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The absorption, excretion and metabolic pattern of bromhexine in man after oral and i.v. administration.

The fate of 14C-labelled bromhexine (Bisolvon¿) in man following intravenous and oral administration was studied by investigation of the blood and plasma levels and the excretion profiles. Slight variations observed between the two administration routes are explained by the somewhat different distribution patterns resulting from the different "first path" after oral application (liver) and intravenous injection (tissues).

Administration, Oral↗

The effect of bromhexine hydrochloride on the viscoelastic properties of mucus from the mini-pig.

Mucus was collected daily from open-ended pouches established surgically in three mini-pigs. After a five day control period bromhexine hydrochloride (BHCl) was administered to each pig at dose levels of 0.5, 1.0 and 2.0 mg.kg-1 twice daily for five days. Each study period was followed by a five day washout period, when mucus was collected but no drug given. The viscoelastic properties of each mucus sample were determined using creep compliance analysis. BHCl was shown to reduce the residual shear viscosity (p less than 0.05) and increase the instantaneous shear compliance at all dose levels (p less than 0.005), despite the large inherent intra- and inter-animal variation in the rheological properties of the daily samples. No change was found in the wet weight of the mucus samples throughout any of the study periods. This experimental model would appear to provide a valuable in vivo method of assessing the mucoregulatory potential of administered compounds.

Animals↗

Kinetic and analytic investigations on the formation of N-nitroso-N-methyl-N-cyclohexylamine from bromhexine and nitrite.

Bromhexine (N-methyl-N-cyclohexyl-(2-amino-3,5-dibromobenzyl)-ammoniumhydr ochloride) forms N-nitroso-N-methyl-N-cyclohexylamine (NMCA) under the conditions of the WHO Nitrosation Assay Procedure (NAP-test). The formation kinetics of this compound was investigated. The formation of NMCA depends on the square of the nitrite concentration. The reaction has a narrow pH-optimum at pH 3. The reaction is quick: After 1 h about 70% of the maximum amount of NMCA is formed. To study this reaction kinetics sensitive assays with a detection limit up to 0.5 ng/ml NMCA were developed. The stability of the components of the system, especially that of NMCA and nitrite, were further studied. The latter is rather instable under conditions found in an acidic stomach.

Bromhexine↗

[The stability of bromhexine and the structure of its degradation products].

Refluxed acid or neutral aqueous solutions of Bromhexine (1) show four degradation products. 1 is decomposed at room temperature (20 degrees C; 1 year) less than 1%. Degradation products of crystalline 1 are not detectable in the temperature-moisture-test. Under normal storage conditions a 5-year stability for aqueous solutions and a more than 10-year stability for crystalline 1 are estimated. Very small amounts of three degradation products were isolated by TLC. According to MS-, UV- and IR-analysis their structures are 3-cyclohexyl-6,8-dibromo-chinazoline-4-one (2a), 3-cyclohexyl-6,8-dibromo-chinazoline (2b) and 3-amino-4,6-dibromo-benzaldehyde (3). The structure of N-Methylcyclohexylamine is supposed for a further product. Ms fragmentation and degradation mechanisms are discussed.

Bromhexine↗

Spectrophotometric determination of bromhexine hydrochloride in pharmaceutical preparations.

The presence of an aromatic primary amino group in bromhexine HCl enables the use of diazotization-coupling, according to the classic Bratton-Marshall method, for its analysis in pharmaceutical preparations. Spectrophotometric parameters were established for standardization of the method, including statistical analysis of data. Substances such as potassium guaiacolsulfonate, ampicillin, cephalexin, oxytetracycline HCl, amoxycillin, and erythromycin ethylsuccinate do not interfere with the determination. The precision of the method is about 2.0%.

Bromhexine↗

Therapeutic and prophylactic effects of cephalexin and bromhexine in respiratory tract complications of abdominal surgery.

We report the results of a study carried out with cephalexin and bromhexine in a group of 100 patients at risk for bronchopulmonary complications following abdominal surgery. The treatment achieved very good activity and excellent tolerance. We consider this therapy very useful for prophylaxis and treatment of bronchopulmonary complications in patients who have undergone surgery.

Abdomen↗

Erythromycin and bromhexine in acute exacerbations of chronic bronchitis. A study on sputum penetration and clinical effectiveness.

A group of 22 patients with acute purulent exacerbations of chronic bronchitis were treated with 1 g erythromycin ethyl succinate granules twice daily orally for 10 days. Half the patients were given bromhexine additionally and the other half received placebo instead. Serum and sputum erythromycin concentrations were measured microbiologically at intervals after the first dose. The clinical results in both treated groups were rather poor, with many patients becoming infected again immediately after the chemotherapy. Blood and sputum concentrations of erythromycin did not greatly differ in the two patient groups. The sputum concentration of erythromycin was often higher than the blood concentration at the same time. The MIC's of erythromycin (in particular, those for the Haemophilus influenzae strains) were often higher than the drug concentrations attained in the sputum.

Bromhexine↗

The antenatal use of ambroxol (bromhexine metabolite VIII) to prevent hyaline membrane disease: a controlled double-blind study.

A prospective double-blind clinical trial was carried out to determine whether ambroxol (bromhexine metabolite VIII) treatment (1000 mg/day for a period of 5 days) reduces the risk of hyaline membrane disease (HMD) in potentially premature infants. Amniocentesis was performed before the first and 24 h after the last application of ambroxol or placebo to assess the development of the total phospholipid phosphorus content, the L/S ratio, the P/S ratio, and the properties of the surface tension of the amniotic fluid after ambroxol or placebo. There were 246 infants born to 224 mothers. Of the 116 infants with less than or equal to 36 completed weeks' gestation, 56 were in the ambroxol and 60 in the placebo group. No differences between groups occurred in risk factors for HMD (diabetes, asphyxia, male sex, cesarean section). Statistically significant differences in favor of the infants in the ambroxol group were found in the HMD incidence: 23.2% in the ambroxol group compared with 41.7% in the placebo group (p less than 0.05). There was no reduction of the HMD incidence in the less than or equal to 32-week gestational age category in the ambroxol group compared with the placebo group inspite of the fact that all the examined parameters for determining lung maturity reflected a stimulatory effect of ambroxol compared with the results of the placebo group, particularly before the 33rd week of gestation. Prolonged rupture of the membranes played no protective role against HMD.

Ambroxol↗

Pharmacokinetics of bromhexine in the dog.

Bromhexine hydrochloride was administered to dogs i.v. and p.o. Plasma determinations of the unchanged drug were carried out by gas-liquid chromatography with electron-capture detection. The plasma levels obtained after i.v. administration were consistent with a two-compartment open model. Comparison of the results of i.v. and oral administration show a low bioavailability, probably due to a first pass effect.

Administration, Oral↗

Improvement of some pharmaceutical properties of drugs by cyclodextrin complexation. 3. Bromhexine hydrochloride.

The potentiality of interaction of bromhexine (1) with beta-cyclodextrin was investigated by spectrophotometric methods. Differential UV spectrophotometry revealed a decrease in the optical density of the drug in presence of beta-cyclodextrin (beta-CD) and a hypsochromic shift in one of the two wavelengths of maximum absorption of the drug from 312 to 309 nm in presence of beta-CD. The continuous variation method based on spectrophotometric measurements revealed the formation of 1:1 complex between the drug and beta-CD. The solubility of 1 in presence of beta-CD was found to increase to a marked extent. Also the dissolution profiles of the drug, physical mixture of the drug and beta-CD as well as the prepared complex showed a great enhancement of the dissolution properties of 1 in presence of beta-CD either in a physical mixture or in complexed state. The partition coefficient between n-octanol and phosphate buffer of pH 7.4 of 1 and its beta-CD complex was also determined. Investigation of the transdermal diffusion of the drug and the complex in different dermatological vehicles was carried out using abdominal rat skin. A linear relationship was found to exist between the amount of drug released and the square root of the time. The drug showed the highest release characteristics from methyl cellulose > PVP > PEG 400, also inclusion complexation of 1 in beta-CD causes an improvement in the release properties of the drug from the investigated dermatological vehicles.

Administration, Cutaneous↗

Double-blind crossover trial of bromhexine (Bisolvon) in the treatment of chronic bronchitis.

The results of a double-blind crossover trial of bromhexine (Bisolvon) in the treatment of chronic bronchitis are reported. Benefit was shown by statistically significant changes in the peak expiratory flow rate, ascultatory findings and sputum volume. Benefit was also demonstrated by changes in dyspnoea, sputum, consistency and ease of expectoration, but these were without statistical significance. A review of the literature together with the results of this trial suggest that, when adequate consideration is given to a number of therapeutic variables, Bisolvon will be effective medication for most patients with chronic bronchitis associated with thick, tenacious sputum.

Adult↗

Effect of bromhexine and guaiphenesine on clinical state, ventilatory capacity and sputum viscosity in chronic asthma.

Thirty-four patients, 21 male and 13 female, with chronic asthma and tenacious mucoid expectoration were studied regarding clinical parameters, PEF, airway resistance and sputum viscosity measured according to the n.m.r. method (nuclear magnetic resonance); a technique for determination of the water phase viscosity. Using double-blind cross-over technique, oral treatment with the two drugs and placebo was given during three consecutive 12-day periods with 48-h intervals free of test drug. No significant improvement in clinical state, PEF or airway resistance could be demonstrated. Nor did the sputum viscosity show any significant change after treatment with the different preparations. However, regarding the patients' own preference of drug as to mucolytic effect, a significant difference in favour of bromhexine at the 0.1% level was shown.

Airway Resistance↗