koften syrup - Bromhexine (4mg/5ml) + Guaifenesin (50mg/5ml) medicine

Brill-X Syrup: Complete Guide to Uses, Dosage, Side Effects, and Safety

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🏭 MDC Pharmaceuticals Pvt Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 25, 2026
⚠️ Nephrotoxicity Risk 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Moderate for symptomatic relief of productive cough.
Reviewed by
SaathiMed Expert Panel | Sep 25, 2026
🩺
Medically Fact-Checked & Clinically Verified by SaathiMed Clinical Review Board
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026

When to Call Your Doctor IMMEDIATELY

  • Difficulty breathing or shortness of breath
  • Chest pain or tightness
  • Coughing up blood
  • High fever (above 101°F) lasting more than 3 days
  • Severe headache with stiff neck
  • Rash, itching, or swelling of the face, lips, or throat
  • Severe abdominal pain or persistent vomiting
  • Decreased urine output or blood in urine

If experiencing severe symptoms, call emergency services immediately.

What is koften syrup used for?

This medicine is a combination cough syrup containing bromhexine (a mucolytic) and guaifenesin (an expectorant). It works by thinning and loosening mucus in the airways, making it easier to cough up. It is used for productive coughs with thick phlegm. It is not for dry coughs. Always follow your doctor's advice and do not exceed the recommended dose.

  • Generic Name: Bromhexine (4mg/5ml) + Guaifenesin (50mg/5ml)
  • Manufacturer: MDC Pharmaceuticals Pvt Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 koften syrup के बारे में (Hindi Summary)

उपयोग: यह दवा बलगम वाली खांसी (उत्पादक खांसी) के इलाज के लिए इस्तेमाल की जाती है। इसमें ब्रोमहेक्सिन और गुआइफेनेसिन दो सक्रिय तत्व होते हैं। ब्रोमहेक्सिन बलगम को पतला करता है और गुआइफेनेसिन बलगम को और पतला करके उसे बाहर निकालने में मदद करता है। यह दवा सूखी खांसी के लिए नहीं है। इसका इस्तेमाल डॉक्टर की सलाह के अनुसार ही करें।

साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, उल्टी, दस्त, पेट में परेशानी और सिरदर्द शामिल हैं। ये आमतौर पर हल्के होते हैं और अपने आप ठीक हो जाते हैं। दुर्लभ मामलों में चक्कर आना, नींद आना, पसीना आना या त्वचा पर दाने हो सकते हैं। गंभीर एलर्जी प्रतिक्रिया (जैसे चेहरे, होंठ या गले में सूजन, सांस लेने में कठिनाई) होने पर तुरंत डॉक्टर से मिलें।

सुरक्षा सलाह: इस दवा को लेने से पहले अपने डॉक्टर को अपनी सभी स्वास्थ्य समस्याओं और दवाओं के बारे में बताएं। 7 दिनों से अधिक इसका इस्तेमाल न करें। खांसी बढ़ने या बुखार, दाने या लगातार सिरदर्द होने पर डॉक्टर से मिलें। इस दवा से नींद या चक्कर आ सकते हैं, इसलिए वाहन चलाने या मशीन चलाने से बचें। शराब न पिएं। गर्भवती या स्तनपान कराने वाली महिलाएं डॉक्टर से सलाह लें। बच्चों की पहुंच से दूर रखें।

💡 Did You Know? India has the highest number of USFDA-compliant plants outside the USA.

💊 koften syrup Uses & Benefits

[{"condition":"Productive cough (with phlegm)","description":"Helps loosen and thin mucus in the airways, making it easier to cough up and clear the chest.","evidence":"Well-established"},{"condition":"Acute bronchitis","description":"Provides symptomatic relief by reducing mucus viscosity and aiding expectoration.","evidence":"Well-established"},{"condition":"Chronic bronchitis","description":"May help manage chronic mucus hypersecretion and improve cough clearance.","evidence":"Moderate"},{"condition":"Respiratory tract infections with thick mucus","description":"Used as an adjunct to help clear secretions and relieve chest congestion.","evidence":"Moderate"}]

Off-label uses: [{"condition":"Sinusitis","description":"Sometimes used to help thin sinus secretions and relieve congestion, though evidence is limited.","evidence":"Limited"},{"condition":"Otitis media with effusion","description":"Occasionally used to help clear middle ear fluid, but not routinely recommended.","evidence":"Limited"}]

Primary treatment for: Productive cough

Also treats: Acute bronchitis, Chronic bronchitis, Respiratory tract infections

📋 Drug Information

Generic Name(s)Bromhexine (4mg/5ml) + Guaifenesin (50mg/5ml)
Brand Namekoften syrup
ManufacturerMDC Pharmaceuticals Pvt Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassRESPIRATORY
Action Class
Route of AdministrationOral
StorageStore at room temperature (15-30°C) in a dry place, away from direct sunlight. Keep the bottle tightly closed. Do not refrigerate unless specified on the label.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Always measure the dose with the provided measuring cup or spoon; do not use a household spoon.
2
Take this medicine with food if it upsets your stomach.
3
Stay well hydrated by drinking plenty of fluids to help thin mucus.
4
Do not use this medicine for a dry cough or if you are coughing up blood.
5
If your cough does not improve within 7 days, consult your doctor.
6
Avoid taking other cough suppressants unless advised by your doctor.
7
Keep a record of your doses to avoid missing or doubling up.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Productive cough with thick phlegm
This medicine is commonly prescribed for this.
Likely Use
❌
Dry cough
This medicine is not for dry cough and may be harmful.
Not Primary
✅
Chest congestion
This medicine helps loosen mucus and relieve congestion.
Likely Use
❌
Fever
This medicine is not a fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionBromhexine is rapidly absorbed from the gastrointestinal tract after oral administration. Guaifenesin is also absorbed from the gastrointestinal tract. The presence of food may slightly delay absorption but does not significantly affect the extent of absorption.
DistributionBromhexine is widely distributed to body tissues, including the lungs. It crosses the blood-brain barrier and placenta. Guaifenesin is also distributed throughout the body. Protein binding information for both agents is not well established.
Protein BindingNot established from the available information.
MetabolismBromhexine undergoes extensive first-pass metabolism in the liver, primarily by cytochrome P450 enzymes, to active and inactive metabolites. Guaifenesin is metabolized in the liver, partly by oxidation and conjugation.
Half-LifeThe elimination half-life of bromhexine is approximately 1-2 hours. The half-life of guaifenesin is approximately 1 hour.
ExcretionBromhexine and its metabolites are mainly excreted in the urine. Guaifenesin and its metabolites are also excreted primarily in the urine.
BioavailabilityThe oral bioavailability of bromhexine is approximately 20-30% due to first-pass metabolism. The bioavailability of guaifenesin is approximately 50%.
Onset of ActionThe onset of action for bromhexine is typically within 30 minutes to 1 hour after oral administration. Guaifenesin also acts relatively quickly, with effects beginning within 30 minutes.
Peak Plasma TimePeak plasma concentrations of bromhexine are reached approximately 1 hour after oral administration. For guaifenesin, peak levels occur around 15-30 minutes after administration.
Duration of ActionThe duration of action for bromhexine is approximately 6-8 hours. For guaifenesin, the duration is approximately 4-6 hours. However, the symptomatic relief from mucus thinning may last longer.

How It Works

This medicine combines two active ingredients with complementary actions. Bromhexine is a mucolytic that reduces the viscosity of mucus by breaking down acidic mucopolysaccharide fibers, making secretions thinner and easier to expectorate. Guaifenesin is an expectorant that increases the volume and reduces the viscosity of respiratory tract secretions by increasing hydration of mucus, thereby facilitating its removal by ciliary action and coughing. Together, they enhance mucociliary clearance and provide symptomatic relief from productive cough.

Mechanism Steps

1
Bromhexine breaks down mucus structure: Bromhexine disrupts the network of acidic mucopolysaccharide fibers in mucus, reducing its thickness and stickiness.
2
Guaifenesin increases mucus hydration: Guaifenesin draws water into respiratory secretions, further thinning the mucus and increasing its volume.
3
Enhanced mucociliary clearance: The combined effect makes it easier for the cilia (tiny hair-like structures) in the airways to move the thinned mucus upward, where it can be coughed out.
4
Symptomatic relief: As mucus is cleared, cough becomes more productive and chest congestion is relieved, providing comfort to the patient.

💡 How to Take koften syrup

Strength: Each 5 ml of syrup contains Bromhexine 4 mg and Guaifenesin 50 mg.

1Shake the bottle well before each use.
2Use a measuring cup or spoon to measure the exact dose.
3Take the medicine orally with or without food.
4If stomach upset occurs, take with a meal or snack.
5Drink a glass of water after taking the medicine.
6Do not exceed the recommended dose.
7Wash the measuring cup after each use.

Dosage Information

Adult DosageThe usual adult dose of this medicine is 10 ml (2 teaspoons) taken three to four times a day, or as directed by your doctor. The dose may vary depending on the severity of your condition and your response to treatment. Do not exceed the recommended dose. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may be more sensitive to the effects of this medicine, especially dizziness and drowsiness. Use with caution and follow your doctor's advice. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Renal ImpairmentCaution is advised in patients with kidney disease. Dose adjustment may be necessary. Consult your doctor for guidance. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Hepatic ImpairmentCaution is advised in patients with liver disease. Dose adjustment may be necessary. Consult your doctor for guidance. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Maximum Daily DoseThe maximum recommended daily dose for adults is 40 ml (8 teaspoons) in 24 hours. Do not exceed this dose.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset.
Water
Drink plenty of fluids
Helps thin mucus and soothe the throat.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of koften syrup

✅ Common Side Effects

Nausea (Common (1-10%))
Take with food or milk to reduce stomach upset. If nausea persists, consult your doctor.
Vomiting (Common (1-10%))
Stay hydrated with small sips of water. If vomiting is severe or persistent, contact your doctor.
Diarrhea (Common (1-10%))
Drink plenty of fluids to prevent dehydration. If diarrhea lasts more than a few days, consult your doctor.
Stomach discomfort (Common (1-10%))
Take the medicine with a meal or snack. Avoid lying down immediately after taking it.
Headache (Common (1-10%))
Rest and stay hydrated. If headache is severe or persistent, consult your doctor.

🚨 Serious Side Effects

Severe allergic reaction (anaphylaxis) (Rare (<0.1%))
Seek immediate medical attention if you experience rash, itching, swelling of the face, lips, or throat, difficulty breathing, or dizziness.
Severe skin reactions (e.g., Stevens-Johnson syndrome) (Very rare (<0.01%))
Stop the medicine and seek immediate medical help if you develop a painful rash, blistering, or peeling skin.
Kidney stones (Rare with normal use; risk increases with high doses or prolonged use)
Report severe back or side pain, painful urination, or blood in urine to your doctor immediately.

⚠️ Rare Side Effects

Dizziness
Avoid driving or operating machinery until you feel normal. If dizziness persists, consult your doctor.
Drowsiness
Avoid activities requiring alertness. If drowsiness is bothersome, talk to your doctor.
Sweating
Stay cool and hydrated. If excessive, consult your doctor.
Skin rash
Stop the medicine and consult your doctor if rash develops.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
MAOIs Major
Codeine Major
Antihistamines Moderate
Diuretics Moderate
Amoxicillin Minor
Cimetidine Minor

🚨 Major Interactions

  • Monoamine oxidase inhibitors (MAOIs)
  • Antitussives (e.g., codeine, dextromethorphan)

⚡ Moderate Interactions

  • Anticholinergic drugs (e.g., atropine, antihistamines)
  • Diuretics

🍷 Alcohol Interaction

Alcohol may increase the risk of drowsiness, dizziness, and stomach upset when taken with this medicine. It is advisable to avoid alcohol while using this product.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known hypersensitivity to bromhexine, guaifenesin, or any component of the formulation.","Children under 2 years of age.","Use in patients with a dry cough or cough associated with excessive secretions.","Use in patients with severe liver or kidney impairment without medical supervision."]

⚠️ Warnings & Precautions

["Do not exceed the recommended dose.","Do not use for more than 7 days without consulting a doctor.","Consult a doctor if cough persists or worsens, or if you develop a fever, rash, or persistent headache.","Use with caution in patients with a history of stomach ulcers.","Use with caution in patients with asthma.","May cause dizziness or drowsiness; avoid driving or operating machinery until you know how it affects you.","Avoid alcohol while taking this medicine.","Consult a doctor before use if you are pregnant or breastfeeding.","Keep out of reach of children."]

🤱 Lactation Safety

It is not known whether bromhexine and guaifenesin pass into breast milk. Consult your doctor before using this medicine while breastfeeding.

💊 Overdose Management

Overdose may cause nausea, vomiting, diarrhea, and abdominal pain. In severe cases, it may lead to central nervous system depression, respiratory depression, and seizures. If you suspect an overdose, seek immediate medical attention. Treatment is supportive and symptomatic. There is no specific antidote.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

Additional Safety Advice

General Safety

Before taking this medicine, inform your doctor if you have a history of stomach ulcers, kidney disease, liver disease, or asthma. Do not take this medicine for more than 7 days without consulting your doctor. If your cough persists or worsens, or if you develop a fever, rash, or persistent headache, stop taking it and seek medical advice. Do not exceed the recommended dose. This medicine may cause dizziness or drowsiness; avoid driving or operating heavy machinery until you know how it affects you. Avoid drinking alcohol while taking this medicine as it can increase drowsiness and stomach upset. If you are pregnant or breastfeeding, consult your doctor before using this medicine. Keep out of reach of children. Do not use this medicine for a dry cough or if you are coughing up blood.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more sensitive to the side effects of this medicine, particularly dizziness, drowsiness, and confusion. Use with caution and monitor for falls. Dose adjustment may be necessary based on kidney and liver function.

🤰 Pregnancy Planning (TTC)

If you are planning to become pregnant, consult your doctor before taking this medicine. The safety of bromhexine and guaifenesin during pregnancy is not well established. Your doctor will weigh the benefits and risks.

🏥 Post-Surgery Considerations

If you have recently undergone surgery, consult your doctor before taking this medicine. It may interact with other medications or affect recovery. Do not self-medicate.

🦷 Dental Procedures

This medicine may cause dry mouth, which can increase the risk of dental problems. Maintain good oral hygiene and stay hydrated. Inform your dentist if you are taking this medicine before any dental procedure.

💚 Lifestyle Tips for Better Results

🏃
Stay well hydrated by drinking plenty of water and warm fluids.
🥗
Use a humidifier or take steamy showers to help loosen mucus.
😴
Avoid smoking and exposure to secondhand smoke.
💧
Get plenty of rest to help your body fight the infection.
🧘
Practice good hand hygiene to prevent spreading infections.
🌞
Elevate your head while sleeping to reduce nighttime coughing.

🏋️ Exercise Considerations

While taking this medicine, you may experience dizziness or drowsiness. Avoid strenuous exercise or activities that require alertness until you know how the medicine affects you. Light activity like walking is generally safe if you feel up to it.

🥗 Diet Recommendations

Drink warm fluids like herbal tea, soup, and broth.
Include honey and ginger in your diet to soothe the throat.
Avoid cold drinks and ice cream which can worsen cough.
Eat a balanced diet rich in fruits and vegetables to support immunity.
Avoid spicy and oily foods that may irritate the throat.

💼 Impact on Daily Work & Life

This medicine may cause dizziness or drowsiness in some people. If affected, avoid driving, operating heavy machinery, or performing tasks that require mental alertness. It is generally safe to continue desk work, but take breaks and stay hydrated. Inform your employer if you need to take time off due to illness.

🛑 When to Stop This Medicine

Stop taking this medicine and consult your doctor if your cough persists for more than 7 days, if it worsens, or if you develop a fever, rash, or persistent headache. Do not stop abruptly if you have been taking it for a long time without medical advice.

📅 Long-Term Use Effects

Long-term use of this medicine is not recommended. Prolonged use of guaifenesin, especially at high doses, may increase the risk of kidney stones. It may also mask underlying conditions. If your cough persists for more than 7 days, consult a doctor to determine the cause. Regular monitoring of kidney function may be advised if used for extended periods.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Steam inhalation

Inhaling steam can help loosen mucus and relieve congestion.

Evidence: Well-established
Saline nasal irrigation

Rinsing nasal passages with saline can reduce postnasal drip and congestion.

Evidence: Moderate
Honey and lemon

A warm mixture of honey and lemon can soothe the throat and reduce cough.

Evidence: Moderate

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

There are no known interactions between this medicine and vaccines. However, if you are due for a vaccination, inform your healthcare provider that you are taking this medicine.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

When traveling, carry this medicine in its original packaging with the prescription label intact. Bring a copy of your prescription in case you need to show it at customs. Store it in a cool, dry place away from direct sunlight. If you are crossing time zones, continue taking your doses at regular intervals as prescribed. Do not leave it in a hot car or checked luggage. If you are flying, keep it in your carry-on bag.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 35-year-old man with acute bronchitis
Ravi developed a bad cough with thick yellow phlegm after a cold. His doctor prescribed this medicine. He took it three times a day with meals. Within two days, his cough became more productive and his chest felt less congested. He made sure to drink plenty of water. He completed the 5-day course and felt much better.
💡 Lesson: Taking the medicine with food and staying hydrated can enhance its effectiveness and reduce stomach upset.
👤 A 60-year-old woman with chronic bronchitis
Mrs. Sharma has chronic bronchitis and often struggles with thick mucus. Her doctor recommended this medicine for short-term relief during flare-ups. She found it helpful but experienced mild nausea initially. By taking it with a small snack, the nausea went away. She was careful not to exceed the recommended dose and used it only when needed.
💡 Lesson: Adjusting the timing of the medicine with food can minimize side effects. It is important to use it only for short periods and as directed.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine usually starts working within 30 minutes to 1 hour after taking a dose. You may notice that your cough becomes more productive and mucus is easier to cough up. However, the full benefit may take a day or two.

Q: Can I take this medicine with other cough medicines?

A: You should not take this medicine with other cough suppressants (like codeine or dextromethorphan) because suppressing cough can lead to mucus buildup. Always consult your doctor before combining any medicines.

Q: Is this medicine safe for children?

A: This medicine is not recommended for children under 2 years of age. For older children, consult a pediatrician for appropriate dosing.

Q: Can I take this medicine if I am pregnant?

A: The safety of this medicine during pregnancy is not well established. Consult your doctor before taking it if you are pregnant or planning to become pregnant.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for koften syrup

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can cure any type of cough.
    Fact: This medicine is only for productive coughs with phlegm. It is not effective for dry coughs and may be harmful if used for dry cough.
  • Myth: More medicine means faster relief.
    Fact: Taking more than the recommended dose does not speed up recovery and can increase the risk of side effects. Always follow the prescribed dose.
  • Myth: It is safe to take this medicine for weeks.
    Fact: This medicine should not be used for more than 7 days without medical advice. Prolonged use may lead to side effects like kidney stones.

🔄 Alternative Options

Generic Alternatives

  • Bromhexine + Guaifenesin syrup (various manufacturers)

Brand Alternatives

  • Brill-X Syrup

📊 Comparison with Similar Medicines

[{"medicine":"This medicine (Bromhexine + Guaifenesin)","composition":"Bromhexine 4mg/5ml + Guaifenesin 50mg/5ml","uses":"Productive cough","notes":"Combines mucolytic and expectorant actions."},{"medicine":"Ambroxol + Guaifenesin","composition":"Ambroxol 15mg/5ml + Guaifenesin 50mg/5ml","uses":"Productive cough","notes":"Ambroxol is a metabolite of bromhexine with similar effects."},{"medicine":"Guaifenesin alone","composition":"Guaifenesin 100mg/5ml","uses":"Productive cough","notes":"Only expectorant action, no mucolytic."}]

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