A fixed-dose combination (FDC) medication primarily used in the Indian market for the symptomatic treatment of allergic respiratory conditions complicated by thick mucus and potential parasitic (filarial) involvement. Bromhexine is a mucolytic, Cetirizine is a second-generation antihistamine, and Diethylcarbamazine (DEC) is an anti-filarial agent. This combination is specifically formulated for conditions where allergy, bronchospasm, and filarial infection may co-exist or present with overlapping symptoms, such as Tropical Pulmonary Eosinophilia (TPE).
Adult: One tablet twice daily after meals. The exact DEC dose must be verified; common strengths are 50mg or 100mg of DEC per tablet.
Note: Administer after food to minimize gastric irritation (especially from DEC). Swallow whole with a full glass of water. Maintain adequate hydration to aid mucolytic action.
This combination exerts a triple action: 1) Bromhexine depolymerizes and lyses acid mucopolysaccharide fibers in bronchial secretions, reducing viscosity. It also stimulates surfactant production. 2) Cetirizine competitively inhibits histamine at H1-receptors, preventing allergic symptoms like rhinorrhea and sneezing. 3) Diethylcarbamazine immobilizes microfilariae by altering their membrane, making them susceptible to host phagocytosis. It may also affect adult worms.
Pregnancy: Category C (US FDA). Adequate human studies lacking. Bromhexine and DEC are not recommended. Cetirizine is Category B but in combination, use only if potential benefit justifies potential risk to fetus. Avoid in first trimester.
Driving: Warn patients that Cetirizine may cause somnolence. Advise not to drive or operate machinery until individual response is known.
| CNS Depressants (Alcohol, Benzodiazepines, Opioids) | Additive sedative effect, increased impairment | Major |
| Theophylline | Bromhexine may increase Theophylline levels, risk of toxicity | Moderate |
| Anticholinergics (Atropine, TCAs) | Increased risk of urinary retention, dry mouth, constipation | Moderate |
| Other Antihistamines | Additive anticholinergic and sedative effects | Major |
| Narcotic Cough Suppressants (Codeine) | Counterproductive - suppresses cough reflex needed to clear liquefied sputum | Moderate |
Same composition (Bromhexine (1005mg) + Cetirizine (8mg) + Diethylcarbamazine (NA)), different brands: