Ambroxol: A multifaceted molecule with additional therapeutic potentials in respiratory disorders of childhood

Davide Paleari, Giovanni A. Rossi, Gabriele Nicolini, Dario Olivieri

Research output: Contribution to journalArticlepeer-review


Mucoactive drugs are currently used to cleanse the respiratory tract following disturbance of the normal mucociliary clearance due to mucous hyperproduction and/or modification of its physicochemical characteristics. However, in addition to possessing the ability to perform specific actions on airway secretion, these compounds have the capability to modulate the mechanisms involved in abnormal secretions. Indeed, over the years, in the postmarketing phase, a large number of studies have been published showing interesting pharmacological activities in addition to their secretagogue activity. Areas covered: This article collates available data on ambroxol (2-amino-3,5-dibromo- N-[trans-4-hydroxycyclohexyl]benzylamine), a metabolite of bromhexine, used as a secretagogue in the treatment of childhood airway diseases. This article goes beyond the mucoactive aspects of the drug covering its multiple pharmacological properties. Expert opinion: The non-mucoactive functions exhibited by the compound may provide beneficial effects on airway structure and function in health and disease. Beyond the mucokinetic and secretagogue effects, ambroxol showed great antioxidant, anti-inflammatory, local anesthetic and surfactant synthesis stimulatory activities. Moreover, some antiviral and antibacterial activities were shown. These findings may better explain the clinical results observed in a variety of airway disorders and suggest additional therapeutic potential. Further studies are needed to better define the clinical relevance of these non-mucolytic activities.

Original languageEnglish
Pages (from-to)1203-1214
Number of pages12
JournalExpert Opinion on Drug Discovery
Issue number11
Publication statusPublished - Nov 2011


  • ambroxol
  • anesthetic
  • anti-inflammatory
  • antibacterial
  • antioxidant
  • antiviral
  • asthma
  • bacterial infection
  • biofilm
  • bronchiectasis
  • mucokinetic
  • mucus
  • oxygen radicals
  • respiratory virus
  • secretagogue
  • surfactant

ASJC Scopus subject areas

  • Drug Discovery


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