Bromhexine is an over-the-counter drug that is recommended to dissolve mucus. It has several brand names worldwide that can be found at this link.
c19bromhexine.com gathers medical studies about the use of bromhexine for COVID-19 and presents them together in a meta-analysis.
The table below is from c19bromhexine.com and presents five studies using bromhexine for prevention and early and late treatment of COVID-19.
The conclusion of the studies shows favorable outcomes when bromhexine is used in all stages of COVID-19. Green diamonds and squares represent the results, and the sizes of the shapes signify the number of people in the studies.
The table below shows the targeted outcomes for each study (hospitalization, ICU admission, ICU admission, death, etc.). All except one study by Tolouian shows a favorable outcome. In the Tolouian research, there were more obese people in the bromhexine group, while none were in the control group.[5] Obesity is a significant risk factor for severe COVID outcomes and skewed the results.
How does bromhexine work?
The spike protein of the SARS-CoV-2, the virus that causes COVID-19, has to attach to the ACE2 receptors of the human cells. Afterward, the spike protein uses the host’s enzyme Transmembrane Serine Protease 2 or TMPRSS2 to enter the cell. Incidentally, the influenza virus also uses TMPRSS2.
In laboratory studies, bromhexine blocks TMPRSS2 and SARS-CoV-2 entry. Camostat, which is available as prescription-only, also blocks TMPRSS2.
omicron and tmprss2
The omicron variant has several mutations which prevent it from using TMPRSS2, and that is why it does not cause severe disease as in the previous variants. Multinational study shows why the Omicron variant has low fatality and high infectivity.
However, if someone gets sick, most will not be able to test whether it is influenza or an omicron variant by PCR testing or gene sequencing, and the result may take days. Early treatment is essential. Thus prophylaxis with bromhexine which is considered safe and inexpensive, may be a viable strategy.[4]
Dosing
Mikhaylov and others used 8 mg 3 times a day in their study to prevent COVID-19 in health care workers [1]. The research by Yu et al. used 8 mg, four times per day to avoid hospitalization [2]
Interestingly, the brand name of bromhexine, Bisolvon is not available in the US, nor is it in Amazon, but it is available in other countries.
Addendum 12/29/2021 4:43 pm: Lisa from the comments sections asked me why there is no bromhexine in the US. I do not know. But I found this entry in peakprosperity.com fro Paul100. Paul100 was able to buy Bromhexine from www.heatlhypill.com. Yes, it looks like a misspelled “healthy pill” but that’s the real URL although the website name is Healthy Pill. Bromhexine is available there at this link.
Bromhexine is also available on eBay.
I have no financial connection with any bromhexine sellers although I wish I do.
Parting words
Disease prevention takes more than taking medications, and no medicine is 100% effective. For COVID-19 prevention, there are several strategies you can use.
16 Ways to Avoid COVID-19 During the Holidays
Losing excess weight and exercise not only prevents viral infections but also other common chronic illnesses like diabetes and hypertension.
Don’t Get Sick!
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References:
- Yu et al. Results of Open-Label non-Randomized Comparative Clinical Trial: “BromhexIne and Spironolactone for CoronаvirUs Infection requiring hospiTalization (BISCUIT) Kardiologiia. 2020 Dec 3;60(11):4-15. English, Russian. doi: 10.18087/cardio.2020.11.n1440. PMID: 33487145.
- Zmora et al. TMPRSS11A activates the influenza A virus hemagglutinin and the MERS coronavirus spike protein and is insensitive against blockade by HAI-1. Journal of Biological Chemistry. Volume 293, Issue 36, September 2018, Pages 13863-13873. https://doi.org/10.1074/jbc.RA118.001273
- Maggio, Roberto, and Giovanni U Corsini. “Repurposing the mucolytic cough suppressant and TMPRSS2 protease inhibitor bromhexine for the prevention and management of SARS-CoV-2 infection.” Pharmacological research vol. 157 (2020): 104837. doi:10.1016/j.phrs.2020.104837
- Tolouian R et al. Effect of bromhexine in hospitalized patients with COVID-19 [published online ahead of print, 2021 Mar 15]. J Investig Med. 2021;jim-2020-001747. doi:10.1136/jim-2020-001747
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DrJesseSantiano.com does not provide medical advice, diagnosis, or treatment
So why can you not boy bromhexine hydrochloride tablets in the US?
Thanks for the excellent question, Lisa! I tried to find out why. It is not on the list of unapproved drugs by the FDA, https://www.fda.gov/drugs/unapproved-drugs/unapproved-prescription-cough-cold-and-allergy-products, when I did a quick scan of the long list. But, you can buy it internationally. I put an addendum on the article. Thanks again and Happy New Year!