What is Bromfed (Brompheniramine) used for?

Bromfed (Brompheniramine) Usage

Bromfed, which contains brompheniramine maleate, is primarily used to treat allergic rhinitis, common cold symptoms, and other upper respiratory conditions by reducing rhinorrhea (runny nose), sneezing, and nasal congestion.

Mechanism of Action

Brompheniramine works through two primary mechanisms:

1. Antihistamine effects: It blocks H1 receptors, antagonizing the allergic response including vasodilation, increased vascular permeability, and mucus secretion in nasal tissue 1

2. Anticholinergic effects: Provides a drying effect that helps reduce rhinorrhea and other nasal secretions 1

Clinical Applications

Allergic Rhinitis

• Effectively treats symptoms of both seasonal and perennial allergic rhinitis
• Particularly effective for rhinorrhea, sneezing, and nasal congestion 2
• Studies show that extended-release formulations of brompheniramine provide significantly better relief of allergic rhinitis symptoms compared to some second-generation antihistamines like terfenadine 3

Common Cold

• Reduces rhinorrhea, sneezing, and cough associated with rhinovirus colds 4
• In randomized controlled trials, brompheniramine significantly reduced nasal secretion weights, rhinorrhea scores, and sneeze counts compared to placebo 4
• First-generation antihistamines like brompheniramine are more effective for common cold symptoms than newer non-sedating antihistamines 5

Upper Airway Cough Syndrome (UACS)

• Effective for treating cough related to post-nasal drip syndrome (now called Upper Airway Cough Syndrome) 5
• Often combined with decongestants like pseudoephedrine for greater efficacy in treating cough associated with common cold 5

Dosing Considerations

• In children, a single dose produces prompt and long-lasting peripheral H1-blockade, with effects lasting up to 24 hours 6
• Peak plasma concentration after a single 4 mg oral dose is reached in approximately 5 hours 1
• Extended-release formulations allow for twice-daily dosing 2

Side Effects and Precautions

• Common side effects include somnolence (drowsiness) and dry mouth 4
• First-generation antihistamines like brompheniramine have more sedative effects than newer non-sedating antihistamines
• Should be used with caution in patients with glaucoma, urinary retention, or prostatic hypertrophy due to anticholinergic effects 5
• The American College of Chest Physicians advises against using OTC cough and cold medications containing brompheniramine in children under 6 years due to potential toxicity concerns 5

Combination Products

Bromfed is often formulated as a combination product that may include:

• Pseudoephedrine (decongestant) which acts on α-sympathetic receptors to produce vasoconstriction of dilated nasal arterioles 1
• Sometimes combined with dextromethorphan (antitussive) which acts centrally to elevate the threshold for coughing 1

These combination products provide comprehensive relief for multiple cold and allergy symptoms, though the efficacy and safety of such combinations should be carefully considered, especially in pediatric populations.