Amoxicillin + Bromhexine


Generic Medicine Info
Indications and Dosage
Oral
Lower respiratory tract infections, Upper respiratory tract infections
Adult: Each capsule contains amoxicillin 250 mg and bromhexine 8 mg: 1-2 capsules 8 hrly.
Child: 40mg/kg/day given in 3 divided doses.
Contraindications
Penicillin allergy, lactation.
Special Precautions
Pregnancy, renal and hepatic disease and history of peptic ulcer . Infectious mononucleosis.
Adverse Reactions
Headache, nausea, dizziness, vomiting, diarrhoea, black hairy tongue, maculopapular rash, urticaria, eosinophilia, hemolytic anemia, thrombocytopenia.
Potentially Fatal: Anaphylaxis, pseudomembranous colitis, acute cytoloytic hepatitis and Stevens-Johnson syndrome.
Drug Interactions
Live oral typhoid vaccine should not be given 3 days before or 3 days after amoxicillin admin as immune response may be attenuated. Amoxicillin increases the anticoagulant response of coumarins. Amoxicillin may reduce OC pill absorption leading to breakthrough bleeding or pregnancy. Amoxicillin reduces the renal clearance of methotrexate and pemetrexate. Amoxicillin level significantly reduced when given with or 2 hr after acacia admin. Bromhexine enhances the penetration of amoxicillin into bronchial secretions.
Food Interaction
Tannins in catha reduced amoxicillin absorption if amoxicillin is admin <2 hr after chewing catha.
Lab Interference
Possible interference with urinary glucose tests using cupric sulfate. May increase degradation of aminoglycosides in vitro. Increase in ALT and AST.
Action
Description:
Mechanism of Action: Amoxicillin inhibits the final transpeptidation of peptidoglycan synthesis in bacterial cell walls. Hence, cell wall synthesis is inhibited and results in bacterial lysis. Bromhexine is a mucolytic. It thins and liquifies the mucus and helps increased penetration of the antibiotic. The less viscous mucus is easily removed by ciliary movement and expectoration.
Pharmacokinetics:
Absorption: Amoxicillin: Rapidly and almost completely absorbed from the GI tract; peak plasma concentration (oral): 1-2 hr. Bromhexine: Bioavailability: 20% (oral); peak plasma concentration: 1 hr.
Distribution: Amoxicillin: Protein binding: 17-20 %; Widely distributed to body fluid and bone, CSF (small concentrations except when meninges are inflamed). Bromhexine: Highly protein-bound; Widely distributed.
Metabolism: Amoxicillin: Partially metabolised to penicilloic acid. Bromhexine: Extensively hepatically metabolized to ambroxol.
Excretion: Amoxicillin: Via urine: 60% as unchanged drug. Elimination half-life: Adults: 0.7-1.4hr, CrCl:<10 ml/min: 7-21 hr; infants & children: 1-2 hr.Bromhexine: Via urine: As mainly metabolites; elimination half-life (terminal): 13-40 hr.
MIMS Class
Penicillins
Disclaimer: This information is independently developed by MIMS based on Amoxicillin + Bromhexine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com
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