Sunward Bromhexine Elixir 4mg/5ml Syrup

Sunward Bromhexine Elixir 4mg/5ml is an oral liquid (elixir) made by Sunward Pharmaceutical. Each 5 mL contains bromhexine hydrochloride 4 mg as the active ingredient, in a flavoured liquid base. Bromhexine is a long-established active ingredient found in a number of brands worldwide, and this is the Sunward-brand generic elixir that is sold in 60 mL and 120 mL bottles in Malaysian pharmacies.

The sources we could access do not itemise the inactive ingredients of this particular elixir, so the content does not state whether it contains sugar, alcohol, sorbitol or specific preservatives. Elixirs commonly contain some of these, so please read the ingredient list on the bottle if you have diabetes, a sugar or alcohol restriction, or a known intolerance, and ask a pharmacist if you are unsure. The pack comes with directions printed by the manufacturer, which take priority over any general information.

Sunward Bromhexine Elixir is supplied through pharmacies without a doctor’s prescription and is offered by DoctorOnCall as an OTC (Over-the-Counter) product. Because bromhexine liquids are pharmacy-supplied medicines, it is sensible to speak with a pharmacist before using it for a child, or if you are pregnant, breastfeeding or taking other medicines, and to check the label for the dosing table that applies to age.

• Measure each dose with the measuring spoon or cup supplied with the pack or a proper oral measuring device, and not with a household spoon.
• Take the dose that matches the age shown in the dosing table on the pack insert, or as directed by a doctor or pharmacist.
• Take after food, as directed on the pack, and drink plenty of fluids during the day unless a doctor has told you to limit fluids.
• Do not give to children under 2 years unless a doctor advises it, and do not exceed the dose or the number of days stated on the pack.
• Do not take it together with other cough or cold medicines that contain bromhexine or similar ingredients unless a pharmacist advises it, and do not use a cough suppressant at the same time without advice.

The dose of Sunward Bromhexine Elixir (4 mg in each 5 mL) depends on age, and the dosing figures printed in different references and on different Malaysian listings are not identical, so please follow the dosing table on the pack insert you received or the advice of a doctor or pharmacist rather than a number from a website. Use the measuring device supplied, take the dose after food, and do not exceed the stated maximum in 24 hours. Children under 2 years should only be given it on a doctor’s advice. If you miss a dose, take the next dose at the usual time and do not double up. Do not use it for longer than the pack states; see a doctor if the cough lasts more than about a week, or sooner if it worsens or comes with a fever or breathlessness.

Use before the expiry date printed on the bottle and carton. Once the bottle has been opened, follow any in-use period stated on the pack insert; if none is stated, ask a pharmacist, and do not use the elixir if it has changed colour, smells different or has become cloudy.

Store in a cool, dry place away from direct sunlight and heat, following any storage temperature printed on the pack, with the bottle tightly closed after each use. Keep out of the reach and sight of children. Do not transfer the elixir to another container.

• Do not use if you are allergic (hypersensitive) to bromhexine hydrochloride or any other ingredient in the elixir.
• Do not give to children under 2 years of age without a doctor’s advice.
• Do not use if you have been diagnosed with a hereditary sugar intolerance (such as hereditary fructose intolerance) and the bottle lists sugar-type ingredients such as sorbitol or sucrose; check the label.

• Cough suppressants (antitussives) such as codeine or dextromethorphan should not be taken at the same time unless a doctor or pharmacist advises it, as this can allow loosened phlegm to build up in the airways.
• Other medicines containing bromhexine or ambroxol, including some cough and cold preparations, should not be combined with this elixir to avoid taking a double dose of similar active ingredients.
• Tell a pharmacist about any other medicines you take, including antibiotics and herbal or traditional products, before using this elixir.
• No specific food interactions are known; taking it after food is generally advised, and drinking fluids through the day is recommended unless your doctor has told you otherwise.

• Always measure with the supplied measuring spoon or cup and never with a kitchen spoon, which can give the wrong dose.
• Take the dose after food and keep drinking fluids through the day unless you have been told to limit them.
• Check the label for sugar or alcohol if you have diabetes or must avoid alcohol, since the inactive ingredients are not itemised in the sources we reviewed.
• Do not combine with a cough suppressant or another bromhexine or ambroxol product without asking a pharmacist.
• Keep a note of the date you open the bottle and follow the in-use period on the pack insert.
• Keep the bottle tightly closed and out of the reach of children.

Precautions: Check the bottle for sugar and alcohol if you have diabetes, a sugar intolerance or must avoid alcohol. Ask a doctor or pharmacist before use if you have a history of stomach or duodenal ulcers, asthma, or serious liver or kidney problems, and if you are pregnant (particularly in the first trimester) or breastfeeding. Do not give to children under 2 years without medical advice, always use the measuring device supplied, and do not exceed the stated dose or duration. Do not combine with cough suppressants without advice. Keep out of the reach of children.

When to See a Doctor or Pharmacist: See a doctor if your cough lasts more than about a week, keeps coming back, or comes with fever, shortness of breath, chest pain, wheezing, or coughing up blood or green or rust-coloured phlegm. Stop the elixir and seek urgent medical attention if you develop a rash that spreads or blisters, peeling skin, sores in the mouth or eyes, swelling of the face or lips, or difficulty breathing.