Positives

• In a primary-care trial, patients on bromhexine reported a meaningfully lower percentage of cough at days 5-7 compared to standard care, per a PMC primary-care randomized trial.
  
  
• Among hospitalized patients an early oral bromhexine arm showed reduced mortality and a milder course, with patients describing easier breathing, per a PMC randomized clinical trial report.
  
  

Negatives

• Outpatient mild-to-moderate trials found no measurable viral load benefit, suggesting many patients see no improvement beyond cough symptoms, per the same PMC primary-care trial.
  
  
• Patients commonly describe nausea, vomiting, diarrhea, and upper abdominal pain, particularly at the higher off-label doses studied for COVID, per a PMC pharmaceutical review.
  
  

Hurdles & Side Effects

• Bromhexine has never been FDA-approved in the US, so patients must either travel or import from abroad with all the legal and quality risks that entails, per Wikipedia's bromhexine entry.
  
  
• No US clinician can write a domestic prescription, so US patients are forced to use guaifenesin or N-acetylcysteine instead, per a MedX availability article.