Bisolvon (Bromhexine)
Mucolytic agent for productive cough with thick mucus
Bisolvon is a widely used mucolytic medicine containing the active ingredient bromhexine hydrochloride. It is designed to break down thick, sticky mucus in the airways, making it thinner and easier to cough up. Available over-the-counter as an oral solution, Bisolvon is indicated for temporary relief of productive cough associated with acute respiratory tract conditions. It is suitable for adults and children from 1 year of age, and treatment should not exceed 14 days without medical consultation.
Quick Facts
Key Takeaways
- Bisolvon contains bromhexine, a mucolytic that thins thick mucus so it is easier to cough up from the airways.
- It is available over-the-counter and suitable for adults and children from 1 year of age, with age-appropriate dosing.
- Treatment is intended for short-term use only; consult a doctor if symptoms persist beyond 14 days.
- Stop taking Bisolvon immediately and seek medical attention if you experience signs of angioedema or severe skin reactions.
- Bisolvon should be avoided during breastfeeding and used with caution during pregnancy, especially in the first trimester.
What Is Bisolvon and What Is It Used For?
Bisolvon belongs to a group of medicines known as mucolytics, which work by altering the structure of mucus to reduce its viscosity. The active ingredient, bromhexine hydrochloride, acts on the mucus-producing cells in the respiratory tract by breaking down acid mucopolysaccharide fibres within the mucus. This biochemical action transforms thick, tenacious mucus into a thinner, more fluid secretion that can be more easily cleared through the normal cough reflex and mucociliary transport mechanism.
Productive cough — sometimes called a “wet” or “chesty” cough — occurs when the body produces excess mucus in response to respiratory tract infections, inflammation, or irritation. Conditions commonly associated with productive cough include the common cold, acute bronchitis, sinusitis, and other upper and lower respiratory tract infections. When the mucus becomes too thick or viscous, it can be difficult to expectorate, leading to persistent coughing, chest congestion, and discomfort.
Bromhexine has been used clinically since the 1960s and is one of the most widely prescribed mucolytics worldwide. It is marketed under several brand names globally, including Bisolvon, Mollipect, and Coldypect. The medicine is available as an oral solution, making it convenient for precise dose measurement across different age groups. The oral solution formulation is particularly practical for paediatric use, as the dosing cup allows accurate measurement of smaller doses.
It is important to note that Bisolvon is intended for short-term use only. If your cough does not improve within 14 days, or if it worsens, you should consult a healthcare professional. A persistent cough may indicate an underlying condition such as asthma, chronic obstructive pulmonary disease (COPD), or a bacterial infection that requires different treatment. In addition, if you experience symptoms such as blood in your sputum, high fever, shortness of breath, or unexplained weight loss alongside your cough, you should seek medical attention promptly.
Bromhexine exerts its mucolytic effect through two primary mechanisms: it reduces the viscosity of bronchial secretions by breaking down mucopolysaccharide fibres, and it stimulates the production of serous (watery) mucus by serous glands in the bronchial epithelium. Together, these actions result in thinner mucus that is more easily transported by the cilia lining the airways. Bromhexine is also believed to enhance the production of pulmonary surfactant, which may provide additional benefit in maintaining airway patency.
What Should You Know Before Taking Bisolvon?
Contraindications
Bisolvon should not be used if you have a known allergy (hypersensitivity) to bromhexine hydrochloride or to any of the other ingredients in the formulation. Allergic reactions to medicines can range from mild skin rashes to severe anaphylactic reactions. If you have previously experienced an adverse reaction to bromhexine or any other mucolytic agent, inform your doctor or pharmacist before considering this medicine.
The oral solution contains several inactive ingredients, including liquid maltitol, sucralose, benzoic acid (preservative E 210), levomentol, and flavouring agents. If you have known sensitivities to any of these substances, you should discuss alternatives with your healthcare provider. In particular, benzoic acid may increase the risk of jaundice (yellowing of the skin and eyes) in neonates up to 4 weeks of age, and therefore Bisolvon should not be given to very young infants.
Warnings and Precautions
Before using Bisolvon, consult your doctor or pharmacist if you have any of the following conditions:
- Stomach or duodenal ulcer: Bromhexine may exacerbate existing gastric conditions. If you have a history of peptic ulcer disease, use this medicine with caution and under medical supervision.
- Haemoptysis (coughing up blood): Blood-stained sputum requires medical investigation and should not be self-treated with over-the-counter mucolytics.
- Severe hepatic impairment: Bromhexine is metabolised in the liver, and patients with significant liver disease may require dose adjustment or avoidance of this medicine.
- Severe renal impairment: Reduced kidney function may affect the elimination of bromhexine metabolites. Medical guidance is recommended.
Stop taking Bisolvon and contact a doctor immediately if you experience any of the following symptoms, which may indicate a severe allergic reaction (angioedema):
- Swelling of the face, tongue, or throat
- Difficulty swallowing
- Hives (urticaria) together with breathing difficulties
Severe cutaneous adverse reactions have been reported in association with bromhexine use. If you develop any skin rash — including sores or lesions on the mucous membranes of the mouth, throat, nose, eyes, or genital area — stop using Bisolvon immediately and seek medical attention. These reactions, although very rare, can include erythema multiforme, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), which are potentially life-threatening conditions.
Pregnancy and Breastfeeding
If you are pregnant, breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before using Bisolvon.
Pregnancy: Bromhexine crosses the placental barrier, meaning it can reach the developing foetus. However, clinical studies and post-marketing surveillance have not demonstrated any harmful effects on the unborn child. Despite this reassuring safety profile, Bisolvon should only be used during pregnancy when considered clearly necessary, and always under the guidance of a healthcare provider. This caution applies particularly during the first trimester, when organogenesis (the formation of the baby's organs) occurs and foetal vulnerability to external substances is at its highest.
Breastfeeding: Bromhexine is excreted in breast milk and should therefore be avoided during breastfeeding. Although the amount that passes into breast milk is small, the potential effects on the nursing infant have not been adequately studied. If you are breastfeeding and require treatment for a productive cough, consult your doctor about alternative approaches.
Driving and Using Machines
No adverse effects on the ability to drive or operate machinery have been observed with bromhexine use. Bisolvon is not known to cause drowsiness, dizziness, or impaired concentration at recommended doses. However, you should be aware of your individual response to the medicine and exercise appropriate caution, particularly when starting treatment.
Important Information About Certain Ingredients
Bisolvon oral solution contains the following ingredients that may be relevant for certain patients:
- Liquid maltitol: If you have an intolerance to certain sugars, consult your doctor before taking this medicine. Doses exceeding 20 ml per day may have a mild laxative effect. Caloric value: 2.3 kcal/g.
- Levomentol: If levomentol comes into contact with the nasal mucosa of infants under 2 years of age, it may cause respiratory pauses during sleep or laryngospasm (spasm of the voice box). Ensure the solution does not enter or come near the child's nostrils. Seek immediate medical attention if the child develops breathing difficulties.
- Benzoic acid (1.27 mg/ml): May increase the risk of jaundice in neonates (up to 4 weeks of age). This medicine should not be given to newborns.
How Does Bisolvon Interact with Other Drugs?
One of the advantages of bromhexine as a mucolytic agent is its favourable drug interaction profile. Clinical studies and decades of post-marketing experience have shown that Bisolvon is not expected to significantly affect or be affected by other medicines. Unlike many other drugs, bromhexine does not inhibit or induce major cytochrome P450 enzymes and is therefore unlikely to alter the metabolism of concomitant medications.
However, there are important pharmacological considerations regarding the combination of mucolytics with certain other respiratory medicines:
Important Pharmacological Considerations
| Drug / Class | Type | Clinical Significance |
|---|---|---|
| Antitussives (codeine, dextromethorphan, pholcodine) | Pharmacological antagonism | Cough suppressants reduce the cough reflex needed to expel loosened mucus, potentially leading to mucus accumulation. Avoid concurrent use. |
| Antibiotics (amoxicillin, erythromycin, doxycycline) | Potential synergy | Bromhexine may enhance the penetration of certain antibiotics into bronchial secretions, potentially improving their efficacy in respiratory infections. |
| Other mucolytics (acetylcysteine, carbocisteine, ambroxol) | Additive effect | Combining multiple mucolytics is generally unnecessary and not recommended, as it provides no additional clinical benefit. |
| NSAIDs (ibuprofen, aspirin) | No significant interaction | Can be used together safely. However, both may affect the gastrointestinal tract; use with caution if you have a history of stomach problems. |
Additional Notes on Drug Combinations
There is some evidence from pharmacokinetic studies suggesting that bromhexine can increase the concentration of certain antibiotics in bronchial secretions. This has been observed with amoxicillin, erythromycin, and some cephalosporins. While this effect may be clinically beneficial during respiratory tract infections treated with antibiotics, it does not typically require dose adjustments. Some clinicians consider this a useful property of bromhexine in the management of acute bacterial bronchitis.
It is important to note that bromhexine is a metabolic precursor of ambroxol, another widely used mucolytic. These two substances should not be taken together, as they share the same mechanism of action and combining them would not provide additional therapeutic benefit while potentially increasing the risk of adverse effects.
Always inform your doctor or pharmacist about all medicines you are currently taking, including over-the-counter preparations, herbal remedies, and dietary supplements. Although Bisolvon has a favourable interaction profile, comprehensive disclosure of all medications ensures the safest possible treatment plan.
Bisolvon can be taken with or without food. There are no known interactions between bromhexine and food or non-alcoholic beverages. The oral solution can be taken directly or mixed with a small amount of water if preferred.
What Is the Correct Dosage of Bisolvon?
The dosage of Bisolvon oral solution varies according to the patient's age. The recommended doses below are based on standard clinical guidelines and the approved product information. Always use the graduated measuring cup provided with the packaging to ensure accurate dosing.
Adults and Adolescents (Over 12 Years)
Standard Adult Dose
10 ml (8 mg bromhexine) three times daily
This equates to a total daily dose of 24 mg bromhexine hydrochloride. The solution should be taken at approximately equal intervals throughout the day, for example in the morning, at midday, and in the evening. Treatment duration should not exceed 14 days unless directed by a healthcare professional.
Children
| Age Group | Single Dose | Frequency | Daily Total |
|---|---|---|---|
| 1–5 years | 2.5 ml | 3 times daily | 7.5 ml (6 mg) |
| 6–12 years | 2.5–5 ml | 3 times daily | 7.5–15 ml (6–12 mg) |
| Over 12 years | 10 ml | 3 times daily | 30 ml (24 mg) |
Bisolvon is not recommended for children under 1 year of age unless specifically directed by a physician. For children aged 1–5 years, always use the smallest graduated marking on the measuring cup to ensure accurate dosing. Parents and caregivers should supervise medication administration in young children.
Elderly Patients
No specific dose adjustment is required for elderly patients. However, as older adults may have reduced liver or kidney function, it may be prudent to start with the lower end of the adult dosing range and monitor for adverse effects. Elderly patients should also be aware that a productive cough with thick mucus can sometimes mask underlying respiratory conditions, and medical assessment is recommended if symptoms persist.
Missed Dose
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a forgotten one. Consistent spacing of doses throughout the day helps maintain steady levels of the medicine in the body and provides optimal therapeutic benefit.
Overdose
If you or someone else has taken too much Bisolvon, contact a doctor, hospital, or your local poison control centre immediately for an assessment of risk and advice on management. Symptoms of overdose may include nausea, vomiting, and diarrhoea. Severe toxicity from bromhexine overdose is uncommon, but medical evaluation is nevertheless recommended, particularly in children. Treatment of overdose is generally supportive, focusing on management of symptoms.
At the start of treatment, Bisolvon may initially increase mucus secretion in the airways. This is a normal and expected effect of the medicine's mucolytic action. The additional mucus production typically settles within the first 1–2 days of treatment as the airways are cleared of accumulated secretions.
What Are the Side Effects of Bisolvon?
Like all medicines, Bisolvon can cause side effects, although not everybody gets them. Most side effects are mild and resolve on their own. The following information is based on clinical trial data and post-marketing surveillance of bromhexine across multiple countries and formulations.
Side effects are categorised by their frequency of occurrence, using standard medical terminology:
Uncommon Side Effects
Affects fewer than 1 in 100 people, but more than 1 in 1,000
- Upper abdominal pain or discomfort
- Nausea
- Vomiting
- Diarrhoea
Rare Side Effects
Affects fewer than 1 in 1,000 people
- Hypersensitivity (allergic) reactions
- Skin rash (exanthema)
- Urticaria (hives)
Frequency Not Known
Cannot be estimated from available data
- Anaphylactic reactions including anaphylactic shock
- Angioedema (rapid swelling of skin and mucous membranes)
- Pruritus (itching)
- Severe skin reactions: erythema multiforme, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalised exanthematous pustulosis (AGEP)
- Bronchospasm (severe constriction of the airways)
The gastrointestinal side effects (nausea, vomiting, abdominal pain, diarrhoea) are the most commonly reported adverse effects. These are generally mild and transient, often resolving without the need to discontinue treatment. Taking Bisolvon with food may help reduce the incidence of stomach-related side effects.
The severe skin reactions listed above, while extremely rare, represent the most clinically significant risk associated with bromhexine. These conditions — particularly Stevens-Johnson syndrome and toxic epidermal necrolysis — involve widespread blistering and detachment of the skin and mucous membranes, and require emergency hospital treatment. If you notice any new skin rash, blistering, or sores in the mouth, nose, eyes, or genital area while taking Bisolvon, stop the medicine immediately and contact a doctor without delay.
Stop taking Bisolvon and contact a doctor immediately if you experience any of the following:
- Swelling of the face, tongue, or throat
- Difficulty swallowing or breathing
- Hives (urticaria) accompanied by breathing difficulties
- Any skin rash, especially with blisters or sores on mucous membranes
Reporting Side Effects
If you experience any side effects while taking Bisolvon, including any not listed above, you can report them to your national medicines regulatory agency. In the United Kingdom, reports can be made to the Medicines and Healthcare products Regulatory Agency (MHRA) via the Yellow Card scheme. In the European Union, reports can be submitted to national competent authorities. Reporting side effects helps regulatory agencies monitor the ongoing safety of medicines and identify previously unrecognised adverse reactions.
How Should You Store Bisolvon?
Proper storage of medicines is essential to maintain their efficacy and safety throughout the stated shelf life. Bisolvon oral solution should be stored according to the following guidelines:
- Keep out of the sight and reach of children. Store in a safe location, preferably in a locked medicine cabinet or high shelf that is inaccessible to young children.
- Check the expiry date before each use. Do not use this medicine after the expiry date stated on the carton and bottle. The expiry date refers to the last day of the stated month.
- Store at room temperature. No special storage temperature requirements are specified for Bisolvon oral solution, but it should be kept away from excessive heat and direct sunlight.
- Keep the bottle tightly closed when not in use to protect the contents from contamination.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures help protect the environment and prevent accidental exposure to unused medicines.
What Does Bisolvon Contain?
Understanding the full composition of a medicine is important, particularly for individuals with known allergies or intolerances to specific excipients. Bisolvon oral solution contains the following ingredients:
Active Ingredient
Bromhexine hydrochloride 0.8 mg/ml. Each millilitre of oral solution contains 0.8 mg of the active substance. Bromhexine is a synthetic derivative of vasicine, an alkaloid originally obtained from the plant Adhatoda vasica (Malabar nut), which has been used in traditional medicine for centuries as a respiratory remedy.
Other Ingredients (Excipients)
- Purified water — base solvent
- Liquid maltitol — sweetening agent (sugar alcohol); may have mild laxative effect in large doses
- Sucralose — non-nutritive sweetener for taste
- Benzoic acid (E 210) — preservative (1.27 mg/ml); caution in neonates
- Levomentol — provides cooling sensation and flavour; caution in infants under 2 years (risk of laryngospasm)
- Flavouring agents (cherry and chocolate) — for palatability
Appearance and Packaging
Bisolvon oral solution is a colourless liquid with a pleasant taste. It is supplied in brown glass bottles with tamper-evident plastic caps, available in sizes of 100 ml, 125 ml, and 250 ml. A graduated measuring cup marked at 1.25 ml, 2.5 ml, and 5 ml is included with all pack sizes to facilitate accurate dosing.
Manufacturer
Bisolvon is manufactured by Delpharm Reims, Reims, France. The marketing authorisation is held by Opella Healthcare France SAS, Neuilly-sur-Seine, France.
Frequently Asked Questions About Bisolvon
Bisolvon (bromhexine) is a mucolytic medicine used to relieve productive (wet) cough with thick, sticky mucus. It works by breaking down the mucus fibres, making the mucus thinner and easier to cough up. It is available over-the-counter as an oral solution and is suitable for adults and children from 1 year of age.
Bisolvon is intended for short-term use only. You should not take it for more than 14 days without consulting a doctor. If your symptoms do not improve or worsen within two weeks, seek medical advice. Prolonged cough may indicate an underlying condition that requires further investigation.
Bromhexine crosses the placenta, but no harmful effects on the foetus have been demonstrated. However, Bisolvon should only be used during pregnancy if considered necessary by a healthcare provider, especially during the first trimester. It should be avoided during breastfeeding as bromhexine passes into breast milk.
Yes, Bisolvon can be given to children from 1 year of age. The dosage varies by age: children aged 1–5 years take 2.5 ml three times daily, children aged 6–12 years take 2.5–5 ml three times daily, and children over 12 years take the adult dose of 10 ml three times daily. Always use the measuring cup provided for accurate dosing.
The most common side effects of Bisolvon are gastrointestinal symptoms including upper abdominal pain, nausea, vomiting, and diarrhoea. These occur in fewer than 1 in 100 people and are usually mild and transient. Rare side effects include hypersensitivity reactions and skin rash. Seek immediate medical attention if you develop facial swelling, difficulty breathing, or severe skin reactions.
Bisolvon is not expected to significantly interact with other medicines. However, it should not be combined with antitussive (cough-suppressing) medicines such as codeine or dextromethorphan, as these reduce the cough reflex needed to expel the loosened mucus. Always inform your doctor or pharmacist about all medicines you are taking.
References
This article is based on evidence from the following peer-reviewed sources, international guidelines, and regulatory documents:
- European Medicines Agency (EMA). Bromhexine-containing medicines – Article 31 referral. Assessment report. www.ema.europa.eu. Accessed January 2026.
- World Health Organization (WHO). Model List of Essential Medicines, 23rd List (2023). www.who.int.
- British National Formulary (BNF). Bromhexine hydrochloride: drug monograph. bnf.nice.org.uk. Accessed January 2026.
- Zanasi A, Mazzolini M, Kantar A. A reappraisal of the mucoactive activity and clinical efficacy of bromhexine. Multidisciplinary Respiratory Medicine. 2017;12:7. doi:10.1186/s40248-017-0088-1.
- Depfenhart M, de Villiers D, Lemperle G, Meyer M, Di Somma S. Potential new treatment strategies for COVID-19: is there a role for bromhexine as add-on therapy? Internal and Emergency Medicine. 2020;15(5):801–812. doi:10.1007/s11739-020-02383-3.
- Balsamo R, Lanata L, Egan CG. Mucoactive drugs. European Respiratory Review. 2010;19(116):127–133. doi:10.1183/09059180.00003510.
- Pharmacovigilance Risk Assessment Committee (PRAC). Signal assessment report: bromhexine and severe cutaneous adverse reactions. European Medicines Agency, 2020.
- National Institute for Health and Care Excellence (NICE). Cough (acute): antimicrobial prescribing guideline. NICE guideline [NG120]. www.nice.org.uk.
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