Bromhexine - instructions for use, dose, side effects, contraindications

Prodrug, turns into ambroxol, which increases the activity of lysosomes of goblet cells of the epithelium of the respiratory tract, as a result of which release of lysosomal enzymes hydrolyzing mucoproteins and mucopolysaccharides occurs. Stimulates the production of neutral polysaccharides and surfactant, restores mucociliary clearance. Liquefies a viscous, sticky bronchial secret and ensures its excretion from the bronchi. Provides antitussive act.

Pharmacokinetics:

Penetrates through the blood-brain barrier. Connection with plasma proteins - 99%; biotransformation in the liver to the active metabolite - ambroxol, pronounced effect of "first passage" through the liver. The effect develops in 20-30 minutes after administration.Half-life is 6.5 hours, an increase in chronic renal failure; is excreted by the kidneys ~ 85-90% in the form of metabolites. Cumulates.

Indications:

Chronic inflammatory lung diseases (bronchial asthma, tuberculosis, tracheobronchitis, pneumoconiosis, spastic bronchitis, bronchiectasis, emphysema); mcystic fibrosis; trauma of the chest; pre- and postoperative period.

ICD-10

X.J00-J06 Acute respiratory infections of the upper respiratory tract

X.J40-J47.J40 Bronchitis, not specified as acute or chronic

XVIII.R00-R09.R09.3 Sputum

Contraindications:

Individual intolerance; Pan electrotic ulcer of the stomach; pregnancy (I trimester) and breastfeeding; childhood.

Carefully:

Renal or hepatic insufficiency; zBone abolition accompanied by excessive accumulation of secretions; gastric bleeding, including in the anamnesis.

Pregnancy and lactation:

Adequate and well-controlled studies on humans have not been conducted. Do not use in the first trimester of pregnancy and breastfeeding. With caution in II-III trimesters.

Dosing and Administration:

Inside, adults and children over 14 years of age 8-16 mg 3-4 times a day, children under 14 years - depending on age.

Solution for inhalation - 8 mg twice a day; diluted with saline 1: 1.

Side effects:

Nervous system: headache, weakness.

Digestive system: stomach pain, nausea, vomiting, diarrhea, constipation, dry mouth.

Others: rhinorrhea, exanthema, dysuria.

Allergic reactions: skin rash, hives, angioedema, anaphylactic shock, allergic contact dermatitis.

With rapid intravenous injection - a feeling of stupor, adynamia, intense headaches, lowering of blood pressure, shortness of breath, hyperthermia, chills.

Overdose:

In case of an overdose, nausea, vomiting, diarrhea, dyspepsia are observed, symptomatic treatment is necessary.

Interaction:

Antitussive remedies - difficulty in getting away from sputum while reducing cough.

Alkaline solutions (hydrogen index higher than 6.3) - pharmaceutical incompatibility.

Special instructions:

During the treatment it is recommended to expand the drinking regime, which supports the secretolitic action of bromhexine.For violations of bronchial motility or with a large amount of sputum, the use of bromhexine requires caution in connection with the risk of delayed discharge in the airways.

With the appearance of the slightest signs of allergy, the drug is urgently to be canceled, since in rare cases development of Stevens-Johnson and Lyell syndromes is possible.

Instructions

Bromhexine (Bromhexinum)