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.
In all of the above drugs, the active ingredient is bromhexine hydrochloride. Only the country of origin and cost differ. Even their effectiveness is relatively identical (a rare exception when a domestically produced drug is not inferior in quality to imported ones).
Today Bromhexine is available in several dosage forms:
- Tablets (available for children and adults, dosage differs).
- Syrup (exactly the same, children's and adult versions are offered).
- Solution for inhalation (only imported Lazolvan and Ambrobene are presented in this form).
You should choose a dosage form based on the age and condition of the patient - they do not differ in effectiveness.
Mechanism of action. Nuances of implementing the effect.
Bromhexine and ACC have something in common
These drugs are in the same pharmacological group: they belong to mucolytics (thin the bronchial secretions) and stimulants of the motor function of the respiratory tract (facilitate the discharge of sputum).
Both substances are used for diseases of the respiratory tract, which are accompanied by the formation of thick, viscous sputum. Indications include acute and chronic bronchitis, pneumonia, tracheitis, bronchial asthma, chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis.
Indications and contraindications
Regardless of the form of the drug, it is prescribed to exclude chronic pathologies of the bronchi and lungs. Due to its simultaneously expectorant and mucolytic action, it allows you to cope with acute bronchitis and its tracheal variety.
Bromhexine Berlin-Chemie is used in the process of excluding bronchial asthma, pneumonia, emphysema, as well as:
- tuberculosis;
- cystic fibrosis (cystic fibrosis);
- obstructive bronchitis;
- bronchiectasis (irreversible expansion of any part of the bronchi).
Contraindications are considered separately. The first case in this list is an increased degree of susceptibility to the components of the product. Particular caution will be required if there is a tendency to bleeding from the stomach area or impaired bronchial motility. Treatment is limited to insufficient liver or kidney function, as well as under the age of six years.
Pulmonologists call absolute contraindications:
- first trimester of pregnancy;
- ulcerative lesions of the duodenum and stomach;
- intolerance to any type of sugar - not only in its pure form, but also derivatives (galactose, fructose).
A similar limitation applies to lactase deficiency. That is why you should consult your doctor before starting use. He will prescribe a specific drug depending on existing diseases and other health conditions.
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What is the difference?
The drugs differ:
- active substance and composition,
- forms of production,
- some application features.
Active substance
Bromhexine hydrochloride is a derivative of vasicin, a chemical derived from the plant Justice vascularis. It has long been used in the East as an expectorant. Bromhexine in the body is converted into an active metabolite - ambroxol .
ACC contains acetylcysteine , which is a derivative of the amino acid cysteine.
Release forms
The choice of dosage form is based on the patient's age and desired dosage, as well as individual characteristics and preferences.
Bromhexine is available in the form of tablets and dragees, fruit-flavored syrup for children, oral solution and alcohol-based drops.
ACC is available as cold or hot drink powder, effervescent tablets, soluble granules, or syrup.
What can replace Bromhexine?
The drug Bromhexine is produced by different pharmaceutical companies under different trade names. If for some reason it is impossible to take Bromhexine, you can buy its analogues in composition or therapeutic effect. The following drugs are considered closest to Bromhexine:
- Bromxine.
- Mucocin.
- Bronchotil.
- Solvin.
- Ambroxol.
- Lazolvan.
- ACC.
All of the above drugs have mucolytic, expectorant properties, but whether they can be taken by a particular patient must be decided by the attending physician.
Application of bromhexine
Bromhexine - description of the substance and instructions
Advantages
- Suitable for the treatment of not yet formed sputum, promotes the transition from a debilitating dry cough to a productive one if indicated.
- It has a higher bioavailability of the active substance and a prolonged effect.
- Suitable for people of all ages. It has several dosage forms for use in pediatric practice. Prescribed for the treatment of cystic fibrosis and other inflammatory diseases in children even under the age of 2 years (for certain dosage forms).
- Can be used to treat pneumonia and bacterial bronchitis in combination with broad-spectrum antibiotics. Bromhexine helps to increase the concentration of antibacterial drugs in the alveoli and bronchial secretions, which makes it easier to get rid of pathogens.
- In the treatment of lung diseases, it activates the synthesis of surfactant, which supports air exchange in the alveoli and the protective function.
Flaws
- With large doses or impaired respiratory peristalsis, a large amount of sputum may be released, which can lead to congestion and difficulty breathing.
- The simultaneous use of bromhexine with antitussives (codeine) is strictly contraindicated.
- It is prohibited to use it during breastfeeding and is not recommended during pregnancy (especially in the first trimester). It has a number of other contraindications and restrictions.
- Some forms are not used in patients under 12 years of age due to the presence of alcohol in the composition (solutions, drops), and also have additional restrictions specified in the instructions.
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.
Use of acetylcysteine
Acetylcysteine - description of the substance and instructions
Advantages
- It is used for the treatment of ENT diseases: chronic sinusitis, laryngitis, otitis, as it has a therapeutic effect on both the upper respiratory tract and the bronchopulmonary system.
- Liquefies very thick purulent sputum, keeping it mobile. Thanks to this quality, the drug is used as part of the complex treatment of severe bronchitis, tracheitis, and pneumonia.
- It also has an anti-inflammatory, antioxidant effect, increasing cell protection from free radical oxidation, which is characteristic of the inflammatory response.
- Has nonspecific antitoxic activity. Acetylcysteine is the main antidote for paracetamol overdose. Acts against damaging toxic factors of polluted air: tobacco smoke, urban smog and others.
- In patients with cystic fibrosis, bacterial complications occur less frequently when taking the drug.
Flaws
- In combination with certain antibiotics (penicillins, cephalosporins), acetylcysteine inhibits their effect. If the concentration of antibacterial agents in the blood is insufficient, resistance of microorganisms may develop. Therefore, it is important to leave at least 2 hours between medications.
- When taken, no more than 10% of the main substance penetrates into the blood, and the drug acts for a relatively short time, so the frequency of administration and dose increases. The highest dosage of ACC Long is allowed only for adults once a day.
- Should not be taken together with paracetamol, as ACC neutralizes it.
- The main component passes through the placenta and is excreted in milk, therefore it is not used in pregnant and nursing mothers. Contraindicated in children under 2 years of age. Has other contraindications and restrictions specified in the instructions.
Instructions for dry cough
The medicine is available for adults and children, and, despite the fact that it is made by different manufacturers, the instructions for all are identical. While taking bromhexine, you should drink plenty of warm liquid to promote the expectorant effect of the medicine. It is often prescribed for complex treatment together with antibiotics, then the effectiveness of the drug increases. It cannot be used in conjunction with alkaline solutions.
For adults
Bromhexine is taken orally, regardless of food intake, with plenty of water. Adult patients need to drink 2 tablets, three cough tablets, four times a day, or 16 ml of syrup at a time the same number of times.
The effect of the drug appears on days 2–6 of treatment. The course of treatment can be 28 days.
Syrup for children: how many days to drink
It is better for a child to buy Bromhexine in syrup. It should not be used for babies under one year old, because they will not be able to cough up all the sputum yet, and it will accumulate in the lungs.
The medicine in this form acts more gently, but at the same time is effective.
For older children, the dosages are as follows:
- from 2 to 6 years - give 2.5 - 5 ml three times a day, depending on the strength and frequency of cough;
- from six to 14 years – half a dragee or 5 to 10 ml of syrup;
- Teenagers are prescribed one tablet at a time, and 2 tablets for advanced forms of cough. They should be drunk 2-3 times a day. You can also use drops of 23–47 drops 3 times a day. The same dose of drops is also suitable for adults.
Read how to treat bronchitis using the provided link.
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The solution is used for inhalation. Adults are prescribed 8 mg at a time, children under 10 years old - 2 mg, and adolescents - 4 mg. Inhalation should be carried out 2 times a day. To do this, take the same amount of distilled water and solution and heat it to 37 degrees, not higher. Then the procedure is carried out in the usual way.
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The effect of the drug on the patient's body
Together with the secretion produced, the medicine enters the sputum, splitting large fractions into small particles, significantly reducing its viscosity. As a result, free flow of sputum is formed, which is easily expelled during coughing. This is facilitated by the ciliated epithelium, brought to a normal state. Thus, a dry cough takes on a wet form. Bromhexine affects the patient’s body as follows:
- Provides active expectoration. The mucus becomes more liquid, its volume increases, and it is much easier to cough up.
- The ciliated epithelium is quickly restored at the cellular level.
- Helps reduce the number of dry cough attacks, resulting in general relief of the patient's condition.
- Improves lung function by participating in the synthesis of phospholipids.
Positive results become noticeable within two days after the start of treatment, and the visible effect occurs after about five days.
