Bromfed Dosing for a 4-Year-Old Child
For a 4-year-old child, the recommended dose of Bromfed (brompheniramine and pseudoephedrine) is 2.5 mL (½ teaspoonful) every 4 hours, not to exceed 6 doses in a 24-hour period. 1
Dosing Guidelines
The FDA-approved dosing for Bromfed (brompheniramine and pseudoephedrine) is age-based:
- Children 2 to under 6 years of age: 2.5 mL (½ teaspoonful) every 4 hours
- Children 6 to under 12 years of age: 5 mL (1 teaspoonful) every 4 hours
- Adults and children 12 years and older: 10 mL (2 teaspoonfuls) every 4 hours
For all age groups, do not exceed 6 doses during a 24-hour period.
Safety Considerations
When administering Bromfed to young children, several important safety considerations should be kept in mind:
- Measure doses accurately: Use a calibrated measuring device (not household spoons) to ensure proper dosing
- Monitor for side effects: Watch for drowsiness, excitability, or dry mouth
- Avoid overdosing: Strictly adhere to the recommended dosing schedule and maximum daily doses
Potential Adverse Effects
Brompheniramine may cause adverse effects in some children, particularly those with asthma. Research has shown that a subset of asthmatic children may experience decreased pulmonary function when taking brompheniramine 2. If the child has asthma, monitor closely for any signs of respiratory distress after administration.
Risk of Toxicity
Overdosage of antihistamine-decongestant combinations can be dangerous in young children. A case report documented a fatal intoxication in an infant involving brompheniramine, pseudoephedrine, and dextromethorphan 3. This underscores the importance of accurate dosing and careful administration.
Pharmacokinetic Considerations
Brompheniramine has been studied in children and demonstrates:
- Peak concentration at approximately 3.2 hours after administration
- Terminal elimination half-life of about 12.4 hours
- Significant antihistamine effects beginning within 30 minutes of administration and lasting up to 30 hours 4
This long duration of action supports the every 4-hour dosing schedule while maintaining therapeutic effects.
Alternative Options
If Bromfed is not well-tolerated or contraindicated, consider consulting with the child's pediatrician about alternative medications for symptom management that may have better safety profiles in young children.
Remember that pediatric patients require individualized dosing based on their unique pharmacokinetic parameters, and simply administering a "small adult" dose is not appropriate 5. Always follow the manufacturer's recommended dosing for the specific age group.