From the Guidelines
Brompheniramine (Bromfed) is not recommended for children under 6 years old due to the potential toxicity and lack of efficacy in this age group, as stated in the study published in the Journal of Allergy and Clinical Immunology 1.
Overview of Bromfed
Bromfed is a combination medication that includes brompheniramine (an antihistamine) and pseudoephedrine (a decongestant) to relieve symptoms of upper respiratory infections (URIs) such as runny nose, sneezing, and nasal congestion.
Side Effects
Common side effects of Bromfed include:
- Drowsiness
- Dizziness
- Dry mouth
- Blurred vision
- Nervousness
- Difficulty sleeping More serious but less common side effects can include rapid heartbeat, increased blood pressure, and urinary retention.
Recommendation
The use of Bromfed in children under 6 years old should be avoided due to the potential for toxicity, as reported in the study published in the Journal of Allergy and Clinical Immunology 1. For children over 6 years old, Bromfed may be considered under a doctor's supervision, but parents should be aware of the potential side effects and the risk of masking symptoms of other conditions.
Alternative Treatments
According to the European position paper on rhinosinusitis and nasal polyps 2020, published in Rhinology 1, alternative treatments for URI symptoms in children include:
- Nasal irrigation with saline
- Paracetamol (acetaminophen) for relief of nasal obstruction and rhinorrhoea
- Zinc lozenges for reduction of cold duration It is essential to consult a healthcare provider before giving any medication to children, especially those with pre-existing conditions or who are taking other medications.
From the FDA Drug Label
ADVERSE REACTIONS The most frequent adverse reactions to Bromfed® DM Cough Syrup are: sedation; dryness of mouth, nose and throat; thickening of bronchial secretions; dizziness. Brompheniramine (Bromfed) may be suitable for a child with upper respiratory infection (URI) symptoms, but caution is advised due to potential side effects. The most commonly reported side effects include:
- Sedation
- Dryness of mouth, nose and throat
- Thickening of bronchial secretions
- Dizziness 2
From the Research
Brompheniramine (Bromfed) Suitability for Children with URI Symptoms
- Brompheniramine is an antihistamine that can be used to relieve symptoms of upper respiratory infections (URI) in children 3.
- However, a study found that an antihistamine-decongestant combination (brompheniramine maleate-phenylpropanolamine hydrochloride) was equivalent to placebo in providing temporary relief of URI symptoms in preschool children, except for sedative effects 3.
Commonly Reported Side Effects
- The most commonly reported side effects of brompheniramine are not explicitly stated in the provided studies, but it is known that antihistamines can cause drowsiness, among other effects 3.
- A study on therapeutic options for acute cough due to upper respiratory infections in children mentions that honey and topically applied vapor rubs may be effective antitussives, but does not discuss brompheniramine specifically 4.
Treatment Outcomes and Antibiotic Prescription
- A prospective observational study found that antibiotic prescription rates for URI and diarrhea groups were 30.2% and 13.6%, respectively, but antibiotic treatment was not significantly associated with better treatment outcomes for both URI and diarrhea cases 5.
- Another study found that clinical factors, which may lead physicians to be concerned about possible bacterial infection in children, are associated with antibiotic use for pediatric URI, but does not discuss brompheniramine 6.
Diagnosis and Treatment of URI
- A review of outpatient diagnosis and treatment of acute upper respiratory tract infections in children discusses the importance of proper management of these illnesses, decreasing the indication of unnecessary diagnostic tests and avoiding non-effective and harmful treatments 7.
- However, this review does not specifically discuss the use of brompheniramine in children with URI symptoms 7.