How many times a day can Bromfed (Brompheniramine) be administered to children?

Bromfed (Brompheniramine) Dosing for Children

Bromfed (brompheniramine) should be administered to children according to age-specific dosing: 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, with no more than 6 doses in a 24-hour period. 1

Age-Specific Dosing Guidelines

The FDA-approved dosing for brompheniramine (Bromfed) in pediatric populations is as follows:

• Ages 12 years and older: 10 mL (2 teaspoonfuls) every 4 hours
• Ages 6 to under 12 years: 5 mL (1 teaspoonful) every 4 hours
• Ages 2 to under 6 years: 2.5 mL (½ teaspoonful) every 4 hours
• Ages 6 months to under 2 years: Dosage must be established by a physician

For all age groups, do not exceed 6 doses during a 24-hour period 1.

Pharmacokinetic Considerations

Research on brompheniramine pharmacokinetics in children shows:

• The terminal elimination half-life is approximately 12.4 hours in children 2
• Maximum antihistamine effect occurs at approximately 6-12 hours after administration 2
• Single-dose studies show similar maximum concentrations (Cmax) across different pediatric age groups, though it tends to occur earlier in younger children 3

Safety Considerations

When administering Bromfed to children, be aware of these important safety considerations:

• The American Academy of Allergy, Asthma, and Immunology and the American College of Chest Physicians recommend against using OTC cough and cold medications in children under 4 years due to lack of efficacy and potential toxicity 4
• Sedation is the most common reported adverse effect and appears to be more prevalent in the 2-5 year age group 3
• Some asthmatic children may experience worsening of pulmonary function with brompheniramine 5, so caution is warranted in children with asthma

Monitoring and Follow-up

• Monitor for signs of sedation, which is the most common side effect
• Assess efficacy within 30 minutes to 1 hour of administration, as antihistamine effects begin promptly 2
• Be aware that antihistamines like brompheniramine have minimal to no efficacy for cough relief in children 4
• If symptoms persist or worsen despite appropriate dosing, reevaluate the diagnosis and consider alternative treatments

Key Points for Optimal Use

• Always adhere to the age-appropriate dosing schedule
• Never exceed 6 doses in a 24-hour period
• For infants 6 months to 2 years, physician evaluation and dosing determination is required
• Consider the long half-life (12.4 hours) when evaluating for potential drug accumulation with repeated dosing
• Be particularly cautious in children with asthma or respiratory conditions