Erythromycin and Bromhexine

Macrolide & similar types · Macrolide/Mucolytic

Indications

Upper and lower respiratory tract infections caused by erythromycin sensitive organisms where mucolytic and expectorant actions are desired.

Dosage

Susp: Children: Below 4 mth (under 5 kg body wt), 1/2 tsp twice daily; 4 mth-1 yr (5-10 kg body wt), 1 tsp twice daily; 1-6 yr (10-25 kg body wt), 1 tsp 3 or 4 times daily; 6-12 yr (over 25 kg body wt), 2 tsp 2 or 3 times daily. Tab: Adults & Children: Over 12 yr, 1 tab twice daily may be increased in severe infections to 1 tab 3 or 4 times daily, taken in the fasting state or immediately before a meal.

Adverse Effects

GI upset, cholestatic jaundice, allergic reactions, reversible hearing loss, pancreatitis, cardiac effects, Myasthaenia-like syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis.

Risk Factor (Pregnancy/Lactation)

Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: Porphyria. Precautions: Predisposition to prolonged QT interval, renal or hepatic impairment, Myasthaenia gravis.

Interactions

Amisulpride, tolterodine, astemizole, mizolastine, ergot derivatives, theophylline, carbamazepine, oral anticoagulants, digoxin, cisapride, alfentanil, bromocriptine, cyclosporin, disopyramide, amiodarone, hexobarbitone, midazolam, phenytoin, triazolam, valproate, statins, zopiclone, tacrolimus, pimozide, quinidine, rifabutin.

Pharmacokinetics

ERYTHROMYCIN: Absorption: Oral: Variable but better with salt forms than with base form; 18%-45%; ethylsuccinate may be better absorbed with food. Metabolism: Hepatic. Half-life elimination: Neonates (=15 days of age): 2.1 hrs. Adults: Peak: 1.5-2 hrs. End-stage renal disease: 5-6 hrs. Time to peak, serum: Base: 4 hrs. Ethylsuccinate: 0.5-2.5 hrs. Stearate: 3 hrs; delayed with food due to differences in absorption. Excretion: Primarily faeces. Urine. BROMHEXINE: Absorption: Rapidly absorbed from the GI tract. Metabolism: Hepatic (undergoes extensive first-pass metabolism). Bioavailability: Oral: 20%. Half-life elimination: 13-40 hrs. Time to peak, plasma: 1 hr. Excretion: Urine (80%-90%). Faeces.

Compiled by Healify Pharmacy from published drug references. How we compile it →

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