What is the recommended dosage of Bromfed DM (brompheniramine and dextromethorphan) for children?

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Bromfed DM Dosage for Children

Bromfed DM should be dosed according to age: children 6-12 years should receive 5 mL (1 teaspoonful) every 4 hours, children 2-6 years should receive 2.5 mL (½ teaspoonful) every 4 hours, and infants 6 months to 2 years require physician-established dosing, not exceeding 6 doses in 24 hours. 1

Age-Specific Dosing Guidelines

Bromfed DM contains brompheniramine (an antihistamine) and dextromethorphan (a cough suppressant). The FDA-approved dosing is as follows:

  • Children 6 to under 12 years of age: 5 mL (1 teaspoonful) every 4 hours
  • Children 2 to under 6 years of age: 2.5 mL (½ teaspoonful) every 4 hours
  • Infants 6 months to under 2 years of age: Dosage must be established by a physician
  • Maximum dosing: Do not exceed 6 doses during a 24-hour period

Safety Considerations

When administering Bromfed DM to children, several important safety factors should be considered:

  • Accurate measurement: Always use a calibrated medication syringe or measuring cup, not household spoons, to ensure accurate dosing
  • Duration of treatment: Limit treatment to 7 days unless otherwise directed by a healthcare provider 2
  • Monitoring: Watch for side effects including drowsiness, dizziness, dry mouth, or gastrointestinal upset

Special Considerations for Young Children

The use of cough and cold medications in very young children requires special attention:

  • Studies show that cough and cold medication use is highest among children 2-5 years old, followed by children under 2 years 3
  • The pharmacokinetics of dextromethorphan (one component of Bromfed DM) varies with age, with different exposure levels observed across age groups 4
  • Brompheniramine has a long half-life in children (approximately 12.4 hours), which supports less frequent dosing but also increases the risk of accumulation with repeated doses 5

Precautions and Contraindications

  • Avoid overdosing: Accidental ingestions can lead to serious adverse effects, particularly in children under 5 years 6
  • Combination products: Be aware that Bromfed DM contains multiple active ingredients, increasing the risk of adverse effects or drug interactions
  • Consultation requirement: For infants 6 months to 2 years, physician evaluation is mandatory before administration

When to Seek Medical Attention

Contact a healthcare provider immediately if:

  • Symptoms worsen despite treatment
  • Fever develops or persists
  • Cough lasts more than 7 days
  • Any unusual or severe side effects occur

Remember that the FDA and American Academy of Pediatrics have expressed concerns about the safety and efficacy of cough and cold medications in young children, particularly those under 2 years of age.

References

Guideline

Guaifenesin Dosage and Administration in Children

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

The clinical pharmacology of brompheniramine in children.

The Journal of allergy and clinical immunology, 1999

Research

Accidental dextromethorphan ingestions in children less than 5 years old.

Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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