Alcophyllex is a cough and chest syrup containing theophylline, an antihistamine and an expectorant. It is taken for chesty coughs with wheeze or tightness. It is a chest medicine, not a digestive one, despite the category it appears in on this site.
What is Alcophyllex?
The South African Medicine Price Registry lists Alcophyllex as a Schedule 2 syrup with four active ingredients:
| Ingredient | What it does |
|---|---|
| Theophylline | Bronchodilator — relaxes and opens the airways |
| Hydroxyethyl theophylline (etofylline) | Related bronchodilator |
| Diphenhydramine hydrochloride | Sedating antihistamine; dries secretions, suppresses cough |
| Ammonium chloride 120 mg/5 ml | Expectorant — intended to loosen mucus |
| Sodium citrate 50 mg/5 ml | Expectorant, and makes secretions less viscous |
One thing to clear up first. Alcophyllex is a respiratory medicine, not a digestive one. It appears in this section of the site because of how the source catalogue was organised; nothing in it acts on the stomach or bowel. If you were given it for indigestion or nausea, check the pack — something has been mixed up. The digestive and stomach medicines hub covers the medicines that genuinely belong there.
The combination is a traditional South African chest-syrup formula: something to open the airways, something to dry and calm, and something to thin the mucus.
Theophylline is chemically related to caffeine. It relaxes the smooth muscle of the airways and stimulates respiratory drive. Its defining feature is a narrow therapeutic index — the level that helps and the level that harms are close together, and many ordinary things shift it.
Diphenhydramine is an older antihistamine and is markedly sedating. It also thickens secretions somewhat, which sits awkwardly beside an expectorant intended to loosen them — a tension inherent in this style of combination product.
What is Alcophyllex commonly used for?
- Chesty cough with tightness or wheeze.
- Bronchitis and chest congestion.
- Cough associated with colds and flu, where the chest feels tight.
- Mild wheezy episodes, though inhalers do this far better.
- Night-time cough, where the sedating antihistamine helps sleep.
Two things are worth stating plainly.
It does not treat the infection. Colds, flu and most bronchitis are viral. Nothing in this syrup shortens the illness; it eases symptoms while the illness runs its course.
It is not asthma treatment. If you wheeze regularly, wake at night with cough or tightness, or become breathless on exertion, that needs proper assessment. Modern asthma care is built on inhalers — an inhaled steroid for control and a reliever for symptoms — which deliver medicine straight to the airways with a fraction of the body-wide exposure. Relying on a chest syrup instead of inhalers is a genuine risk, because poorly controlled asthma kills people and is highly treatable.
Do not use it as an everyday cough remedy. A cough lasting more than three weeks needs investigating, and in South Africa a persistent cough with weight loss, night sweats or blood in the sputum should always prompt a TB check.
How Alcophyllex fits into this medicine category
Alcophyllex belongs with the respiratory medicines:
| Group | Examples | Role |
|---|---|---|
| Methylxanthines | Theophylline (Alcophyllex), aminophylline | Older oral bronchodilator; narrow safety margin |
| Inhaled steroids | Budesonide, fluticasone | The mainstay of asthma control |
| Reliever inhalers | Salbutamol | Acute symptoms — the emergency treatment |
| Sedating antihistamines | Diphenhydramine, promethazine | Dry secretions; cause drowsiness |
| Expectorants | Ammonium chloride, guaifenesin | Loosen mucus; modest evidence |
For contrast, the medicines that genuinely treat the gut work quite differently — antispasmodics such as hyoscine (Hyospasmol) relax gut muscle for cramping, and prokinetics such as metoclopramide (Adco-Contromet) treat nausea. Neither has anything in common with a chest syrup.
What to check before using Alcophyllex
Tell every prescriber that you are taking theophylline, because an unusual number of things change its blood level.
Raising theophylline levels (risk of toxicity): ciprofloxacin, erythromycin and clarithromycin, fluconazole, allopurinol, cimetidine, verapamil, diltiazem, the oral contraceptive pill — and fever, viral illness, heart failure and liver disease.
Lowering levels (loss of effect): carbamazepine, phenytoin, rifampicin, St John’s wort — and smoking. Stopping smoking can push a stable theophylline dose into the toxic range within days.
Also speak to a pharmacist or doctor if you:
- Have a heart rhythm problem, heart failure, liver disease, an overactive thyroid, epilepsy, or a stomach ulcer.
- Have glaucoma, an enlarged prostate or difficulty passing urine — relevant to diphenhydramine.
- Take sedating medicines, or drink alcohol. The drowsiness adds up.
- Are pregnant or breastfeeding.
- Are treating a child. Theophylline is cleared differently in children, and sedating antihistamines are not suitable for young children. Follow the age limits on the pack and ask a pharmacist.
- Are elderly, where both sedation and theophylline accumulation are more likely.
Practical points: measure with the device supplied; limit caffeine, which adds to the same effects; do not drive until you know how it affects you; and do not use it for more than a few days without advice.
Possible cautions and when to ask a pharmacist or doctor
Common effects are drowsiness, dry mouth, nausea, stomach upset, restlessness, difficulty sleeping, tremor and palpitations — the last four much like too much coffee, for the same underlying reason.
Learn the signs of theophylline toxicity. Early: persistent nausea and vomiting, worsening tremor, agitation, insomnia, a racing heart. Later, and dangerously: confusion, a very fast or irregular heartbeat, and seizures. Seizures and arrhythmias can occur without much warning, and theophylline toxicity is a medical emergency.
Get emergency help for:
- Persistent vomiting, especially with agitation or tremor.
- A very fast or irregular heartbeat, palpitations with dizziness, or fainting.
- Seizures, confusion or severe agitation.
- Severe breathlessness or wheeze that a reliever inhaler does not settle — treat that as an asthma attack.
- Swelling of the face, lips or tongue, or difficulty breathing.
Contact your doctor if:
- Cough lasts more than three weeks, or comes with weight loss, night sweats, fever or blood in the sputum — get a TB check.
- You develop a fever or chest infection, or start a new antibiotic — both can raise theophylline levels.
- You stop or start smoking.
- Wheeze or breathlessness is recurring, which suggests asthma or COPD needing proper treatment.
- A child is using it regularly, or seems unusually drowsy.
Related medicine guides
Frequently asked questions
What is Alcophyllex used for? Chesty cough with wheeze or chest tightness, bronchitis and chest congestion. It contains theophylline, a sedating antihistamine and expectorants.
Is it a stomach medicine? No. It is a chest and cough syrup with no action on the stomach or bowel.
Is it an antibiotic? No. Colds, flu and most bronchitis are viral, and nothing in it treats infection.
Why does it make me drowsy? It contains diphenhydramine, an older sedating antihistamine. Do not drive until you know how it affects you.
Can I use it for asthma? It is not asthma treatment. Asthma needs inhalers, and relying on a syrup instead is risky.
Does smoking affect it? Yes. Smoking speeds up theophylline breakdown; stopping smoking can push levels into the toxic range within days. Tell your doctor.
Can I take antibiotics with it? Tell your doctor — ciprofloxacin, erythromycin and clarithromycin all raise theophylline levels significantly.
How long can I take it? A few days. A cough lasting more than three weeks needs a doctor, and in South Africa a TB check.