Bromhexine + Diphenhydramine + Pseudoephedrine

Usage

This combination medication is primarily prescribed for the symptomatic relief of cough, nasal congestion, and other respiratory symptoms associated with the common cold, flu, allergies, and other respiratory tract infections like bronchitis and sinusitis.

Pharmacological Classification:

This drug is a combination of three different classes of medications:

• Mucolytic: Bromhexine
• Antihistamine: Diphenhydramine
• Decongestant: Pseudoephedrine

Alternate Names

There is no internationally recognized non-proprietary name for this specific combination. Alternate names are generally brand names specific to the region where the drug is marketed. Brand names vary depending on the manufacturer and country.

How It Works

Bromhexine:

• Pharmacodynamics: Reduces the viscosity of mucus by breaking down mucopolysaccharides, making it easier to expectorate.
• Pharmacokinetics: Well-absorbed orally. Metabolized in the liver and excreted primarily in the urine.

Diphenhydramine:

• Pharmacodynamics: An antihistamine that blocks the effects of histamine, reducing allergic symptoms like runny nose and sneezing. Also possesses antitussive (cough-suppressing) and sedative properties. It acts primarily as an inverse agonist of the H1 receptor.
• Pharmacokinetics: Well-absorbed orally. Metabolized in the liver and excreted in the urine.

Pseudoephedrine:

• Pharmacodynamics: A sympathomimetic amine that acts as a decongestant by constricting blood vessels in the nasal passages, reducing swelling and congestion. Acts on alpha-adrenergic receptors.
• Pharmacokinetics: Readily absorbed from the gastrointestinal tract. Partially metabolized in the liver and excreted primarily in the urine.

Dosage

Standard Dosage: Information on the standard combined dosage of Bromhexine, Diphenhydramine and Pseudoephedrine is unavailable. However, we can provide information on the dosage of Bromhexine and Pseudoephedrine separately as described in some of the sources.

Adults: Bromhexine 8mg thrice daily; Pseudoephedrine 60mg every 4-6 hours.

Children: The safety and efficacy of this combination in children have not been established. It is advised to consult a physician if you are considering administering this medication to children.

Special Cases: Dosage adjustments may be needed in elderly patients and those with renal or hepatic impairment. Individualized dosing based on patient-specific factors should be considered in cases of comorbid conditions. Consult with a nephrologist or hepatologist for specific recommendations.

Side Effects

Common Side Effects:

• Drowsiness, dizziness, dry mouth/nose/throat, headache, upset stomach, constipation, trouble sleeping, nausea, restlessness, increased heart rate.

Rare but Serious Side Effects:

• Allergic reactions (rash, itching/swelling, severe dizziness, trouble breathing), mental/mood changes (confusion, hallucinations), ringing in the ears, difficulty urinating, vision changes, seizures, fast/irregular heartbeat.

Long-Term Effects: Data is limited on the long-term effects of this combination. Individual components may have specific long-term side effects.

Contraindications

• Hypersensitivity to any of the components.
• Severe hypertension, severe coronary artery disease, history of stroke or risk factors for stroke.
• Severe renal impairment.
• Concomitant use of monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping MAOIs.
• Newborns, premature infants, and nursing mothers (for certain combinations).

Drug Interactions

• MAOIs: Potential for serious interaction.
• Antihypertensives, tricyclic antidepressants, beta-blockers.
• Alcohol, other CNS depressants.
• Other medications containing antihistamines or decongestants.

Pregnancy and Breastfeeding

The safety of this combination during pregnancy and breastfeeding has not been well-established. It is generally advised to avoid using this medication during pregnancy, especially the first trimester, and while breastfeeding.

Drug Profile Summary (As of today)

Comprehensive data for this specific combination is lacking. The information available is based on the individual components. Please consult with a pharmacist or refer to specific product inserts for detailed and updated drug profiles.

Popular Combinations

Data on popular combinations specifically for Bromhexine + Diphenhydramine + Pseudoephedrine is unavailable. However, some commonly used combinations for respiratory symptoms include:

• Bromhexine + Guaifenesin: For chesty cough.
• Diphenhydramine + other antihistamines: For allergy relief.
• Pseudoephedrine + other decongestants: For nasal congestion.

Precautions

Standard precautions apply, including assessing patient history for allergies, metabolic disorders, and organ dysfunction. Specific considerations should be made for pregnant women, breastfeeding mothers, children, the elderly, and those with relevant comorbid conditions. Lifestyle advice like limiting alcohol and avoiding driving when drowsy should be provided.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Bromhexine + Diphenhydramine + Pseudoephedrine?

A: Currently, standard combined dosage for Bromhexine + Diphenhydramine + Pseudoephedrine is unavailable. More research is needed to provide a definitive recommendation. Always consult with a healthcare professional for any dosage inquiries, and follow specific product labels.

Q2: What are the common side effects?

A: Common side effects include drowsiness, dizziness, dry mouth/nose/throat, headache, gastrointestinal upset, and difficulty sleeping.

Q3: Is it safe to use during pregnancy or breastfeeding?

A: Its use during pregnancy and breastfeeding is generally not recommended, especially in the first trimester, due to the lack of definitive safety data.

Q4: What are the major drug interactions?

A: It can interact with MAOIs, certain antihypertensives, antidepressants, and other medications metabolized by the liver.

Q5: Are there any contraindications to this medication?

A: It is contraindicated in severe cardiovascular conditions, severe renal impairment, and hypersensitivity to any component of the combination.

Q6: How does this combination work to relieve cold symptoms?

A: Bromhexine thins mucus, diphenhydramine reduces allergic symptoms, and pseudoephedrine relieves nasal congestion.

Q7: Can this medication be used in children?

A: Safety and efficacy in children have not been fully established. Dosage recommendations for children are generally unavailable, and it’s advisable to consult a pediatrician.

Q8: What should I do if I experience side effects?

A: If side effects are mild, they may resolve on their own. For persistent or bothersome side effects, consult a healthcare professional. In case of serious or allergic reactions, seek immediate medical attention.

Q9: How should this medicine be stored?

A: Store in a cool, dry place away from direct sunlight and out of reach of children. Refer to specific product labels for detailed storage instructions.