Bromhexine + Guaifenesin + Phenylpropanolamine

Usage

This combination medication is prescribed for the relief of cough with mucus, chest congestion, and common cold symptoms. It is classified as an expectorant, mucolytic, and decongestant. The combination works by thinning and loosening mucus (bromhexine and guaifenesin), suppressing cough (dextromethorphan, if present in some formulations), and reducing nasal congestion (phenylpropanolamine).

Alternate Names

Bromhexine-Guaifenesin-Phenylpropanolamine. Brand names vary depending on the manufacturer and region. Examples found include Kabu Tablet, Sudin Kid Syrup, and Tussnil Tablet. It is important to note that this exact combination isn’t a standard fixed-dose combination in all regions.

How It Works

Pharmacodynamics:

• Bromhexine: This mucolytic agent breaks down mucopolysaccharides, reducing the viscosity of mucus. This makes it easier to expectorate.
• Guaifenesin: An expectorant that increases the volume and reduces the viscosity of respiratory secretions, facilitating their removal by coughing.
• Phenylpropanolamine: An alpha-adrenergic agonist that constricts blood vessels in the nasal mucosa, reducing swelling and congestion.

Pharmacokinetics:

• Absorption: All three components are absorbed orally.
• Metabolism: Primarily hepatic metabolism, although the specific pathways for this combination aren’t detailed in the provided sources.
• Elimination: Primarily renal excretion. Specific details on CYP enzyme involvement aren’t available in the provided sources.

Mode of Action:

• Bromhexine: Depolymerizes mucopolysaccharides.
• Guaifenesin: Stimulates receptors in the gastric mucosa, indirectly increasing respiratory tract fluid.
• Phenylpropanolamine: Acts on alpha-adrenergic receptors in the nasal mucosa.

Dosage

The dosage for this specific combination wasn’t available in the provided sources. Dosage should be determined by a physician based on the patient’s condition and individual components’ recommended dosing.

Standard Dosage

Not explicitly provided in the sources. Information on individual components:

• Guaifenesin: Adults 200-400mg every four hours or 600-1200 mg every twelve hours (extended-release). Children 6-12 years: 100 mg four times daily (maximum 400 mg/day). Children ≥12 years: Same as adult dose.
• Phenylpropanolamine: Adults 25-50 mg every 4-6 hours (maximum 150 mg/day).

Children:

Use with caution in children. Some sources advise against phenylpropanolamine use in children under a certain age (e.g., below 6 years). Consult reliable sources or the prescribing physician for children’s dosing.

Special Cases, Clinical Use Cases, Dosage Adjustments

This information is not provided in the sources for this combination. However, dosage adjustments may be necessary in patients with renal or hepatic impairment, or other medical conditions. Consult a physician for tailored advice.

Side Effects

Common Side Effects:

Nausea, dizziness, headache, anxiety, insomnia.

Rare but Serious Side Effects:

Allergic reactions (rash, itching, difficulty breathing), increased blood pressure, palpitations, cardiovascular events (stroke, heart attack – associated with phenylpropanolamine).

Long-Term Effects: Not specifically addressed in the provided sources.

Adverse Drug Reactions (ADR): Severe allergic reactions, cardiovascular events.

Contraindications

Hypersensitivity to any component, severe liver or kidney disease, recent MAOI use, severe cardiovascular disease, uncontrolled hypertension, hyperthyroidism, closed-angle glaucoma, prostatic hypertrophy.

Drug Interactions

MAOIs, antidepressants, antihypertensives, caffeine, alcohol. Consult a doctor for additional details.

Pregnancy and Breastfeeding

Safety not fully established. Consult a physician before use during pregnancy or breastfeeding. Phenylpropanolamine may decrease milk production.

Drug Profile Summary

As stated previously in this response.

Popular Combinations

Often combined with analgesics, antihistamines, or antipyretics for comprehensive cold symptom relief.

Precautions

Evaluate pre-existing conditions (hypertension, heart disease, diabetes, etc.). Exercise caution in elderly patients. Avoid alcohol and driving if drowsiness occurs.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Bromhexine + Guaifenesin + Phenylpropanolamine?

A: The dosage for this specific combination is not available in the sources. Dosage should be decided by a physician, considering individual component guidelines and patient factors.

Q2: What are the common side effects?

A: Common side effects can include nausea, dizziness, headache, anxiety, and insomnia.

Q3: What are the contraindications for this combination?

A: Contraindications include hypersensitivity, severe liver or kidney disease, recent MAOI use, and certain cardiovascular or thyroid conditions.

Q4: Can this medication be used during pregnancy or while breastfeeding?

A: Safety during pregnancy and breastfeeding isn’t established. Consult a physician before use.

Q5: How does this combination work to relieve cold symptoms?

A: It works by thinning mucus (bromhexine and guaifenesin) and reducing nasal congestion (phenylpropanolamine).

Q6: Are there any drug interactions I should be aware of?

A: Potential interactions exist with MAOIs, antidepressants, antihypertensives, caffeine, and alcohol. Consult a doctor before taking other medications with this combination.

Q7: Can this combination be used in children?

A: Phenylpropanolamine is advised against in young children. Consult a physician regarding the use of this combination in children. Bromhexine and guaifenesin can be used in children with appropriate dose adjustments.

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

A: If you experience any side effects, particularly severe ones like allergic reactions or cardiovascular issues, immediately contact your doctor or seek medical attention.

Q9: Is it safe to drive or operate machinery while taking this medication?

A: This medication can cause dizziness or drowsiness in some people. It is advisable to avoid driving or operating heavy machinery until you know how the medication affects you.

Q10: Can I take this medicine with other cold medications?

A: Taking this combination with other cold or cough medications, especially those containing similar ingredients, can increase the risk of side effects and overdose. It is important to talk to your doctor or pharmacist before combining any medications.