Bromhexine: Into the spotlight

Bromhexine is a synthetic molecule derived from the natural product vasicinone isolated from Adhatoda vasica, an important ayurvedic medicinal plant. Bromhexine was validated as an active ingredient for pharmaceutical use at Boehringer Ingelheim and was introduced in 1963. Bromhexine is widely prescribed as OTC mucoactive drug to treat a broad range of respiratory diseases. The mechanism of action of bromhexine is primarily associated with its secretomotoric effect through expectorating the mucus out of the lungs with the modification in the physiochemical features of mucus. Bromhexine has been recently in the spotlight for its possible application as a repurposing drug candidate for the management of COVID-19 patients. In this chapter, we have provided a perspective for the application of bromhexine in COVID-19 patients based on the safety assessment, mechanistic findings, and reports from many clinical trials around the world. The chapter also tried to shed light on the therapeutic aspects of bromhexine in different disease conditions.