Bromhexine is a mucolytic drug used in the treatment of respiratory disorders associated with viscid or excessive mucus. As an over-the-counter medicine, it is found in brand names such as:

Barkacin
Benadryl Chesty/Forte
Bisolex
Bisolvon
Brofentol
Brofentol Plus
Bromex
Bromhexin
Broncholyte Elixir
Cofdex
Duro-Tuss Chesty/Forte
Dysolvon
Flegamina
Movex
Mucolyte
Paxirasol
Robitussin Chesty/Forte
Solvex
Vasican
Ventilate Forte (combination of bromhexine and salbutamol)

Bromhexine appears to be an inhibitor of the TMPRSS2 enzyme. Some coronaviruses, e.g. SARS-CoV-1, MERS-CoV, and SARS-CoV-2 are activated by TMPRSS2 and can thus be inhibited by TMPRSS2 inhibitors. SARS-CoV-2 uses the receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming.

Thus, bromhexine may be effective at inhibiting infection by COVID-19.

https://en.wikipedia.org/wiki/Bromhexine
https://en.wikipedia.org/wiki/TMPRSS2

KJW said:

Bromhexine is a mucolytic drug used in the treatment of respiratory disorders associated with viscid or excessive mucus. As an over-the-counter medicine, it is found in brand names such as:

Barkacin
Benadryl Chesty/Forte
Bisolex
Bisolvon
Brofentol
Brofentol Plus
Bromex
Bromhexin
Broncholyte Elixir
Cofdex
Duro-Tuss Chesty/Forte
Dysolvon
Flegamina
Movex
Mucolyte
Paxirasol
Robitussin Chesty/Forte
Solvex
Vasican
Ventilate Forte (combination of bromhexine and salbutamol)

Bromhexine appears to be an inhibitor of the TMPRSS2 enzyme. Some coronaviruses, e.g. SARS-CoV-1, MERS-CoV, and SARS-CoV-2 are activated by TMPRSS2 and can thus be inhibited by TMPRSS2 inhibitors. SARS-CoV-2 uses the receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming.

Thus, bromhexine may be effective at inhibiting infection by COVID-19.

https://en.wikipedia.org/wiki/Bromhexine
https://en.wikipedia.org/wiki/TMPRSS2

Who cares? I’m sufffering emphysema.

fair possibility although we remind everyone that something is even more effective at achieving the lack of SARS-CoV-2 infection, and that is good infection practices that prevent exposure in the first place

KJW said:

Bromhexine is a mucolytic drug used in the treatment of respiratory disorders associated with viscid or excessive mucus. As an over-the-counter medicine, it is found in brand names such as:

Barkacin
Benadryl Chesty/Forte
…

Bromhexine appears to be an inhibitor of the TMPRSS2 enzyme. Some coronaviruses, e.g. SARS-CoV-1, MERS-CoV, and SARS-CoV-2 are activated by TMPRSS2 and can thus be inhibited by TMPRSS2 inhibitors. SARS-CoV-2 uses the receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming.

Thus, bromhexine may be effective at inhibiting infection by COVID-19.

https://en.wikipedia.org/wiki/Bromhexine
https://en.wikipedia.org/wiki/TMPRSS2

The list of respiratory diseases associated with excessive mucus would be much wider than coronaviruses. Bronchitis or pneumonia?

I’m just going to look down my list of Chinese medicines for treatment of coronavirus/pneumonia to see if some are also associated with fixing mucus problems.

Yes. Tanreqing injection, Chinese patent medicine number Z20030054, is claimed to have a similar effect and has been used in treatment of Covid.

https://clinicaltrials.gov/ct2/show/NCT04355026
Hypothesis. Combined treatment with bromhexin and hydroxychloroquine shortens the course of disease in hospitalized Covid-19 patients compared to hydroxychloroquine alone and/or lowers the incidence of secundary pulmonary infections.
No results posted.

https://pubmed.ncbi.nlm.nih.gov/32983936/
Jul 19, 2020.
“Results: A total of 78 patients … were enrolled. There was a significant reduction in ICU admissions (2 out of 39 vs. 11 out of 39, P = 0.006), intubation (1 out of 39 vs. 9 out of 39, P = 0.007) and death (0 vs. 5, P = 0.027) in the bromhexine treated group compared to the standard group. No patients were withdrawn from the study because of adverse effects. Conclusion: The early administration of oral bromhexine reduces the ICU transfer, intubation, and the mortality rate in patients with COVID-19. This affordable medication can easily be administered everywhere with a huge positive impact(s) on public health and the world economy.”

Ivermectin

polonium-210

Flegamina. :)

Such a luverlee name for a girl😁.

mollwollfumble said:

KJW said:

Bromhexine is a mucolytic drug used in the treatment of respiratory disorders associated with viscid or excessive mucus. As an over-the-counter medicine, it is found in brand names such as:

Barkacin
Benadryl Chesty/Forte
…

Bromhexine appears to be an inhibitor of the TMPRSS2 enzyme. Some coronaviruses, e.g. SARS-CoV-1, MERS-CoV, and SARS-CoV-2 are activated by TMPRSS2 and can thus be inhibited by TMPRSS2 inhibitors. SARS-CoV-2 uses the receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming.

Thus, bromhexine may be effective at inhibiting infection by COVID-19.

https://en.wikipedia.org/wiki/Bromhexine
https://en.wikipedia.org/wiki/TMPRSS2

…

https://pubmed.ncbi.nlm.nih.gov/32983936/
Jul 19, 2020.
“Results: A total of 78 patients … were enrolled. There was a significant reduction in ICU admissions (2 out of 39 vs. 11 out of 39, P = 0.006), intubation (1 out of 39 vs. 9 out of 39, P = 0.007) and death (0 vs. 5, P = 0.027) in the bromhexine treated group compared to the standard group. No patients were withdrawn from the study because of adverse effects. Conclusion: The early administration of oral bromhexine reduces the ICU transfer, intubation, and the mortality rate in patients with COVID-19. This affordable medication can easily be administered everywhere with a huge positive impact(s) on public health and the world economy.”

Although insufficient data, note that preliminary results indicate that bromhexine reduces mortality due to Covid by about 80%, an enormous reduction in mortality. So every doctor who did not prescribe bromhexine for their Covid patients after July 2020 is guilty of mass murder, adding up to perhaps as many as 1.7 million murders in all.

mollwollfumble said:

mollwollfumble said:

KJW said:

Bromhexine is a mucolytic drug used in the treatment of respiratory disorders associated with viscid or excessive mucus. As an over-the-counter medicine, it is found in brand names such as:

Barkacin
Benadryl Chesty/Forte
…

Bromhexine appears to be an inhibitor of the TMPRSS2 enzyme. Some coronaviruses, e.g. SARS-CoV-1, MERS-CoV, and SARS-CoV-2 are activated by TMPRSS2 and can thus be inhibited by TMPRSS2 inhibitors. SARS-CoV-2 uses the receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming.

Thus, bromhexine may be effective at inhibiting infection by COVID-19.

https://en.wikipedia.org/wiki/Bromhexine
https://en.wikipedia.org/wiki/TMPRSS2

…

https://pubmed.ncbi.nlm.nih.gov/32983936/
Jul 19, 2020.
“Results: A total of 78 patients … were enrolled. There was a significant reduction in ICU admissions (2 out of 39 vs. 11 out of 39, P = 0.006), intubation (1 out of 39 vs. 9 out of 39, P = 0.007) and death (0 vs. 5, P = 0.027) in the bromhexine treated group compared to the standard group. No patients were withdrawn from the study because of adverse effects. Conclusion: The early administration of oral bromhexine reduces the ICU transfer, intubation, and the mortality rate in patients with COVID-19. This affordable medication can easily be administered everywhere with a huge positive impact(s) on public health and the world economy.”

Although insufficient data, note that preliminary results indicate that bromhexine reduces mortality due to Covid by about 80%, an enormous reduction in mortality. So every doctor who did not prescribe bromhexine for their Covid patients after July 2020 is guilty of mass murder, adding up to perhaps as many as 1.7 million murders in all.

Nah, that’s an overestimate. Probably only half that.

mollwollfumble said:

mollwollfumble said:

mollwollfumble said:

…

https://pubmed.ncbi.nlm.nih.gov/32983936/
Jul 19, 2020.
“Results: A total of 78 patients … were enrolled. There was a significant reduction in ICU admissions (2 out of 39 vs. 11 out of 39, P = 0.006), intubation (1 out of 39 vs. 9 out of 39, P = 0.007) and death (0 vs. 5, P = 0.027) in the bromhexine treated group compared to the standard group. No patients were withdrawn from the study because of adverse effects. Conclusion: The early administration of oral bromhexine reduces the ICU transfer, intubation, and the mortality rate in patients with COVID-19. This affordable medication can easily be administered everywhere with a huge positive impact(s) on public health and the world economy.”

Although insufficient data, note that preliminary results indicate that bromhexine reduces mortality due to Covid by about 80%, an enormous reduction in mortality. So every doctor who did not prescribe bromhexine for their Covid patients after July 2020 is guilty of mass murder, adding up to perhaps as many as 1.7 million murders in all.

Nah, that’s an overestimate. Probably only half that.

only if they failed to support infection control measures

wookiemeister said:

Ivermectin

From https://en.wikipedia.org/wiki/Ivermectin#COVID-19:

“In vitro, ivermectin has antiviral effects against several distinct positive-sense single-strand RNA viruses, including SARS-CoV-2. Subsequent studies found that ivermectin could inhibit replication of SARS-CoV-2 in monkey kidney cell culture with an IC50 of 2.2–2.8 μM. Based on this information, however, doses much higher than the maximum approved or safely achievable for use in humans would be required for an antiviral effect. Aside from practical difficulties, such high doses are not covered by current human-use approvals of the drug and would be toxic, as the antiviral mechanism of action is considered to operate via the suppression of a host cellular process, specifically the inhibition of nuclear transport by importin α/β1.”

**********

The reason I started this thread is because bromhexine…

(1) is an over-the-counter medicine,
(2) has proven to be safe at therapeutic doses,
(3) has a well-defined mechanism for inhibiting covid-19 infection,
(4) has demonstrated inhibition of covid-19 infection in clinical trials.

KJW said:

wookiemeister said:

Ivermectin

From https://en.wikipedia.org/wiki/Ivermectin#COVID-19:

“In vitro, ivermectin has antiviral effects against several distinct positive-sense single-strand RNA viruses, including SARS-CoV-2. Subsequent studies found that ivermectin could inhibit replication of SARS-CoV-2 in monkey kidney cell culture with an IC50 of 2.2–2.8 μM. Based on this information, however, doses much higher than the maximum approved or safely achievable for use in humans would be required for an antiviral effect. Aside from practical difficulties, such high doses are not covered by current human-use approvals of the drug and would be toxic, as the antiviral mechanism of action is considered to operate via the suppression of a host cellular process, specifically the inhibition of nuclear transport by importin α/β1.”

**********

The reason I started this thread is because bromhexine…

(1) is an over-the-counter medicine,
(2) has proven to be safe at therapeutic doses,
(3) has a well-defined mechanism for inhibiting covid-19 infection,
(4) has demonstrated inhibition of covid-19 infection in clinical trials.

Is this what Craig Kelly was on about?

PermeateFree said:

Is this what Craig Kelly was on about?

I don’t think so. I discovered bromhexine through my own reading. I’m actually quite surprised that it isn’t better known.

I went to the pharmacy yesterday to get some medicine containing bromhexine. The lady behind the counter asked me what sort of cough I had. When I told her that bromhexine might inhibit covid-19 infection, she looked at me like I was a nutter. I didn’t explain to her that bromhexine was a TMPRSS2 inhibitor, so she was probably left with the thought that I was a “hydroxymoron”.

Oh, it’s Bisolvon.

buffy said:

Oh, it’s Bisolvon.

The one I bought was called “Duro-Tuss Chesty Cough Liquid Double Strength”. I made a point of getting one that contained ONLY bromhexine.

The studies are conflicting, small and of low quality.

It hasn’t been shown to be effective. This is a recent paper:

https://jim.bmj.com/content/early/2021/03/14/jim-2020-001747

>>The potential prevention benefits of bromhexine in asymptomatic postexposure patients or those with mild infection managed out of medical centers remain to be determined.<<

There remains significant uncertainty whether bromhexine hydrochloride is more effective and safer than standard care in treating patients with COVID-19.

What is the evidence informing this recommendation?
Evidence comes from two randomised trials that compared bromhexine hydrochloride with placebo in 96 adults hospitalised with mild or moderate COVID-19 .

We have found one new study comparing bromhexine with standard care (Tolouian et al. J Investig Med doi: 10.1136/jim-2020-001747). This study is currently under review and an updated recommendation will be included in a future version of the guideline.

Study characteristics
In the study by Ansarin et al. mean age was 60 years and 45% were women ; in Li et al. mean age was 50 years and 22% were women . Patients in Ansarin et al. received 8 mg bromhexine hydrochloride three times a day for 14 days; patients in Li et al. received 32 mg three times a day for 14 days. Pregnant and breastfeeding women were ineligible.

What are the main results?
There were too few who died (five deaths) or suffered adverse events to determine whether bromhexine hydrochloride makes a difference. No patients experienced serious adverse events. It is unclear whether bromhexine hydrochloride increases or decreases time to clinical improvement or viral clearance by day 28.

Our confidence in the results
Certainty of the evidence is very low for all outcomes due to very serious risk of bias (lack of blinding of patients and outcome assessors) and very serious imprecision (low patient numbers, few events and wide confidence intervals).

For children & adolescents and pregnant & breastfeeding women, certainty is also downgraded for serious indirectness (absence or limited inclusion of these populations in the included studies).

Additional information
The safety profile for bromhexine hydrochloride indicates the following adverse effects: nausea, vomiting, diarrhoea and allergy (e.g. rash, urticaria, angioedema). Bromhexine hydrochloride has been associated with a low risk of severe skin reactions including erythema multiforme, Stevens-Johnson syndrome and acute generalised exanthematous pustulosis .

See section 6.9.7 here:

https://app.magicapp.org/#/guideline/L4Q5An/section/LwkyoL

From the Australian guidelines for the clinical care of people with COVID19.

>>Do not use bromhexine hydrochloride for the treatment of COVID-19 outside of randomised trials with appropriate ethical approval.<<

poikilotherm said:

There remains significant uncertainty whether bromhexine hydrochloride is more effective and safer than standard care in treating patients with COVID-19.

What is the evidence informing this recommendation?
Evidence comes from two randomised trials that compared bromhexine hydrochloride with placebo in 96 adults hospitalised with mild or moderate COVID-19 .

We have found one new study comparing bromhexine with standard care (Tolouian et al. J Investig Med doi: 10.1136/jim-2020-001747). This study is currently under review and an updated recommendation will be included in a future version of the guideline.

Study characteristics
In the study by Ansarin et al. mean age was 60 years and 45% were women ; in Li et al. mean age was 50 years and 22% were women . Patients in Ansarin et al. received 8 mg bromhexine hydrochloride three times a day for 14 days; patients in Li et al. received 32 mg three times a day for 14 days. Pregnant and breastfeeding women were ineligible.

What are the main results?
There were too few who died (five deaths) or suffered adverse events to determine whether bromhexine hydrochloride makes a difference. No patients experienced serious adverse events. It is unclear whether bromhexine hydrochloride increases or decreases time to clinical improvement or viral clearance by day 28.

Our confidence in the results
Certainty of the evidence is very low for all outcomes due to very serious risk of bias (lack of blinding of patients and outcome assessors) and very serious imprecision (low patient numbers, few events and wide confidence intervals).

For children & adolescents and pregnant & breastfeeding women, certainty is also downgraded for serious indirectness (absence or limited inclusion of these populations in the included studies).

Additional information
The safety profile for bromhexine hydrochloride indicates the following adverse effects: nausea, vomiting, diarrhoea and allergy (e.g. rash, urticaria, angioedema). Bromhexine hydrochloride has been associated with a low risk of severe skin reactions including erythema multiforme, Stevens-Johnson syndrome and acute generalised exanthematous pustulosis .

Ah, you beat me to the link.

:)

buffy said:

It hasn’t been shown to be effective. This is a recent paper:

https://jim.bmj.com/content/early/2021/03/14/jim-2020-001747

>>The potential prevention benefits of bromhexine in asymptomatic postexposure patients or those with mild infection managed out of medical centers remain to be determined.<<

I wouldn’t expect bromhexine to be effective against the severe illness of covid-19. I read quite a while ago that the severe illness is the result of cytokine storm that is largely independent of viral load, whereas bromhexine is about avoiding getting infected in the first place.

KJW said:

whereas bromhexine is about avoiding getting infected in the first place.

we mean our line is still to apply the maximally beneficial-versus-risk nonpharmaceutical interventions first, but sure, the moment you use the word “prevention” in a COVID-19 context it seems 5/6 of the world just falls asleep

Although I purchased bromhexine, one problem I face is not knowing when to take it. Its use as a preventative suggests ongoing regular doses, but I consider that to be unacceptable.

KJW said:

Although I purchased bromhexine, one problem I face is not knowing when to take it. Its use as a preventative suggests ongoing regular doses, but I consider that to be unacceptable.

how about on days of planned excursions to indoor environments at times when the epidemiological risk in the community is moderate to high, and regularly when the epidemiological risk is extreme

SCIENCE said:

KJW said:

Although I purchased bromhexine, one problem I face is not knowing when to take it. Its use as a preventative suggests ongoing regular doses, but I consider that to be unacceptable.

how about on days of planned excursions to indoor environments at times when the epidemiological risk in the community is moderate to high, and regularly when the epidemiological risk is extreme

I was thinking along the lines of taking it after being exposed to people not wearing their masks and coughing, etc.

KJW said:

she looked at me like I was a nutter.

Welcome to my world

Have you found a study that showed it worked for your intended case? Only one I seem to come across, the trial has been finished by no results published, although it could be in Russian.

poikilotherm said:

Have you found a study that showed it worked for your intended case? Only one I seem to come across, the trial has been finished by no results published, although it could be in Russian.

Well if you can’t find it there is no point in me looking.