bromhexine hydrochloride / Generic mfg. - LARVOL DELTA

Impact of treatment protocols on hospital length of stay for COVID-19 patients: A machine learning analysis of cases in Khuzestan province, Iran. (PubMed, Health Informatics J) - " Actemra and Bromhexine exhibited the strongest correlation with LOS. The ML models predicted LOS with high accuracy, demonstrating their potential to assist clinical decisions. Overall, early treatment and predictive modeling can enhance patient outcomes and optimize hospital resource use."

Journal • Cardiovascular • Diabetes • Infectious Disease • Metabolic Disorders • Novel Coronavirus Disease

Association between early administration of mucoactive agents and in-hospital mortality in patients with pneumonia requiring mechanical ventilation: a nationwide cohort study. (PubMed, J Intensive Care) - "In patients with ventilated pneumonia, early administration of mucoactive agents was associated with lower in-hospital mortality."

Journal • Infectious Disease • Pneumonia • Respiratory Diseases

N-acetylcysteine inhalation improved sputum rheology in chronic productive cough: Clinical application in two cases. (PubMed, Respir Investig) - "Rheological measurements before and 30 min after inhalation were compared retrospectively in 16 outpatients receiving either NAC (n = 9) or bromhexine hydrochloride (BXH) (n = 7). In addition, two case reports, a 67-year-old man with bronchorrhea and a 79-year-old woman with refractory asthma, demonstrated improved quality-of-life scores evaluated with the Cough and Sputum Assessment Questionnaire (CASA-Q) and rheological improvement following 1-2 weeks of twice-daily NAC inhalation. These findings suggest that nebulized NAC may be a promising add-on therapy for refractory airway diseases characterized by high sputum stringiness (γC)."

Journal • Asthma • Cough • Immunology • Pulmonary Disease • Respiratory Diseases

Endobronchial chondroma with ossification mimicking chronic obstructive pulmonary disease: a case report. (PubMed, Front Med (Lausanne)) - "Upon admission, the patient received treatment with ceftazidime and bromhexine hydrochloride; however, no significant improvement was observed. Despite being rare and lacking specific clinical manifestations or imaging characteristics, it is crucial to remain vigilant regarding potential uncommon diseases such as endobronchial chondroma in patients presenting with long-term cough, expectoration, asthma symptoms alongside a smoking history-even when common conditions like chronic obstructive pulmonary disease are initially suspected. When conventional treatments prove ineffective, timely examination via fiberoptic bronchoscopy should be conducted to prevent missed diagnoses of rare lesions like endobronchial chondroma due to symptom overlap with more prevalent diseases."

Journal • Asthma • Chronic Cough • Chronic Obstructive Pulmonary Disease • Cough • Immunology • Infectious Disease • Lung Cancer • Oncology • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • Solid Tumor

Multiple concurrent opportunistic infections in patient with myasthenia gravis: A case report. (PubMed, Virulence) - "The patient exhibited persistent ptosis and pulmonary infection, and was treated with Meropenem 12 mg once daily (qd), Tacrolimus 2 mg qd, and Bromhexine 60 mg three times daily (tid)...Based on these findings, the treatment plan was adjusted to include Amphotericin B complex 25 mg via intravenous (IV) qd, Tigecycline 100 mg q12h, and Sulfamethoxazole (SMZ) 0.96 g q6h for anti-infection, along with Ganciclovir 250 mg IV q12h. The patient continues to receive infusions of immunoglobulins and albumin. This case underscores the importance of monitoring MG patients on immunosuppressive therapy for opportunistic infections, emphasizing the complexity of managing multiple pathogens simultaneously."

Journal • CNS Disorders • Cytomegalovirus Infection • Gastroenterology • Immunology • Infectious Disease • Myasthenia Gravis • Respiratory Diseases

Exploring Schiff base bromhexine derivatives: study on synthesis, characterization, biological assays, molecular docking. (PubMed, Future Med Chem) - "Molecular docking studies against α-amylase and α-glucosidase revealed strong inhibition scores, with BM6 and BM7 emerging as the most promising candidates. This study concludes that derivatives could serve as lead compounds in the development of novel therapeutic agents."

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Combining kinetics and in silico approaches to evaluate bromhexine as an anti-pancreatic lipase agent for obesity management. (PubMed, Sci Rep) - "Currently, the only clinically approved pharmacological agent for pancreatic lipase inhibition is Orlistat. Collectively, our findings suggest that Bromhexine displays potent pancreatic lipase (PL) inhibition activity and could serve as a potential candidate in weight management as demonstrated by both in silico and in vitro analyses. However, further investigations, including structure-activity relationship (SAR) analyses and in vivo studies, are necessary to confirm its clinical potential as a pancreatic lipase inhibitor."

Journal • Genetic Disorders • Obesity

Study on the Pharmacokinetics of Bromine Hexane Hydrochloride Tablets in Healthy Adults (clinicaltrials.gov) - P1 | N=33 | Completed | Sponsor: Second Affiliated Hospital of Wenzhou Medical University | Not yet recruiting ➔ Completed | Trial completion date: Dec 2024 ➔ Jul 2024 | Trial primary completion date: Dec 2023 ➔ Jul 2024

Trial completion • Trial completion date • Trial primary completion date

A confirmatory clinical trial of inhaled bromhexine hydrochloride solution for adult expectorant therapy (ChiCTR) - P3 | N=316 | Recruiting | Sponsor: Shenzhen People's Hospital; Shenzhen People's Hospital

New P3 trial • Bronchiectasis • Chronic Obstructive Pulmonary Disease • Immunology • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

Phase IIa randomized placebocontrolled clinical trial to evaluate the efficacy of bromhexine in combination with standard therapy in the early treatment of COVID-19 in primary care patients. (PubMed, Rev Med Chil) - "Since coughing is one of the primary forms of transmission for SARS-CoV-2, the observed reduction of coughing might be highly beneficial, particularly for patients living in crowded, poorly ventilated, or confined environments."

Clinical • Journal • P2a data • Cough • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Comparative Pharmacokinetics and Egg Residues of Amoxicillin, Single and in Combination with Bromhexine, in Laying Hens. (PubMed, Pathogens) - "The concentration of BRM in the eggs remained at 100 μg/kg up to the fourth day following drug administration. These results confirmed that BRM co-administration increased systemic exposure to AMX, with a negligible residual impact of amoxicillin in eggs."

Combination therapy • Journal • PK/PD data

Development of a rapid method for the simultaneous determination of aminophylline, doxofylline, bromhexine, and ambroxol by HPLC. (PubMed, Sci Prog) - " The established HPLC method is simple, reliable, and stable, allowing for the simultaneous determination of the four antitussive and expectorant drugs. APL, DXL, BXH, and AXH were stable within 48 hours when mixed with 0.9% sodium chloride and 5% glucose injections."

Journal • Respiratory Diseases

Efficacy and safety of mucolytics in patients with stable chronic obstructive pulmonary disease: A systematic review and meta-analysis. (PubMed, Respir Investig) - "Mucolytics reduce exacerbations and hospitalizations in patients with stable COPD and have a safety profile comparable to that of placebo."

Journal • Retrospective data • Review • Chronic Obstructive Pulmonary Disease • Immunology • Pulmonary Disease • Respiratory Diseases

Analysis of binary mixture of oxytetracycline and bromohexine in their combined veterinary formulation by four simple spectrophotometric methods with greenness assessment. (PubMed, BMC Chem) - "Formulating bromhexine (BR) with oxytetracycline (OTC) improved the antibacterial activity of OTC, besides it is considered as a mucolytic agent. The proposed methods are highly selective, robust and precise. Additionally they are time and money effective and can be used in any analytical laboratory."

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Application of Hydrophilic Polymers to the Preparation of Prolonged-Release Minitablets with Bromhexine Hydrochloride and Bisoprolol Fumarate. (PubMed, Pharmaceutics) - "Sodium alginate in the amount of 50% was also effective in prolonging dissolution, but PVA was much less effective. Studies on the release kinetics showed that dissolution from prolonged-release minitablets with BHX fit the best to Hopfenberg or Hixson-Crowell models, while in the case of BFM, the best fit was found for Hopfenberg or Korsmeyer-Peppas models."

Journal • Pediatrics

Bidentate bromhexine drug coordination modes with various transition metal ions: Synthesis, characterization, and in vitro antibacterial and anti-breast cancer activity tests. (PubMed, J Trace Elem Med Biol) - "All the output data conjugated to confirm the octahedral geometry of the metal complexes. The biological findings revealed that metal complexes can be more active than the free BHX ligand. Against MCF-7 cell line, Cd(II)-L complex is highly active complex (4.95 µg/mL) but BHX free drug is the most active compound (3.96 µg/mL)."

Journal • Preclinical • Breast Cancer • Oncology • Respiratory Diseases • Solid Tumor

Prospective,multi-center,and large-scale hospital centralized monitoring of clinical safety of Reduning Injection in 100249 children cases (PubMed, Zhongguo Zhong Yao Za Zhi) - "47 cases(61.84% of ADR patients) were treated with medication, of which dexamethasone was the most used(24 cases, 46.15% of ADR patients). ADRs are more likely to occur when diagnosed with acute bronchitis by western medicine and cough by traditional Chinese medicine(TCM), TCM syndrome type is wind heat syndrome, and the combination medicine is ambroxol hydrochloride and bromhexine hydrochloride injection, ascorbic acid/vitamin C injection. This result provides an evidence-based safety basis for active pharmacovigilance of Reduning Injection in adolescents aged 14 years and below."

Journal • CNS Disorders • Cough • Dermatology • Epilepsy • Pain • Pruritus • Pulmonary Disease • Respiratory Diseases

Clinical Toxicology of OTC Cough and Cold Pediatric Medications: A Narrative Review. (PubMed, Pediatric Health Med Ther) - "This review underscores the critical importance of clinical toxicology in evaluating the safety and toxicity profile of OTC medications employed for treating CCS in pediatric patients. The findings highlight the significance of informed clinical practice and public health policies to ensure the well-being of children using OTC cough and cold medications."

Journal • Review • Cough • Pain • Pediatrics • Respiratory Diseases

Beyond the lungs: Exploring diverse applications of bromhexine and ambroxol. (PubMed, Life Sci) - "Accordingly, more clinical studies are needed to determine the effectiveness of bromhexine and ambroxol in these conditions. This article provides an overview of the potential extrapulmonary applications of bromhexine and ambroxol and discusses the potential advantages of using these drugs in multisystem disorders."

Journal • Review • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Pulmonary Disease • Respiratory Diseases

Enhancing pulmonary delivery and immunomodulation of respiratory diseases through virus-mimicking nanoparticles. (PubMed, J Control Release) - "Composed of low molecular weight polyethylene glycol-coated lipid nanoparticles with bromhexine hydrochloride, NBL exhibit a size of 118 ± 24 nm, a neutral zeta potential, osmolarity of 358 ± 28 mOsmol/kg, and a pH of 6.5...These findings suggest a potential mechanism to regulate the excessive IL-6 expression triggered by virus infection. Therefore, the NBL platform demonstrates promising potential for efficient pulmonary drug delivery and immunomodulation, offering a novel approach to addressing mucus permeation and inflammation in pulmonary diseases."

Immunomodulating • Journal • Immunology • Infectious Disease • Inflammation • Novel Coronavirus Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases • IL10 • IL6 • MUC1 • MUC5AC

A drug-excipient interaction impurity of bromhexine hydrochloride injection: Structure and formation mechanism elucidation. (PubMed, J Pharm Biomed Anal) - "Further, the formation mechanism of the impurity was discussed. Overall, this study elucidates the cause, origin, and mechanism of an unknown impurity in bromhexine hydrochloride injection, providing a basis for quality control for bromhexine hydrochloride injections and drug products containing both amine and tartaric acid."

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Effect of increasing doses of colchicine on the treatment of 333 COVID-19 inpatients. (PubMed, Immun Inflamm Dis) - "Inpatients in Bulgaria with added colchicine and bromhexine to SOC achieved better clinical and mortality outcomes than those on SOC alone. These results question the World Health Organization-recommended strategy to inhibit viral replication. We posit that our treatment strategy to inhibit the Severe acute respiratory syndrome coronavirus 2 entry into the cell with inhaled bromhexine and the hyperactivated NLRP3 inflammasome with higher doses of colchicine, prevents the development of cytokine storm. The timing of the initiation of treatment seems critical."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • NLRP3

Mucolytic Drugs Ambroxol and Bromhexine: Transformation under Aqueous Chlorination Conditions. (PubMed, Int J Mol Sci) - "Seven of them, including methoxy derivatives, were first discovered in the present study. One more novel class of DBPs associated with bromhexine and ambroxol is represented by halogenated indazoles formed through dealkylation of the primary transformation products containing pyrazoline or tetrahydropyrimidine cycle in their structure."

Journal • Respiratory Diseases

Research Note: Pharmacokinetics of bromhexine hydrochloride in broilers after single oral and intravenous administration. (PubMed, Poult Sci) - "Furthermore, gender effects were assessed on the pharmacokinetics of bromhexine hydrochloride in broilers, revealing better absorption in male broilers compared to females. This disparity may be attributed to the faster blood flow and richer blood volume typically found in male broilers."

Journal • PK/PD data

Antimicrobial efficiency of bromhexine hydrochloride against endometritis-causing Escherichia coli and Trueperella pyogenes in bovines. (PubMed, Braz J Microbiol) - "The bacterial isolates showed greater resistance to sulfamethoxazole + trimethoprim (58.2%) and tetracycline (56.3%). Among the species, E. coli showed the highest resistance rates, with 100% of isolates showing resistance to amoxicillin, streptomycin, and gentamicin...Bromhexine hydrochloride showed antimicrobial activity against 100% of E. coli isolates and 66.6% of T. pyogenes isolates. Furthermore, when associated with antimicrobials, bromhexine hydrochloride has a synergistic and additive effect, proving to be an option in the treatment of endometritis in cows and an alternative for reducing the use of antimicrobials."

Journal • Endometriosis