Bromhexine HCL,Guaiphenesin & Dextromethorphan HBR Soft Gel Capsules

This softgel contains a combination of Bromhexine, Guaiphenesin and Dextromethorphan. This cough formula offers relief from productive cough with their synergistic effects. Bromhexine hydrochloride is a synthetic derivative of the alkaloid vasicine. Bromhexine is used in a condition where there is a lot of thick mucus in the airways. As a mucolytic, it helps to relieve productive cough by thinning the mucus in the airways and facilitating the removal of the mucus. Guaiphenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth. Guaiphenesin is used to reduce chest congestion caused by the common cold, infections, or allergies. Dextromethorphan belongs to a group of medications called antitussives (cough suppressants). This medication works by suppressing dry, hacking coughs. It is usually used for a short term to control coughing associated with the flu, cold, or due to inhaled irritants. Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.
This combination is useful in Productive cough caused by flu, cold, or due to inhaled irritants.

BROMHEXINE:

Bromhexine hydrochloride is a synthetic derivative of the alkaloid vasicine. Bromhexine is used in a condition where there is a lot of thick mucus in the airways. As a mucolytic, it helps to relieve productive cough by thinning the mucus in the airways and facilitating the removal of the mucus.
How it Works?
Bromhexine works by encouraging the body's natural process for clearing mucus from the respiratory tract. It does this by increasing the production of serous mucus which is a thin type of mucus which dilutes the phlegm making it less hard and sticky. This also helps to 'lubricate' that hard phlegm which is already there – aiding the cilia (tiny hairs which line the respiratory tract) in sliding the phlegm out from the lungs.

GUAIPHENESIN:

Guaiphenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth. Guaiphenesin is used to reduce chest congestion caused by the common cold, infections, or allergies.
How it Works?
Guaiphenesin is an expectorant which after absorption from the gastrointestinal tract secreted by tracheobronchial glands and directly increase bronchial secretion and mucosal ciliary action. It increases respiratory tract fluid by reducing adhesiveness and surface tension, reducing viscosity of the secretions and there by facilitating their removal and clears chest congestion. 

DEXTROMETHORPHAN:

Dextromethorphan belongs to a group of medications called antitussives (cough suppressants). This medication works by suppressing dry, hacking coughs. It is usually used for a short term to control coughing associated with the flu, cold, or due to inhaled irritants. Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.
How it Works?
Dextromethorphan doesn’t actually treat the cause of cough or speed up recovery—but it can offer you some much-needed relief. It works by decreasing activity in the part of the brain that causes coughing.

Pharmacokinetics of Bromhexine

Following oral administration, bromhexine is rapidly absorbed, with peak plasma levels being reached within 1 h. As it is lipophilic, it is rapidly redistributed, undergoes extensive hepatic metabolism and is excreted via the urine and bile.

Pharmacokinetics of Guaiphenesin

Absorption: Well absorbed orally.
Distribution: It is secreted by the tracheobronchial glands. 
Metabolism: It is metabolized primarily to Beta-2-methoxyphenoxy-lactic acid.
Excretion: It is excreted in the urine. 

Pharmacokinetics of Dextromethorphan

Following oral administration, dextromethorphan is rapidly absorbed from the gastrointestinal tract, where it enters the bloodstream and crosses the blood–brain barrier. Dextromethorphan is rapidly absorbed from the gastrointestinal tract and converted into the active metabolite dextrorphan in the liver by the cytochrome P450 enzyme CYP2D6.

Side effects of Bromhexine:

This medicine may cause side effects such as:
  • Gastrointestinal symptoms (nausea, vomiting, stomach ache or diarrhoea);
  • Lightheadedness;
  • Sweating.
Consult a doctor if these or other side effects are severe.
When not to use Bromhexine?
  • Do not use Bromhexine, if you are allergic to any of its ingredients.
  • Expectorant cough medicine should not be combined with cough suppressants (medicine for dry coughs).
Interactions with other medications:
Inform your doctor or pharmacist if you are taking any antibiotics as bromhexine may increase the absorption of antibiotics or if you are planning to take other medications, nutritional supplements, or herbal products.

Pregnancy/driving ability/alcohol:
Do not use Bromhexine, or only with a doctor's approval, if you are pregnant or breastfeeding.
This medicine may cause side effects that interfere with your ability to react. Stay out of traffic if you are less alert or dizzy. Bromhexine does not interact with alcohol.

Side effects of guaiphenesin:

Common side effects of guaiphenesin may include:
  • dizziness or headache,
  • a rash, or
  • nausea, vomiting, or stomach upset.
Consult a doctor if these or other side effects are severe.
When not to use Guaiphenesin?
You should not use guaiphenesin if you are allergic to guaiphenesin.
Do not give guaiphenesin to a child younger than 4 years old. 

Interactions with other medications:
There may be other drugs that can interact with guaiphenesin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Pregnancy/driving ability/alcohol:
Tell your doctor if you are pregnant or plan to become pregnant while using this medication. 
It is not known whether guaiphenesin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Side effects of Dextromethorphan:

Side effects associated with use of Dextromethorphan, include the following:
  • nausea
  • vomiting
  • constipation
  • drowsiness
  • dizziness
  • sedation
  • confusion
  • nervousness
Consult a doctor if these or other side effects are severe.

When not to use Dextromethorphan?
  • Avoid simultaneous use with nonselective monoamine oxidase inhibitors (MAO inhibitors) – serotonin syndrome
  • May cause hallucinations, confusion, agitation, overactive reflexes, shivering, twitching of muscles and rapid heart rate
  • Not for use in children under 4 years old and use caution when using in children younger than 6 years old
  • Use caution in patients who are sedated, debilitated or confined to a supine position


Interactions with other medications
Severe Interactions of Dextromethorphan include:
  • isocarboxazid
  • phenelzine
  • procarbazine
  • rasagiline
  • safinamide
  • selegiline
  • tranylcypromine
Pregnancy/driving ability/alcohol
  • Use dextromethorphan during pregnancy with caution if benefits outweigh risks.
  • It is not known if dextromethorphan is excreted in breast milk, use caution if breastfeeding
  • This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages.
Store in a cool, dry place.
Keep out of reach of children