Proper Dosage and Usage of Brompheniramine for Allergy Symptoms or Cold Relief
For adults and children 12 years and older, the recommended dosage of brompheniramine is 10 mL (2 teaspoonfuls) every 4 hours, not exceeding 6 doses in a 24-hour period. 1
Dosage Guidelines by Age
- Adults and children ≥12 years: 10 mL (2 teaspoonfuls) every 4 hours
- Children 6 to <12 years: 5 mL (1 teaspoonful) every 4 hours
- Children 2 to <6 years: 2.5 mL (½ teaspoonful) every 4 hours
- Infants 6 months to <2 years: Dosage must be established by a physician
Efficacy for Allergy Symptoms
Brompheniramine is a first-generation antihistamine that effectively treats allergic rhinitis symptoms. Research shows it provides significant relief for:
- Rhinorrhea (runny nose)
- Sneezing
- Nasal congestion
- Itchy nose, eyes, or throat
- Excessive tearing
- Postnasal drip
Extended-release formulations of brompheniramine (12 mg twice daily) have demonstrated superior efficacy compared to terfenadine (60 mg twice daily) in reducing total nasal symptom severity in patients with allergic rhinitis. 2
Efficacy for Cold Relief
Brompheniramine has proven efficacy for treating rhinovirus cold symptoms. Clinical studies show it significantly reduces:
- Nasal secretion weights
- Rhinorrhea scores
- Sneeze counts and severity
- Cough counts (after initial treatment day)
Total symptom scores were significantly lower in patients receiving brompheniramine compared to placebo. 3
Pharmacokinetics and Duration of Action
Brompheniramine has a relatively long half-life (mean 24.9 hours) and large volume of distribution in adults. Key pharmacokinetic properties include:
- Peak serum concentration: 11.6 ng/mL (occurs at approximately 3.1 hours after administration)
- Prolonged antihistaminic effect: Suppression of histamine-induced wheal and flare response for up to 48 hours
- Significant suppression of pruritus (itching) for up to 24 hours 4
Important Considerations and Precautions
Side Effects
The most common side effects include:
- Drowsiness/somnolence
- Confusion (rare)
- Impaired performance and coordination
Performance impairment typically occurs between 1.5-3 hours after ingestion of standard formulations and may persist longer with sustained-release preparations. 5
Special Populations
- Pregnancy: Avoid use, especially during the first trimester
- Renal impairment: Use with caution; consider dose reduction
- Hepatic impairment: Use with caution
- Elderly: May be more sensitive to anticholinergic effects; consider lower doses
Alternative Options
For patients concerned about sedation or who cannot tolerate brompheniramine:
- Second-generation antihistamines (e.g., fexofenadine, loratadine) offer less sedation
- Intranasal corticosteroids are more effective for controlling all rhinitis symptoms
- Nasal saline irrigation is a safe, non-pharmacological option 6
Limitations and Warnings
- Do not exceed recommended dosage (maximum 6 doses in 24 hours)
- First-generation antihistamines like brompheniramine should be avoided in children under 6 years when possible
- Brompheniramine may cause significant drowsiness and should not be taken when operating machinery or driving
Treatment Algorithm for Allergic Rhinitis and Cold Symptoms
- For mild symptoms: Start with brompheniramine at recommended dosage
- For moderate symptoms: Consider combining brompheniramine with nasal saline irrigation
- For severe symptoms: Consider adding a topical decongestant for breakthrough congestion (limit use to 3 days)
- For persistent symptoms: Consider switching to or adding an intranasal corticosteroid
Remember that brompheniramine is considered a second-line therapy to epinephrine in the treatment of anaphylaxis and should never be administered alone in this emergency situation. 7