Natterman Hoestdrank Extra Sterk Suikervrij (Bromhexine Hydrochloride)

Bromhexine Hydrochloride is indicated for respiratory conditions where thick mucus impairs clearance.

• Cough with thick mucus: reduces mucus viscosity to facilitate expectoration and ease coughing.
• Acute bronchitis: improves clearance of secretions, helping to relieve productive cough and discomfort.
• Upper respiratory tract infections: assists in loosening mucus associated with viral or bacterial infections, supporting normal breathing.

• Bromhexine Hydrochloride acts as a mucolytic by depolymerising mucopolysaccharide fibers in respiratory secretions. This reduces the viscosity and elasticity of mucus, enhancing ciliary transport and promoting expectoration. The drug does not possess direct bronchodilator activity but improves airway clearance by modifying the physical properties of sputum.

Bromhexine Hydrochloride is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhoea: increased loose stools.
• Taste disturbance: altered or unpleasant taste.
• Headache: mild cranial discomfort.

Serious or Rare Side Effects

• Allergic reactions: rash, urticaria, or angioedema.
• Severe gastrointestinal bleeding: uncommon but serious.
• Hepatic enzyme elevation: rare liver function changes.
• Anaphylaxis: life‑threatening hypersensitivity.
• Eosinophilia: abnormal increase in eosinophils.

When using bromhexine syrup, consider the following safety measures.

• Pregnancy: consult a healthcare professional; safety data are limited.
• Breastfeeding: use with caution; excretion in milk is not well defined.
• Renal impairment: dose adjustment may be required in severe dysfunction.
• Asthma: monitor for bronchospasm, although rare.
• Drug interactions: review all concomitant medications for potential effects.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Bromhexine may interact with other medicines; awareness helps avoid reduced efficacy or increased risk.

Major Interactions (Avoid)

• Cough suppressants (e.g., codeine): may mask the expectorant effect of bromhexine.
• Certain macrolide antibiotics (e.g., erythromycin): can increase bromhexine plasma concentrations.

Moderate Interactions (Monitor Closely)

• Anticholinergic agents: may diminish mucociliary clearance benefits.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): monitor for gastrointestinal irritation.
• Antihistamines: observe for additive sedation or drowsiness.