Consists of bromhexine hydrochloride, guaiphenesin, phenylephrine
Bromhexine hydrochloride indications
respiratory-tract disorders with viscous mucus
Uses of Bromhexine hydrochloride in details
Bromhexine hydrochloride is used to treat breathing difficulties caused by excessive mucus secretions in the air passages associated with respiratory tract infections.
Bromhexine hydrochloride description
Bromhexine hydrochloride is an expectorant/mucolytic agent. Bromhexine hydrochloride is in the United States. It is marketed under the trade name Bromhexine hydrochloride(R) in Germany, England, Belgium, France, Italy, Netherlands, Norway, Sweden, Australia, and South Africa.
Bromhexine hydrochloride dosage
Unless otherwise prescribed, the following doses are recommended:
Tablet: Adults and Children >12 years: 8 mg (1 tab) thrice daily; 6-12 years: 4 mg (½ tab) thrice daily; 2-6 years: 4 mg (½ tab) twice daily.
Oral Solution:
Adults and Children >12 years: 4 mL thrice daily; 6-12 years: 2 mL thrice daily; 2-6 years: 20 drops thrice daily; <2 years: 10 drops thrice daily.Inhalation Solution (with aerosol apparatus): It is generally recommended to warm inhalation solution to body temperature before inhalation. Patients with bronchial asthma may be advised to commencing inhalation after they have taken their regular bronchospasmolytic therapy.
Adults: 4 mL. Children >12 years: 2 mL; 6-12 years: 1 mL; 2-6 years: 10 drops; <2 years: 5 drops. All doses to be taken twice daily.
The solution may be diluted 1:1 in physiological saline solution. In order to avoid precipitation, the solution should be inhaled immediately after mixing. The combined administration of inhalation and oral application intensifies the effect, and is especially suited for the commencement of treatment in cases where the full effect is to be reached quickly.
Syrup: Adults and Children >12 years: 5 ml (1 tsp) thrice daily.
At commencement of treatment, it may be necessary to increase the total daily dose up to 48 mg in adults.
The syrup is sugar-free and therefore suitable for diabetics and small children.
Ampoule: Severe cases, before and after surgical intervention: 1 amp SC, IM or IV (duration of injection: 2-3 min) 2-3 times daily.
Capsule: Adults: 1 cap 3 times daily.
It is recommended for the initial phase of treatment usually lasting not more than a week.
Patients being treated with Bromhexine hydrochloride should be notified of an expected increase in the flow of secretions.
Bromhexine hydrochloride interactions
A reduction in dose of cardiac glycosides (e.g. digitalis) and quinidine might become necessary in patients suffering from congestive cardiac failure because of the positive inotropic effect of orciprenaline sulphate.
Bromhexine hydrochloride hydrochloride SYRUP should not be administered concomitantly with beta-blocking agents, due to orciprenaline’s reversal of anti-hypertensive action.
The concomitant use of other sympathomimetic agents should be carefully controlled to avoid potentiation of effects.
Bromhexine hydrochloride side effects
Like all medicines, Bromhexine hydrochloride can have side effects. Bromhexine hydrochloride is, in general, easily digested, both in the short
and the long-term.
Very exceptionally: queasiness, a heavy feeling in the stomach.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your
doctor or pharmacist.
Bromhexine hydrochloride contraindications
Bromhexine hydrochloride hydrochloride SYRUP is contra-indicated in patients with known hypersensitivity to sympathomimetic amines or any of the other ingredients; hypertrophic obstructive cardiomyopathy; and tachyarrhythmia.
Sympathomimetics, such as orciprenaline sulphate, may interact with monoamine oxidase inhibitors (MAOI), and therefore Bromhexine hydrochloride hydrochloride SYRUP should not be given to patients receiving such treatment or within 14 days of MAOI treatment termination.
Safety in pregnancy and lactation has not been established.
Guaiphenesin indications
Helps loosen phlegm & helps clear chest congestion.
Guaiphenesin description
A centrally acting muscle relaxant whose mode of action has not been established. It is used as an adjunct in the symptomatic treatment of musculoskeletal conditions associated with painful muscle spasm. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1206)
Guaiphenesin dosage
Adult & childn >12 yr 10-20 mL. Childn 6-12 yr 5-10 mL. To be taken 4 hrly. Max: 6 doses/24 hr.
Guaiphenesin interactions
No information available.
Guaiphenesin side effects
Diarrhea, laxative effect.
Guaiphenesin contraindications
Guaiphenesin Tablets are contraindicated in patients hypersensitive to any of the ingredients.
What is Phenylephrine?
Phenylephrine (phenylephrine) is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
Phenylephrine is used to treat nasal and sinus congestion, or congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes.
Phenylephrine may also be used for purposes not listed in this medication guide.
Phenylephrine indications
Phenylephrine is used for the temporary relief of stuffy nose, sinus, and ear symptoms caused by the common cold, flu, allergies, or other breathing illnesses (e.g., sinusitis, bronchitis). This medication works by decreasing swelling in the nose and ears, thereby lessening discomfort and making it easier to breathe.
Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.
How should I use Phenylephrine?
Use Phenylephrine as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Phenylephrine is for use in the eye only. Avoid contact with the nose or mouth.
- To use Phenylephrine, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
- To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed.
- Do not wear contact lenses while you are using Phenylephrine. Sterilize contact lenses according to the manufacturer's directions and check with your doctor before using them.
- Do not use Phenylephrine if it is brown or contains particles.
- If you miss a dose of Phenylephrine, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Phenylephrine.
Uses of Phenylephrine in details
Use: Labeled Indications
Hypotension/shock: Treatment of hypotension, vascular failure in shock. Note: Not recommended for routine use in the treatment of septic shock; use should be limited until more evidence demonstrating positive clinical outcomes becomes available (Rhodes 2017).
Guideline recommendations:
Cardiogenic shock: The 2017 American Heart Association (AHA) scientific statement for the Contemporary Management of Cardiogenic Shock recommends phenylephrine, if needed, be considered for initial vasoactive management of cardiogenic shock due to aortic stenosis, mitral stenosis, or dynamic left ventricular outflow tract (LVOT) obstruction (AHA [van Diepen 2017]).
Hypotension during anesthesia: As a vasoconstrictor in regional analgesia
Nasal congestion: As a decongestant [OTC]
Off Label Uses
Hypotension in patients with obstructive hypertrophic cardiomyopathy
Phenylephrine is a pure alpha1 agonist that will increase systemic vascular resistance without increasing heart rate or contractility. This is advantageous in patients with obstructive hypertrophic cardiomyopathy and hypotension since increases in both heart rate and contractility may cause the obstruction to worsen, leading to a decrease in cardiac output. Other vasopressors like dopamine, epinephrine, and norepinephrine may increase contractility and/or heart rate. Additional trials may be necessary to further define the role of phenylephrine in this condition.
Based on the American Urological Association guidelines for the management of priapism, due to the low risk of cardiovascular side effects intracavernous injection of phenylephrine is recommended for ischemic priapism that persists following aspiration/irrigation.
Phenylephrine description
Phenylephrine is a sympathomimetic amine that acts predominantly on α-adrenergic receptors. It is mainly used to treat nasal congestion, but may also be useful in treating hypotension and shock, hypotension during spinal anaesthesia, prolongation of spinal anaesthesia, paroxysmal supraventricular tachycardia, symptomatic relief of external or internal hemorrhoids, and to increase blood pressure as an aid in the diagnosis of heart murmurs.
Phenylephrine dosage
Phenylephrine Dosage
Generic name: PHENYLEPHRINE HYDROCHLORIDE 10mg in 1mL
Dosage form: injection
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
General Dosage and Administration Instructions
Phenylephrine (phenylephrine hydrochloride) Injection, 10 mg/mL must be diluted before administration as an intravenous bolus or continuous intravenous infusion to achieve the desired concentration:
- Bolus: Dilute with normal saline or 5% dextrose in water.
- Continuous infusion: Dilute with normal saline or 5% dextrose in water.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Do not use if the solution is colored or cloudy, or if it contains particulate matter. The diluted solution should not be held for more than 4 hours at room temperature or for more than 24 hours under refrigerated conditions. Discard any unused portion.
During Phenylephrine administration:
- Correct intravascular volume depletion.
- Correct acidosis. Acidosis may reduce the effectiveness of phenylephrine.
Dosing for Treatment of Hypotension during Anesthesia
The following are the recommended dosages for the treatment of hypotension during anesthesia.
- The recommended initial dose is 40 to 100 mcg administered by intravenous bolus. May administer additional boluses every 1-2 minutes as needed; not to exceed a total dosage of 200 mcg.
- If blood pressure is below the target goal, start a continuous intravenous infusion with an infusion rate of 10 to 35 mcg/minute; not to exceed 200 mcg/minute.
- Adjust dosage according to the blood pressure goal.
Prepare a 100 mcg/mL Solution for Bolus
Intravenous Administration
For bolus intravenous administration, prepare a solution containing a final concentration of 100 mcg/mL of Phenylephrine:
- Withdraw 10 mg (1 mL of 10 mg/mL) of Phenylephrine and dilute with 99 mL of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP.
- Withdraw an appropriate dose from the 100 mcg/mL solution prior to bolus intravenous administration.
Prepare a Solution for Continuous
Intravenous Administration
For continuous intravenous infusion, prepare a solution containing a final concentration of 20 mcg/mL of Phenylephrine in 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP:
- Withdraw 10 mg (1 mL of 10 mg/mL) of Phenylephrine and dilute with 500 mL of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP.
Directions for Dispensing from Pharmacy Bulk Vial
The Pharmacy Bulk Vial is intended for dispensing of single doses to multiple patients in a pharmacy admixture program and is restricted to the preparation of admixtures for infusion. Each closure shall be penetrated only one time with a suitable sterile transfer device or dispensing set that allows measured dispensing of the contents. The Pharmacy Bulk Vial is to be used only in a suitable work area such as a laminar flow hood (or an equivalent clean air compounding area). Dispensing from a pharmacy bulk vial should be completed within 4 hours after the vial is penetrated.
More about Phenylephrine (phenylephrine)
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Support Group
- 0 Reviews - Add your own review/rating
Consumer resources
- Phenylephrine
- Phenylephrine (Advanced Reading)
- Other brands: Neo-Synephrine, Phenylephrine Congestion, Sudogest PE, Phenylephrine Children's Nasal Decongestant, More (9) »
Professional resources
- Phenylephrine (FDA)
- Phenylephrine Hydrochloride (AHFS Monograph)
Related treatment guides
- Hypotension
Phenylephrine interactions
See also:
What other drugs will affect Phenylephrine?
Acetaminophen: May increase the serum concentration of Phenylephrine (Systemic). Monitor therapy
Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Monitor therapy
AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Consider therapy modification
Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy
Chloroprocaine: May enhance the hypertensive effect of Phenylephrine (Systemic). Monitor therapy
CloZAPine: May diminish the therapeutic effect of Phenylephrine (Systemic). Monitor therapy
Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification
Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy
Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Avoid combination
FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy
Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy
Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine (Systemic). Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of phenylephrine. Use of hyaluronidase for other purposes in patients receiving phenylephrine may be considered as clinically indicated. Avoid combination
Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Avoid combination
Ioflupane I 123: Phenylephrine (Systemic) may diminish the diagnostic effect of Ioflupane I 123. Monitor therapy
Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification
Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Exceptions: Linezolid. Avoid combination
Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification
Propacetamol: May increase the serum concentration of Phenylephrine (Systemic). Management: Monitor patients closely for increased side effects of phenylephrine if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies. Monitor therapy
Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy
Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Tricyclic Antidepressants: May enhance the therapeutic effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the therapeutic effect of Alpha1-Agonists. Monitor therapy
Phenylephrine side effects
See also:
What are the possible side effects of Phenylephrine?
Applies to phenylephrine: intravenous solution
As well as its needed effects, phenylephrine (the active ingredient contained in Phenylephrine) may cause unwanted side effects that require medical attention.
If any of the following side effects occur while taking phenylephrine, check with your doctor or nurse immediately:
Incidence not known:
- Blurred vision
- chest pain or discomfort
- difficult or labored breathing
- dizziness
- fainting
- fast, slow, or irregular heartbeat
- headache
- nausea or vomiting
- nervousness
- pain in the shoulders, arms, jaw, or neck
- pounding in the ears
- sweating
- tightness in the chest
- unusual tiredness
If any of the following symptoms of overdose occur while taking phenylephrine, get emergency help immediately:
Symptoms of overdose:
- Feeling of fullness in the head
- pounding or rapid pulse
- tingling in the arms or legs
- vomiting
Minor Side Effects
Some phenylephrine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:
Incidence not known:
- Heartburn
- itching skin
- nausea
- pain in the neck
- pain or discomfort in chest, upper stomach, or throat
Phenylephrine contraindications
See also:
What is the most important information I should know about Phenylephrine?
Phenylephrine hydrochloride should not be used in patients with severe hypertension, ventricular tachycardia, or in patients who are hypersensitive to it or to any of the components.
Active ingredient matches for Bromhexine hydrochloride/guaiphenesin/phenylephrine:
Bromhexine hydrochloride/guaiphenesin/phenylephrine
References
- PubChem. "phenylephrine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- PubChem. "bromhexine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "Bromhexine". http://www.drugbank.ca/drugs/DB09019 (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Bromhexine hydrochloride/guaiphenesin/phenylephrine are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Bromhexine hydrochloride/guaiphenesin/phenylephrine. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
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| Users | % | ||
|---|---|---|---|
| 46-60 | 1 | 100.0% | |
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Information checked by Dr. Sachin Kumar, MD Pharmacology
