules decreases, which is externally manifested by a decrease in mucus viscosity. Upon contact with mucus-forming cells, bromhexine binds to specific receptors on the cell surface, triggering a cascade of complex biochemical reactions. As a result, mucous cells begin to produce more secretion of reduced viscosity.

In addition to the above effects, bromhexine accelerates the maturation of alveolocytes - cells located in the alveoli of the lungs and producing a specific secretion called surfactant. Surfactant is vital for normal breathing in any mammal, as it is responsible for keeping the alveoli apart during inspiration. In its absence, a condition called respiratory distress syndrome develops. It is manifested by shortness of breath, blueness of the skin and mucous membranes, loss of consciousness and, ultimately, the death of the patient. Therefore, bromhexine can be prescribed to pregnant women in the second and third trimester, however, only if there is a threat of premature birth. The purpose of prescribing the drug is to prevent respiratory distress syndrome in a newborn by accelerating the maturation of alveolocytes in his lungs.

The last but not least important property of bromhexine is the ability to accelerate the oscillatory movements of the villi lining the epithelium of the respiratory tract. Through this, liquid sputum is mechanically removed from the bronchial tree, causing it to accumulate in the upper airways and irritate the cough receptors. As a result, the cough is reduced and becomes productive ( coughing up phlegm) and less painful.

Due to the fact that the drug is metabolized by the liver and excreted from the body by the kidneys, diseases of these organs can lead to the accumulation of the drug in the body and, ultimately, to its overdose. For this reason, in patients with chronic liver failure and renal failure, it is important to adjust the dose based on the function of the above organs. Liver functionality is checked through tests such as the level of prothrombin, fibrinogen, bilirubin, etc. Kidney functionality is assessed by determining creatinine clearance.

For what pathologies is it prescribed?

Bromhexine is indicated for diseases of the bronchopulmonary system accompanied by the formation of viscous sputum. Such diseases are acute and chronic bronchitis, pneumonia, bronchiectasis, bronchial asthma, chronic obstructive pulmonary disease, cystic fibrosis, tuberculosis, silicosis, etc. Also in some countries of the world, the use of bromhexine and its analogues is practiced to prevent neonatal distress syndrome.

Application of bromhexine

Name of the disease	Mechanism of therapeutic action	Dosage of the drug
Acute and chronic bronchitis	Bromhexine affects the mucous cells of the respiratory epithelium, causing them to secrete less viscous sputum in larger quantities. The drug reduces the viscosity of the mucus itself by simplifying the structure of the mucopolysaccharides included in its composition. In addition, bromhexine increases the frequency of oscillatory movements of the villi of the respiratory epithelium, which results in accelerated secretion of sputum from the bronchi. The drug can be used to prevent neonatal distress syndrome, but in practice, the metabolite of bromhexine, ambroxol, is more often used for this purpose.	Adults and children over 14 years old the drug is indicated in a dose of 8 – 14 mg 3 – 4 times a day. Children from 6 to 14 years old and patients weighing less than 50 kg the drug is prescribed at 8 mg 3 times a day.
Pneumonia
Bronchiectasis of the lungs
Bronchial asthma
Chronic obstructive pulmonary disease
Tuberculosis
Silicosis
Cystic fibrosis		Due to the need to take the drug daily, it is extremely important to choose the optimal dose that causes the desired effect and is not complicated by adverse reactions. Thus, medium doses of the drug are initially prescribed, which are gradually reduced to a level at which their effect is maintained and adverse reactions are minimal.

How to use the medicine?

Bromhexine is taken with or after meals. The frequency of administration and dose should correspond to the age of the patient and the severity of his disease.

Adults and children over 14 years old Bromhexine is prescribed mainly in the form of tablets and dragees 3 - 4 times a day, 8 - 16 mg.

Children from 6 to 14 years old the drug is indicated in the form of syrups containing 8 mg in one dose 3 times a day.

Taking bromhexine should be accompanied by an increase daily consumption fluid due to the fact that the drug accelerates its elimination through the lungs. If the patient has chronic renal or liver failure, the dose of the drug must be reduced or the interval between doses increased to avoid overdose.

Possible side effects

Bromhexine may cause the following side effects:

• allergic reactions;
• violations by gastrointestinal tract;
• disorders of the central nervous system;
• other adverse reactions.

Allergic reactions

Allergic reactions are a manifestation of a hypertrophied response of the body upon contact with a substance that is absolutely harmless and normally never causes tissue damage. Signs of allergy never develop at the first contact of the body with an allergen, since the development of immune aggression requires specific antibodies and immune cells sensitized against the allergen. To create them, the body requires an average of two weeks.

Bromhexine may cause the following allergic reactions:

• contact dermatitis;
• Quincke's edema ( angioedema);

Hives
Hives are the most common manifestation of allergies. The cause of its development in most cases is the consumption of an allergen with food. Subsequently, after 15–30 minutes, a pinpoint rash appears on the patient’s stomach, back, thighs, buttocks, neck, and elbows, slightly visible above the surface of the skin. The appearance of a rash is often accompanied by itching of varying intensity. As the allergy progresses, the affected area expands, and the elements of the rash merge and protrude more strongly above the surface of the skin, forming blisters. The size of the blisters can vary - from 1 - 2 centimeters to 20 - 30 cm in diameter, especially on the torso.

Contact dermatitis
This manifestation allergic reaction characteristic of skin contact with an allergen. In this case, an allergic rash appears in the form of blisters, as with urticaria, but the contours of the lesion clearly correspond to the boundaries of contact between the skin and the allergen.

Quincke's edema
Quincke's edema, or angioedema, is a specific type of allergic reaction that often develops in response to an allergen coming into contact with the mucous membrane of the nose or mouth. A feature of Quincke's Edema is the predominant damage to loose connective tissue located around the eyes and mouth, in the cheeks, lips, earlobes, scrotum, labia, etc. A distinction is made between acute and chronic edema. Acute swelling develops within a few minutes and poses an immediate threat to the patient's life, as it tends to spread to the vocal cords. Swelling of the vocal cords sharply reduces the amount of air entering the lungs, up to the complete cessation of its circulation. Chronic edema develops according to the same scenario, but much longer. In this case, the patient has at least 6 to 8 hours to seek medical help.

Anaphylactic shock
Anaphylactic shock or anaphylaxis develops in most cases when a certain amount of allergen enters the patient’s blood. In this case, a highly sensitized body immediately releases a huge amount of antibodies into the blood. As a result, antibodies attack the allergen, form complexes with it, which are deposited on the inner lining of the blood vessels and cause local inflammation. Given the fact that the number of circulating immune complexes is enormous, the inflammatory response caused by their deposition is also pronounced. Inflammation is accompanied by the release of substances into the blood that lead to vasodilation ( histamine, serotonin, bradykinin, etc.), and, accordingly, a decrease in blood pressure. Thus, the clinical manifestation of anaphylaxis is a sharp drop in blood pressure with loss of consciousness after the allergen enters the blood.

Gastrointestinal disorders

As stated earlier, bromhexine reduces the viscosity of the secretions of all glands of the body, including the gastric ones. The mucus on the inner surface of the stomach protects it from the aggressive action of hydrochloric acid contained in gastric juice. When mucus is liquefied by high doses or long-term use Bromhexine causes corrosion of the gastric mucosa, accompanied by the formation of erosions and even peptic ulcers.

In addition to the above side effect Bromhexine can sometimes lead to irregular bowel movements, unpleasant taste in the mouth, heartburn, nausea, vomiting, etc.

Central nervous system disorders

Due to the fact that bromhexine is able to penetrate the blood-brain barrier and directly affect neurons in the brain, its use in certain cases can lead to a number of side effects. The chance of unwanted effects from this drug increases when you take an overdose, especially over a long period of time.

The most common side effects from the nervous system are:

• severe weakness;
• dizziness;
• nausea;
• paresthesia ( goosebump sensation);
• increase in body temperature ( rarely) and etc.

Other adverse reactions

Side effects included in this subgroup are associated partly with the weak dehydrating effect of bromhexine, partly with its effect on the autonomic nervous system in people with vegetative-vascular dystonia.

Among the side effects of this group are:

• excessive sweating;
• thirsty;
• dry mucous membranes;
• increased heart rate;
• lowering blood pressure, etc.

Overdose

An overdose of bromhexine threatens the development of severe complications, such as nausea, vomiting, pale skin, severe general weakness, drop in blood pressure and loss of consciousness. To avoid overdose of the drug, you should take the drug only as prescribed by a doctor in the dose prescribed according to the accompanying instructions.

In case of intentional or accidental overdose of the drug, you should immediately call ambulance. Before her arrival, the following measures must be taken:

• If the patient is conscious, then bring him to the knee-elbow position and induce vomiting by pressing on the root of the tongue. Then force you to drink at least 1 liter of water ( better 2 – 2.5 liters) and repeat artificial vomiting. Continue alternately drinking water and vomiting until clear vomit appears. After this you should drink Activated carbon at the rate of 1 tablet per 10 kg of body weight.
• If the patient is unconscious, then it is necessary to place him in a horizontal position and turn him to his side to prevent vomit from entering the respiratory tract. Place a pillow, folded clothes or any improvised stand under your head and wait for the arrival of a specialized team.

Interaction with other drugs

Bromhexine is not recommended for use together with drugs that suppress the cough center. As a result of this interaction, the resulting liquid sputum will not be coughed up and, accordingly, will accumulate in the respiratory tract, supporting the inflammatory process.

The combined use of bromhexine and antibiotics, especially penicillins and cephalosporins, has a positive effect, since bromhexine increases the concentration of the latter in the bronchial lumen.

Approximate cost of the medicine

The cost of bromhexine varies significantly depending on the region Russian Federation. The table below shows the average prices for the drug in pharmacies in some large cities in Russia. The difference in prices is explained by different manufacturers of the medicine and its expiration date ( The more time remains before the expiration date, the more expensive the drug).

City	Average cost of the drug
	Tablets for adults	Tablets for children	Dragee	Oral solution	Syrup
Moscow	30 rubles	48 rubles	30 rubles	127 rubles	116 rubles
Kazan	42 rubles	42 rubles	98 rubles	71 ruble	120 rubles
Krasnoyarsk	28 rubles	28 rubles	75 rubles	75 rubles	98 rubles
Khabarovsk	40 rubles	40 rubles	74 rubles	87 rubles	109 rubles
Samara	26 rubles	26 rubles	74 rubles	80 rubles	108 rubles
Stavropol	45 rubles	45 rubles	74 rubles	78 rubles	96 rubles

The drug "Bromhexine" for children is indicated for the presence of respiratory tract diseases in young patients. This secretomotor and secretolytic medicine has excellent mucolytic properties, thanks to which the child, after the first days of treatment, passes sputum without much difficulty. In addition, the above remedy is a motor activator, that is, motor function respiratory tract.

The drug "Bromhexine" for children: a brief description

The instructions describe this product as a powerful mucolytic medicine that has an amazing therapeutic effect. The drug has an antitussive and expectorant effect.

You can purchase Bromhexine at the pharmacy without a special prescription. Its price is approximately 71 rubles. for 1 bottle (100 ml).

The instructions for the above medicine advise storing it at normal room temperature. It should be kept in a dry and dark place, away from children. The drug should not be used after the expiration of its period of use, which is about three years.

Release form and composition of the drug

The medicinal product "Bromhexine" for children is produced by the manufacturer in tablet and syrup form. One pill contains 4 mg of bromhexine hydrochloride. One package contains 10 or 20 tablets.

Bromhexine (5 mg syrup) contains 4 mg bromhexine hydrochloride, 2 g sorbitol, 96% ethanol (alcohol), 5 mg methyl p-hydroxybenzoate. The excipients that are included in the above preparation are propylene glycol, succinic acid, apricot flavor, sodium benzoate, eucalyptus oil, purified water. One bottle contains 100 mg of medication.

pharmachologic effect

The drug "Bromhexine" for children is used as a powerful antitussive agent. It has the following effects on the respiratory tract of young patients:

Indications and contraindications

The instructions recommend using the medicine “Bromhexine” for children for symptoms of the following diseases:

• cystic fibrosis;
• pneumonia;
• emphysema;
• tracheobronchitis;
• pulmonary tuberculosis;
• bronchiectasis;
• sanitation of the bronchial tree (during preparation for surgery, in the postoperative period to prevent the accumulation of viscous sputum, during intrabronchial diagnostic and therapeutic manipulations);
• obstructive bronchitis.

The instructions do not recommend using the drug “Bromhexine” (tablets, syrup) if a small patient has the following health problems:

• in the acute stage of gastric ulcer;
• gastroduodenitis;
• hypersensitivity to the ingredients of the above product;
• renal failure;
• fructose intolerance (hereditary);
• liver failure;
• bleeding in the stomach, which is in the anamnesis;
• bronchial disease, which is accompanied by excessive accumulation of secretions.

Experts warn that it is very important to follow the indicated dosages and in no case exceed them. After all, this can lead to side effects in young patients. For example, there have been cases of allergies, nausea, dizziness, exacerbation of gastroduodenitis, headache, vomiting, and increased activity of liver transaminases in children after taking this drug.

If any of the above signs are observed, parents should immediately show the child to the attending physician and stop giving him Bromhexine. The instructions for use indicate that in some cases, some patients experienced a side effect such as angioedema, in other words, allergic Quincke's edema.

Treatment of drug overdose involves the following actions:

• inducing artificial vomiting;
• gastric lavage.

An overdose of this drug does not cause life-threatening symptoms.

Bromhexine tablets (syrup) and other drugs

When taking the above medication, its interaction with other drugs should be taken into account. For example, this drug is completely incompatible with alkaline solutions. In no case should the above medicine be prescribed together with antitussives, since in most cases they complicate the process of sputum release.

The drug "Bromhexine" promotes the penetration of sulfonamide drugs and antibiotics (cephalexin, amoxicycline) into the bronchial secretions during the first 5 days of antimicrobial treatment.

How should small patients take Bromhexine?

Instructions for use for children recommend the following doses of the above medicine depending on their age:

• For babies under 2 years old, it is recommended to take 2.5 ml or 2 mg of the product every 8 hours;
• children aged 2 to 6 years need to take 5 ml or 4 mg of medication three times a day;
• young patients aged 6 to 14 years are recommended to take 10 ml and 8 mg of the drug every 8 hours;
• Children over 14 years old can take 16 mg or 20 ml of the medicine three times a day.

It is important to take the drug with a sufficiently large amount of liquid to maintain the secretolytic effect of the main substance.

The instructions recommend combining the medication “Bromhexine” (syrup, tablets) with vibration massage of the chest of small patients or with postural drainage. This therapy facilitates the evacuation of secretions from the bronchi.

The instructions note that if the child does not have a therapeutic effect during the first 4 days, then parents should consult a doctor.

An hour after consuming the above medicine, its maximum concentration in the blood is reached.

The drug "Bromhexine" is an excellent mucolytic drug for young patients.

Bromhexine Berlin Chemie instructions for use refer to drugs that stimulate the motor function of the respiratory tract and secretolytics. Tablets 4 mg and 8 mg, syrup, solution have mucolytic, expectorant and bronchodilator effects. Reviews from patients and recommendations from doctors indicate that this medicine helps in the treatment of cough, including dry cough, bronchitis and asthma.

Release form and composition

Bromhexine is available in the following dosage forms:

1. Tablets 8 mg (in cell packs and jars of various packaging).
2. Syrup 4 mg/5 ml (in bottles of 60 and 100 ml).
3. Tablets for children 4 mg (in blisters of 10 pieces).
4. Oral solution 4 mg/5 ml (in bottles of 100 ml).

The active ingredient of the drug is bromhexine hydrochloride.

pharmachologic effect

Bromhexine reduces the viscosity of bronchial secretions, as it depolarizes the acidic polysaccharides it contains 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 thins mucus, 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 medicine becomes noticeable 2-5 days after starting treatment. Taking Bromhexine tablets and other forms of release of the drug 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 does Bromhexine Berlin Chemie help with?

Indications for the use of the drug include diseases of the respiratory tract, the course of which is associated with the formation of a difficult-to-discharge viscous secretion:

• 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 2 years of age - 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 to 16 mg 4 times a day, for children - up to 16 mg 2 times a day.

In the form of inhalations, adults - 8 mg, children over 10 years old - 4 mg, aged 6-10 years - 2 mg. At the age of up to 6 years - used in doses of up to 2 mg. Inhalations are carried out 2 times a day. The therapeutic effect may appear on days 4-6 of treatment.

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. Administer 2 mg subcutaneously, intramuscularly or intravenously 2-3 times a day slowly over 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

Bromhexine is usually 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;
• increased aminotransferase activity 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;
• skin itching;
• headache;
• chills;
• anaphylactic shock.

Children, pregnancy and breastfeeding

Prescribed if the expected benefit to the mother exceeds the expected risk to the fetus or child.

Syrup and tablets are contraindicated in children under 2 years of age. Due to the specific dosage, it is advisable for children under 6 years of age to take syrup; those over 6 years of age should take syrup and tablets for children.

special instructions

When treating patients suffering peptic ulcer stomach, as well as persons with a history of gastric bleeding, the use of the drug should be carried out under the supervision of a physician. For patients diagnosed with bronchial asthma, Bromhexine is prescribed with caution.

It is not recommended to take the medicine simultaneously with drugs that contain codeine, which is explained by the difficulty of coughing up liquefied sputum. Bromhexine can be used as part of combination preparations of herbal origin containing essential oils(including menthol, eucalyptus oil, peppermint, anise).

Drug interactions

Do not prescribe in parallel with antitussive drugs (for example, codeine-containing ones), due to difficulty in the discharge of bronchial secretions.

Combined use 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 Bromhexine

Analogues are determined by structure:

1. Vero-Bromhexine.
2. Phlegamine.
3. Bromhexine Berlin-Chemie (MS; Grindeks; Nycomed; -Ruspharm; -Akri; -Egis;).
4. Solvin.
5. Flexoxin.
6. Bronchotil.

Analogues of action include:

1. Acestine.
2. Acetylcysteine.
3. Fluditek.
4. Fluimucil
5. Ascoril.
6. AmbroHexal.
7. Libexin.
8. Bronchosan.
9. Flavamed.
10. Bronchoxol.

Vacation conditions and price

The average price of Bromhexine (8 mg tablets No. 50) in Moscow is 30 rubles.

Available without a prescription. Should be stored in a dry place, protected from light, at a temperature not exceeding 25 °C. Shelf life – 5 years.

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