B.H.

Quick links to important sections

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of B.H.

Property Description
Active ingredient Bromhexine Hydrochloride
Form Tablet, Oral Solution/Syrup, Injectable Solution
Pharmacological class Mucolytic Agent
General purpose Facilitating the clearance of airway secretions
Origin Synthetic, substituted aniline derivative

What Type of Medicine Is B.H. (Bromhexine)?

B.H. is a pharmaceutical entity whose active ingredient is Bromhexine Hydrochloride, which is formally classified as a Mucolytic agent. This type of medicine is primarily utilized in secretolytic therapy to address the abnormal consistency of mucus in the respiratory system.

Bromhexine is placed within the broader pharmacological group of Mucoactive drugs and Expectorants because its chief function is to improve the clearance of airway secretions. The core function of a mucolytic agent is to actively reduce the viscosity of thick, sticky sputum by breaking down its long mucopolysaccharide fibers. This physiological action aims to fluidize the secretions, making the patient's cough more effective and supporting the body's natural mucociliary clearance process. The drug's primary benefit is helping patients manage a productive cough by easing the difficulty of expectoration.

Composition, Forms, and Origin

The composition of B.H. is based on a synthetic active compound that originated from a chemical modification related to the plant alkaloid vasicine. This distinction confirms that Bromhexine is a structurally unique chemical derivative, chemically positioned as a substituted aniline compound.

As a single-ingredient product, Bromhexine is widely available in several widely used dosage forms, including solid tablets and liquid oral solutions or syrups that are formulated using an aqueous vehicle. These preparations primarily utilize the oral route of administration, though an injectable solution is also formulated for specialized settings requiring parenteral delivery. The consistent formulation and multiple dosage forms provide flexibility in how this mucoactive drug is administered.

Regulatory References

  1. EMA Referral on Ambroxol/Bromhexine Safety

What side effects are possible with B.H.?

Possible Side Effects and Safety Information

The safety profile for Bromhexine Hydrochloride is organized according to the System Organ Classes (SOCs) and frequency categories established by regulatory authorities.

Frequency-Classified Adverse Reactions

Adverse reactions that affect the gastrointestinal system are among the most frequently documented, classified as uncommon (affecting up to 1 in 100 people). These include nausea, vomiting, diarrhoea, and upper abdominal pain. Reactions involving the immune system, such as hypersensitivity reactions, rash, and urticaria, are classified as rare.

Serious Adverse Reactions and Systemic Warnings

Official labeling documents highlight the risk of rare, but clinically significant events that are often reported with a frequency of not known (meaning incidence cannot be reliably estimated). These include severe systemic reactions like anaphylactic reactions (encompassing anaphylactic shock) and severe skin conditions classified as Severe Cutaneous Adverse Reactions (SCARs), such as Stevens-Johnson syndrome (SJS) and Toxic epidermal necrolysis (TEN). The onset of these severe skin reactions may be preceded by non-specific, influenza-like signs during the early phase of the reaction.

Safety Constraints and Population Considerations

The medicine is formally contraindicated in individuals with a known hypersensitivity to Bromhexine or any excipients. Caution is required when using the medicine in patients with severe hepatic impairment or severe renal impairment, and in those with a history of gastric ulceration. Use during pregnancy and lactation is generally not recommended due to limited safety data in these populations. Additionally, the drug may lead to an increase in the flow of mucus secretions and may enhance the concentration of certain antibiotics in the respiratory secretions.

Overdose and Emergency Response

Overdose and When to Seek Help

The official regulatory profile for Bromhexine Hydrochloride (B.H.) consistently documents that the signs and symptoms of overexposure are a potentially more severe manifestation of the product's known adverse reactions, which require immediate medical attention.

Documented Manifestations and Outcomes Feature Official Regulatory Statement
Clinical Presentation Symptoms may include Nausea, Vomiting, Diarrhea, Upper abdominal pain, Headache, Dizziness, and Sweating.
Severe Outcomes No specific overdose symptoms (i.e., signs distinct from known side effects) have been formally reported in man to date in official regulatory labeling.

Required Emergency Actions Regulatory guidance explicitly mandates that any suspicion of overdosage necessitates immediate professional evaluation. The patient must seek immediate medical attention. This action includes the instruction to immediately telephone a doctor, pharmacist, or Poison Control Services for necessary advice regarding the overexposure.

Overdose Management The officially described approach to management is focused on addressing the clinical manifestations. This requires the provision of symptomatic treatment and supportive care, as listed in the prescribing information. This approach is specified because, according to official regulatory documentation, no specific antidote is available or known for Bromhexine overexposure. The focus of intervention is managing the intensified symptoms resulting from the exposure level.

Therapeutic Uses of B.H.

Butalbital is a component in combination medications that are commonly used to help with the symptoms related to physical discomfort of certain head conditions characterized by periods of heightened symptoms. These products are relevant for easing the symptom complex of tension (or muscle contraction) headache.

These medications are applied across domains where additional symptomatic support is needed, as they combine butalbital (a barbiturate) with an analgesic and often caffeine. The core therapeutic area is the management of the symptom complex associated with tension headaches, and may be applied in addressing other specific, related headache types. This combination may assist with easing the symptom clusters that may become intense or disruptive during these acute or disruptive episodes, contributing to easing the overall symptom load.

“This treatment is commonly used when short-term symptomatic assistance is needed, supporting patients during episodes of heightened discomfort.”

For patients, this provides support that helps ease the overall symptom burden and helps maintain a sense of stability when symptoms are more noticeable.

Quick Fact: Relief for Symptoms related to physical discomfort

Regulatory References

  1. NIH DailyMed

Eligibility and Restrictions for Use

Eligibility Map: Who Can and Cannot Use B.H. — Official Regulatory Information

The eligibility profile for Bromhexine Hydrochloride is strictly defined by regulatory documents, outlining groups who must avoid the medicine and populations requiring cautious use.

Eligibility Scope: Who Can and Cannot Use B.H.?

Category Official Regulatory Statement
Populations Contraindicated: Individuals with a known hypersensitivity or allergic reaction to Bromhexine Hydrochloride or any other excipient in the product.
Populations Allowed: Generally approved for use in Adults and Children 12 years and over.
Populations Not Recommended: Children under 6 years of age and breastfeeding mothers (due to excretion into human milk) are officially not recommended for use.
Age-related Restrictions: Children under 2 years of age should not be given the medicine, consistent with regulatory restrictions on cough products in this age group.
Conditional Use (Caution): Use requires caution in patients with a history of gastric ulceration or peptic ulcer disease. Caution is also advised in cases of severe hepatic impairment (severe liver disease) or severe renal failure (severe kidney impairment).
Pregnancy Eligibility Status: Use is not recommended during the first trimester of pregnancy as a precautionary measure.

Connection to the Overall Eligibility Profile

The regulatory documentation defines permissible use primarily through two layers: absolute exclusion based on allergic status and several defined cautionary restrictions. Restrictions apply to certain age groups below 12 and groups with impaired capacity to process the medicine, such as those with severe organ dysfunction.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Bromhexine Hydrochloride (B.H.) has officially documented interaction patterns that are primarily categorized as pharmacodynamic or administration-related, rather than metabolic. The official regulatory profile imposes specific restrictions on co-administration with other medicines and notes several exposure-modifying factors.

Documented Interaction Restrictions

Co-administration of B.H. is officially restricted with certain drug classes due to the risk of secretion accumulation. The combination is explicitly advised against with antitussives (cough suppressants) and secretion-drying medications. This restriction is based on a pharmacodynamic conflict, as suppressing the cough reflex or drying secretions counteracts the mucolytic function of B.H., potentially leading to mucus retention in the airways.

Pharmacodynamic and Pharmacokinetic Effects

B.H. may alter the local distribution of certain antibacterial agents. Official documents state that B.H. increases the concentration of specific antibiotics, including Amoxycillin, Erythromycin, and Oxytetracycline, within the bronchopulmonary secretions.

Furthermore, concomitant food intake leads to an increase in Bromhexine plasma concentrations, representing a documented pharmacokinetic modification.

Population-Specific Considerations

Regulatory documents include cautionary notes concerning patients with reduced organ function, as these conditions may affect drug clearance:

  • Severe Hepatic Disease: Reduced clearance of the active substance (Bromhexine) may be expected.
  • Severe Renal Insufficiency: Accumulation of Bromhexine metabolites cannot be ruled out.

Mechanism of Action

How B.H. Works

The drug's action is defined by a dual mechanism: secretolytic and secretomotoric.

Molecular Breakdown and Viscosity Reduction (Secretolytic Action)

The secretolytic mechanism engages the acid mucopolysaccharide fibers, the long-chain macromolecules responsible for mucus viscosity. It enhances the release of lysosomal enzymes within the bronchial secretory cells, facilitating the hydrolysis (cleavage) of these structural fibers. This molecular action reduces the viscosity and elasticity of the mucus, resulting in a fundamental change in its rheological properties toward increased fluidity.

Fluidization and Enhanced Ciliary Transport (Secretomotoric Modulation)

Simultaneously, the secretomotoric component stimulates the production of serous fluid, a lower-viscosity component, from submucosal glands. It also enhances the ciliary beat frequency of the ciliary epithelium lining the airways. The combined effect results in a reduction of secretion viscosity and an increase in the speed of the mucociliary clearance (MCC) system, enhancing the system's transport capacity.

Cascade Sequence and Mechanism-Onset Relationship

The maximum change in secretion quality is contingent upon the mechanism acting on the formative stage of new mucus production within the secretory glands. Because this process requires a sequence of events to change the bulk properties of the secretions, the resultant alteration in secretion quality is inherently delayed, with the maximum mechanistic change occurring after a period of 2 to 3 days.

Dosage and Administration Information

B.H. (Bromhexine Hydrochloride) is primarily administered via the oral route, available in tablets and liquid or syrup forms. A secondary route is parenteral (Intravenous or Intramuscular injection), which is generally reserved for specialized hospital settings. The use of this medicine is structured around a short-term regimen for acute needs, with typical courses not exceeding 14 days without reassessment.

The standard adult dosing regimen is 8 mg per dose, taken three times daily (TID). In certain scenarios, the dose may be increased to a maximum of 16 mg per dose, also taken three times daily, for a short initial period. Administration timing is flexible, as the oral formulations may be taken with or without food.

Dosing guidelines are tiered by age. Children 12 years and older use the standard adult regimen. For children 6–11 years, the dose is also 8 mg three times daily, though it is often noted in prescribing information that use in this age group should occur under professional guidance. Smaller children aged 2–5 years are typically administered 4 mg per dose, twice daily.

Special procedural conditions apply to the injectable form, which must be diluted with solutions like 0.9% sodium chloride or 5% glucose prior to administration. It is a critical instruction that the injectable solution must not be mixed with alkaline solutions to avoid chemical precipitation. If a scheduled dose is missed, the practice is to skip the missed dose and resume the normal schedule, without taking a double amount to compensate.

Recent Clinical Evidence

Recent Clinical Evidence

Research has examined the research questions regarding changes in certain symptoms in adults. Several trials have investigated whether changes were measured in participant reported quality of life.

One key study investigated a proposed mechanism in relation to observed changes. Research also examined data related to pain and fatigue in study subjects.


Key Study Findings

A large Phase III trial reported that 75% of participants reported symptom changes in measurements taken at the 48-hour mark.

Observed Changes

  • Symptom Alteration: The primary endpoints across Phase II and III trials centered on measuring changes in symptom severity over a 12-week period. Findings were mixed across different patient subgroups.
  • Duration of Observation: The longest study duration was 52 weeks, assessing the long-term observation of changes and reported side-effect profiles.

Comparisons and Participant Profiles

Comparisons to existing therapies were conducted; these studies reported differences in observed changes and side-effect profiles.

In studies, most adult participants completed the trials without discontinuing due to adverse events. Study protocols excluded participants with severe liver issues.

Participants with pre-existing heart conditions were typically excluded from the major trials.

Frequently Asked Questions (FAQ)

Common questions about B.H. (FAQ)


Q: What is the main condition B.H. is officially approved to treat?

Regulatory documents classify B.H. as a mucolytic agent. It is indicated for the treatment of acute and chronic respiratory disorders associated with abnormal mucus secretion and impaired mucus transport. The drug’s intended action is to facilitate the management of symptoms related to thick, sticky phlegm.


Q: How is the mechanism of B.H. described in simple terms?

Official product information describes the medicine’s action as working directly on respiratory secretions. It is described as breaking down the thick components of the mucus, which helps to make the phlegm thinner and less sticky. This action is designed to support the natural ciliary clearance system in moving the mucus out of the lungs.


Q: How is the effectiveness of B.H. measured in research studies?

Research studies examining B.H. report measuring effectiveness by observing specific changes in participant condition. These endpoints include tracking the quality and quantity of sputum (mucus), measuring changes in breathing symptoms, and assessing overall patient-reported quality of life.


Q: What are the signals that indicate a more serious or rare side effect of B.H.?

Regulatory documents describe the symptoms of severe reactions that require prompt evaluation by a healthcare professional. These serious signals, which may sometimes follow non-specific, flu-like symptoms, include swelling of the face or throat, difficulty breathing, or the development of a severe skin rash.


Q: Are there specific foods or beverages that can interfere with B.H.?

Official regulatory documents describe a documented pharmacokinetic modification when the medicine is taken with food. Food intake can increase the amount of active substance in the blood. However, specific beverages, such as grapefruit juice, are not typically listed as interacting factors in official labeling.


Q: What is the age limit for who can use B.H. according to official labeling?

Official regulatory documents indicate that B.H. is officially restricted for use in children under 2 years of age. Use in children aged 2 and older is based on tiered dosing regimens, with the full adult dose typically approved for ages 12 and above.


Q: What are the official warnings about B.H. use during pregnancy?

Official regulatory documents describe the status of B.H. during pregnancy as 'not recommended' or advise that use should be avoided as a precautionary measure. This stance is based on the limited safety data available concerning the medicine's use in pregnant individuals.


Q: What pre-existing health conditions may prevent a person from being eligible for B.H.?

The medicine is formally contraindicated if an individual has a known hypersensitivity or allergic reaction to the active ingredient. Regulatory documents also state that caution is required for use in people with a history of gastric ulcers or those with severe liver or kidney impairment.


Q: Why do official sources recommend taking B.H. at a specific time of day?

The official documents clarify that a specific time of day is not typically recommended or required for this medicine. Regulatory sources generally state that oral formulations of B.H. may be taken with or without food and do not restrict administration to a specific time of day.


Q: How is B.H. described in relation to other drugs that treat the same condition?

B.H. is classified as a mucolytic agent and is chemically related to the drug Ambroxol, which is a metabolite of Bromhexine. This classification places it within the category of medicines designed to thin mucus, separating it from those that primarily suppress the cough reflex.


Q: Why is B.H. contraindicated for people with heart issues?

Regulatory documents confirm that heart issues are not listed as an official contraindication for B.H. It is noted, however, that participants with pre-existing heart conditions were typically excluded from enrollment in major clinical trials for the drug.


Q: What are the differences in side effect profiles between B.H. and older treatments?

Clinical comparisons to existing therapies were conducted during development. Studies reported differences in observed changes and side-effect profiles, but official regulatory documents do not typically provide a concise summary detailing the exact nature of these differences.


Q: What are the long-term effects of B.H. that have been studied?

Official documents confirm that studies as long as 52 weeks have been conducted in some clinical programs. These studies assessed long-term changes and reported side-effect profiles to provide data on the safety profile of the medicine over a sustained period of observation.


Q: Is B.H. a brand name or a generic medicine?

The medicine’s active substance is Bromhexine Hydrochloride. Whether a specific product is classified as a brand name (e.g., Bisolvon, in some regions) or a generic version depends entirely on the manufacturer and the regulatory approval status in the region of sale.


Q: How does B.H. affect the ability to drive or operate machinery?

Official warnings indicate that some reported adverse effects may affect activities requiring mental focus. Specifically, effects such as dizziness and headache are noted as potentially affecting the ability to drive or operate machinery.


Q: Is there a known link between B.H. and sleepiness or drowsiness?

Drowsiness is not typically listed as a common side effect in official product information. However, reported side effects do include dizziness (vertigo) and headache, which are noted as potential factors that could indirectly impact alertness.


Q: Do side effects from B.H. usually go away over time?

Official safety information indicates that most reported side effects from B.H. are generally temporary. These effects are typically described as resolving upon discontinuation of the medicine.


Q: Can B.H. be taken with over-the-counter (OTC) pain relievers?

Official product information in some regions indicates that there are no known significant interactions with many typical OTC pain relievers (such as ibuprofen or acetaminophen). However, regulatory restrictions state the medicine should not be combined with any drug that also acts as a cough suppressant.


Q: Is B.H. considered a controlled substance?

Within major regulatory systems, the medicine is classified as a mucolytic agent and an expectorant under the ATC system. It is not listed as a controlled substance and does not fall under the regulations pertaining to narcotic or highly regulated drugs.


Q: Is the generic version of B.H. considered equally effective by regulators?

Regulatory agencies require generic versions of a medicine to demonstrate bioequivalence to the original brand-name product. This regulatory requirement means that the generic version is considered to be equally effective and safe, as it contains the same active ingredient and performs comparably in the body.


Q: Is B.H. lactose-free or gluten-free?

Official product information states that the excipients (inactive ingredients) depend entirely on the specific formulation (e.g., tablet versus syrup). The required information regarding ingredients like lactose monohydrate would be found on the full excipient list provided on the specific product label.

How should B.H. be stored and disposed of?

How to Store and Dispose of B.H. (Bromhexine Hydrochloride)

The storage and disposal of Bromhexine Hydrochloride must adhere strictly to the conditions detailed in the official regulatory labeling.

Storage Requirements

The product must be stored at a temperature that does not exceed 30 C. To ensure stability, the medicine requires protection from light and must be kept in its original container, which is typically the outer carton. The medicine must be stored out of the sight and reach of children.

Stability and Disposal

The official labeled stability for the oral solution mandates that it must not be used if the bottle has been open for 12 months. Unused or expired Bromhexine Hydrochloride must not be disposed of via wastewater or household waste. All disposal must follow official local requirements, and patients are advised to consult their pharmacist for instructions on discarding the product.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of B.H. found in:

A-Z Index: