Alcohol-containing dosage forms of Bromhexine and endogenous alcohol
The medicine belongs to the group of secretolytics and stimulants of motor function of the respiratory tract. It has an expectorant and antitussive effect. Increases the activity of the ciliated epithelium. Stimulates the formation of endogenous surfactant (a substance that covers the alveoli and prevents their collapse), stabilizing alveocytes during breathing. Available in tablet form (4 mg and 8 mg tablets), as well as in the form of ointment, syrup or drops. The syrup contains 12.5% vol. 96% ethyl alcohol, while the volume of ethanol drops is 41%.
Ethyl alcohol in low concentrations is a natural metabolite. The natural alcohol content in the body of a healthy person is 0.01-0.1‰.
Natural alcohol is divided into:
- Conditionally endogenous or physiological, synthesized during enzymatic processes during the digestion of food. Its participation in metabolism is similar to the fate of alcohol supplied with alcoholic beverages.
- True endogenous alcohol is formed as a result of metabolic processes and takes part in cellular respiration. Found in alveo- and hepatocytes.
“Dose” of alcohol and types of alcoholic drinks
The concept of “alcohol” includes various alcoholic beverages such as beer, champagne, red or white wine, vodka or brandy. To calculate the ethyl alcohol taken, a conditional value is used, which is called the “dose”. Dose is the average indicator of an alcoholic drink consumed, corresponding to the onset of an average degree of intoxication for a person weighing 60 kg. For comparison, 1 dose of beer corresponds to 355 ml of drink (5% ethanol by volume), table wine - 150 ml (12% ethanol by volume), port wine - 100 ml (17% ethanol by volume) and vodka or brandy - 45 ml (40 % vol. ethanol). Clinical observations indicate that the absence of the effect of alcohol on the body is usually observed when its concentration in the blood plasma reaches 0.5-3.0‰.
The effect of Bromhexine and alcohol on the respiratory system
This drug is a synthetic analogue of the alkaloid vizicine and is used as an adjuvant:
- For the treatment of acute and chronic diseases of the respiratory system (bronchi, trachea and lungs), accompanied by the formation of thick and viscous sputum.
- When conducting studies of the bronchi (for example, bronchography), with the concomitant introduction of radiopaque substances into them.
- In the pre- and postoperative period (during surgical treatment of the respiratory system).
Bromhexine increases secretion volumes, reducing the viscosity of sputum (depolymerizes mucoprotein and mucopolysaccharide fibers), which facilitates its secretion. Has an antitussive effect. The pronounced effect appears 2-6 days after the start of treatment. A significant advantage of the drug is its low toxicity.
The respiratory organs become a target for alcohol due to the fact that approximately 5% of alcohol and its breakdown products (including toxic acetaldehyde) are excreted through the lungs, which leads to irritation of the bronchial epithelium and damage to lung tissue.
Indications for use
Acute and chronic diseases of the respiratory tract, accompanied by the formation of difficult-to-discharge viscous secretions:
- pneumonia,
- tracheobronchitis,
- obstructive bronchitis,
- bronchial asthma,
- cystic fibrosis,
- emphysema,
- pneumoconiosis,
- pulmonary tuberculosis.
Sanitation of the bronchial tree in the preoperative period and during therapeutic and diagnostic intrabronchial manipulations, prevention of accumulation of thick viscous sputum in the bronchi after surgery.
The effects of ethanol and Bromhexine on the digestive organs and kidneys
The group of relative contraindications for Bromhexine includes peptic ulcer of the stomach or duodenum, as well as liver and kidney diseases.
Pain in the epigastric region when drinking alcohol is caused by the damaging effect of the substance on the mucous membranes of the stomach and small intestine, including the duodenum and jejunum.
Bromhexine itself has an irritating effect on mucous membranes. In addition, a number of its dosage forms contain propylene glycol, which can enhance the irritating effect of alcohol on the mucous membranes of the gastrointestinal tract.
After absorption and “passing” through the liver, the bioavailability of Bromhexine is reduced to 20% due to demethylation and subsequent oxidation. The active metabolite of Bromhexine is Ambroxol. Bromhexine is excreted mainly by the kidneys. Its half-life is 15 hours. Alcohol has either a direct hepatotoxic effect or provokes inflammatory changes in the liver, accompanied by stagnation of bile. In addition, by triggering autoimmune processes, ethyl alcohol can cause chronic kidney disease - alcoholic nephropathy.
Action
Pharmacological action - expectorant, mucolytic, antitussive.
The mucolytic effect is associated with the depolymerization of mucoprotein and mucopolysaccharide fibers and an increase in the serous component of bronchial secretions.
Reduces the viscosity of bronchial secretions by depolarizing the acidic polysaccharides it contains and stimulating the secretory cells of the bronchial mucosa, which produce secretions containing neutral polysaccharides.
Stimulates the production of endogenous surfactant, which ensures the stability of alveolar cells during breathing, their protection from unfavorable factors, improving the rheological properties of bronchopulmonary secretion, its sliding along the epithelium and the release of sputum from the respiratory tract.
Pharmacokinetics
Bromhexine is rapidly absorbed from the gastrointestinal tract and undergoes intensive metabolism during the “first pass” through the liver. Bioavailability is low, about 20%. In healthy patients, Cmax in plasma is determined after 1 hour.
Widely distributed in body tissues. The binding of bromhexine to plasma proteins is high. Penetrates through the blood-brain and placental barriers. In the liver it undergoes demethylation and oxidation. T1/2 in the terminal phase is about 12-15 hours. It is excreted in the urine mainly in the form of metabolites (ambroxol). The clearance of bromhexine or its metabolites may be reduced in patients with severe hepatic or renal impairment. May accumulate with repeated use.
Bromhexine and alcohol
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Medications while breastfeeding Most medications are not recommended when breastfeeding. This is primarily due to the lack of relevant research. There is a small list of studied medications that can be used while breastfeeding. Most of these drugs do pass into breast milk, so they should be used with caution when breastfeeding (i.e. strictly according to indications, not exceeding the dose and monitoring the child’s condition). In the case of a pronounced negative effect on the child’s body, the drug is considered contraindicated when breastfeeding. How does the medicine affect the child’s body? The degree of adverse effect. Continue reading →
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Bromhexine - a proven cough remedy
The effectiveness of bromhexine has been confirmed by medical practice for a very long time - long before evidence-based medicine was recognized as the “gold standard” of quality, therefore this drug is classified as over-the-counter.
The modern pharmacological market offers customers several commercial names for this drug:
- Ambroxol.
- Lazolvan.
- Ambrobene.
- Bromhexine Berlin-Chemie.
Use of the drug for alcoholism
Alcoholism is the state of alcohol dependence, leading to the formation of inflammatory diseases of the abdominal organs. Gastritis and colitis occur, which then turn into ulcers. The greater impact falls on the liver tissue.
Hepatocytes are destroyed and an inflammatory reaction occurs. Both conditions are not contraindications for taking the medicine, but against the background of addiction, its use is not recommended.
If prolonged use of the drug can cause an increase in liver enzymes, then alcoholism forms hepatitis. Due to the increased impact on the organ, the stage of fibrosis occurs faster.
In what cases is it recommended to take Bromhexine?
The drug taken orally has a pronounced secretolytic and secretomotor effect on the mucous membrane of the bronchial tract. Accordingly, as a result of the implementation of this effect, the intensity of bronchial secretion increases significantly, the viscosity of mucus (sputum) decreases and the activity of the cilia of the ciliated epithelium increases. All these factors together contribute to the acceleration of the movement of mucus (phlegm) through the respiratory tract.
Please note that Bromhexine is effective only for dry cough. Accordingly, it makes sense to use it (like all other mucolytics) in the initial stage of the disease. If the patient is already expelling large quantities of sputum, then there is no point in enhancing the mucociliary effect - with a high probability this can lead to the syndrome of “flooding” the bronchial tree with sputum, and will worsen the patient’s condition.
Pathologies (diseases) for which it is recommended to take bromhexine include infections of the upper, lower and middle parts of the respiratory tract (bronchitis, laryngitis, pneumonia). Please note that even with the mildest viral infection, Bromhexine is used only in complex therapy, because it does not directly affect the microorganism that caused the disease. This drug only alleviates the patient’s condition by helping to remove phlegm.
Interaction
Bromhexine is not prescribed simultaneously with codeine-containing antitussive drugs, because due to the suppression of the cough reflex, the evacuation of liquefied sputum is difficult, which can lead to the accumulation of secretions in the respiratory tract.
The combination of glaucine + ephedrine + basil oil is not recommended for use simultaneously with bromhexine - due to difficulty in coughing up sputum.
When used simultaneously with some NSAIDs, it is possible to increase the irritant effect of the latter on the gastric mucosa.
Bromhexine is incompatible with alkaline solutions.
Bromhexine can be prescribed simultaneously with other drugs used in the treatment of bronchopulmonary diseases.
Promotes the penetration of antibiotics (erythromycin, cephalexin, oxytetracycline) and sulfonamide drugs into bronchial secretions, leading to an increase in the concentration of antibiotics in lung tissue.
Dosage and frequency of administration
Bromhexine should be taken only after meals, with plenty of liquid - this rule is true both in the case of tablets and in the case of taking syrup.
Adult patients and adolescents over the age of 14 years take 8-16 mg (1-2 tablets) 3 times a day. In terms of the active substance, this amounts to 24-48 mg/day of bromhexine hydrochloride.
Children from 6 to 14 years of age, as well as patients weighing less than 50 kg: 8 mg (1 tablet) 3 times a day is indicated. In terms of the active substance - 24 mg/day of bromhexine hydrochloride.
Syrup in children is taken in a dose of 2.5 to 10 ml once a day. – calculated based on body weight, a gradation scale is included with instructions.
The duration of the course of taking the drug is determined solely on an individual basis - depending on the severity of the patient’s condition, the presence of concomitant diseases and drugs taken in parallel with Bromhexine.
If the patient has a history of impaired renal function or other severe somatic diseases, the dosage should be reconsidered - ideally together with a specialized specialist.
Instructions for use of bromhexine
Tablets are taken orally at 8 mg. 2 times a day. Children over 2 years of age are given 4 mg. 2 times a day. In the form of inhalations and syrup, the dosage is no different, approximately 8-9 mg. 3 times a day. The course of treatment is up to 6 days. Use for children for a longer period of time should be discussed with a doctor individually. During postoperative therapy for sputum discharge, the recommended dose is approximately 2 mg.
Dosage in tablets for adults
As a therapy for the treatment of cough, adults take 2-3 tablets 2 times a day, depending on the type of cough of the patient.
Bromhexine Berlin chemical syrup for children instructions for use
Syrup for children has a pleasant taste and smell. You can find syrup in the pharmacy in the form of an apricot suspension, which makes its use pleasant for the child. The formula of the product does not suffer and has antimicrobial and anti-inflammatory effects. Children can also take tablets, which must be calculated depending on the child’s body weight.
Bromhexine during pregnancy
The medication should not be used by pregnant women to avoid harmful effects on the fetus. If this cannot be avoided, it is worth assessing the possible risks and benefits for the mother. The medicine can pass into breast milk during lactation and breastfeeding.
Restrictions
For diseases
Use under medical supervision:
- for diseases of the respiratory tract accompanied by excessive accumulation of secretions;
- with a history of gastric ulcer or gastric bleeding;
- with renal and/or liver failure;
- for bronchial asthma.
For children
Use with caution in children - according to indications, in doses and dosage forms recommended according to age.
Pregnancy and lactation
Use is contraindicated in the first trimester of pregnancy. Use in the II-III trimesters of pregnancy and during breastfeeding is possible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus or infant.
Bromhexine tablets reviews
According to numerous reviews on the Internet and forums, one can note the mild effect on the body and the high effectiveness of the product. The drug fights pathogenic microorganisms and enhances the secretion and discharge of sputum.
Contraindications
- 1. Pregnancy
- 2. Hypersensitivity to bromhexine and its derivatives
- 3. Individual intolerance to the drug.
Side effects:
- 1. Headache, dizziness, confusion
- 2. Allergic reactions on the skin - rash, dermatitis, urticaria
The drug is compatible with alcohol. Does not affect vehicle control. Cases of overdose have not been registered, however, if you feel nausea, headache or poor health, you should stop taking the drug.
Side effect
Nervous system and sensory organs
Dizziness, headache.
Digestive system
Nausea, vomiting, dyspeptic disorders, abdominal pain, exacerbation of gastric and duodenal ulcers, increased activity of liver transaminases.
Respiratory system
Cough, bronchospasm.
Allergic reactions
Skin rashes, itching, urticaria, rhinitis, angioedema.
Other
Shortness of breath, increased body temperature, chills, increased sweating.
Stevens-Johnson and Lyell syndromes have been reported very rarely. If changes occur on the skin or mucous membranes, the drug should be stopped.
It is also possible to develop side effects caused by excipients.
Analogs
The drug has a number of analogues that are used during the period when bromhexine does not cope. If you have bronchitis or an allergic cough, you should consult a doctor before use. The mechanism of action is approximately the same. It is better to avoid simultaneous use with bromhexine. Overdose is impossible. For a list of side effects, see the instructions.
Bromhexine or Lazolvan, which is better?
Lazolvan is a medicine that causes virtually no side effects. Suitable even for newborns.
Description, customer opinion, what is the difference, advertising, solution, medicine for children, photo, the same thing, recipe in Latin, annotation, is it possible in the first trimester, tablets or inhalations - more detailed information can be requested at the pharmacy or on the forums in Internet.
Consequences of drinking alcohol
If a person drinks alcohol once during treatment with a mucolytic, no serious adverse reactions will occur.
But if you use the medicine throughout the entire therapy, the following consequences occur:
- nausea, vomiting, due to which all the medicine taken is evacuated from the digestive tract, so there is no therapeutic effect;
- allergic skin reactions, manifested in the form of a rash, but they disappear after stopping the use of both substances;
- high risk of spasm in the bronchi due to the accumulation of exudate, which can lead to a severe attack of suffocation and increased coughing;
- alcohol leads to increased kidney function, so fluid is removed from the body faster, dehydration occurs, which thickens the sputum even more;
- with constant violation of the rule, gastritis is formed, which transforms into a stomach or duodenal ulcer;
- if the patient had inflammation of the gastrointestinal mucosa at the time of treatment, the risk of bleeding increases.
To clarify the possibility of consequences, consult a therapist about the joint use of substances.
