A reappraisal of the mucoactive activity and clinical efficacy of bromhexine.
Since its introduction to the market in 1963, bromhexine, an over-the-counter drug, has been investigated for its activity in animal models and in humans with diverse respiratory conditions. Bromhexine is a derivate of theAdhatoda vasicaplant used in some countries for the treatment of various respiratory diseases. Bromhexine has been found to enhance the secretion of various mucus components by modifying the physicochemical characteristics of mucus. These changes, in turn, increase mucociliary clearance and reduce cough. Principal clinical research studies were primarily developed in an era when stringent methodological approaches and good clinical practices were not developed yet. Clinical studies were conducted mainly in patients with chronic bronchitis and in patients with various respiratory diseases, and demonstrated the efficacy of bromhexine in improving respiratory symptoms. Furthermore, the co-administration of antibiotics with bromhexine amplified the actions of the antibiotic. Although the clinical evidence shows only modest but positive results, bromhexine is indicated for its mucoactive activity. Larger trials with adequate methodology are required to identify when treatment with bromhexine can improve clinical outcomes.
Italian Association for Cough Study (AIST), Via Mazzini 12, 40138 Bologna, Italy.
Alessandro
A
Zanasi
Department of Specialistic-Diagnostic and Experimental Medicine (DIMES), Respiratory and Critical Care Unit, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Massimiliano
M
Mazzolini
Pediatric Asthma and Cough Centre, Istituti Ospedalieri Bergamaschi, University and Research Hospitals, Via Forlanini, 15, 24036 Ponte San Pietro, Italy.
Ahmad
A
Kantar
Bromhexine; Bronchitis; Chronic; Cough; Expectorants [Pharmacological Action]; Pediatrics