What is the recommended dose of Bromfed (Brompheniramine and Pseudoephedrine) for a 30-pound child?

Bromfed Dosing for a 30-Pound Child

For a 30-pound (13.6 kg) child, the recommended dose of Bromfed (brompheniramine and pseudoephedrine) is 1 teaspoon (4 ml) every 4-6 hours, not to exceed 4 doses in 24 hours.

Dosing Rationale

The appropriate dosing for Bromfed in pediatric patients is based on weight considerations, with particular attention to both safety and efficacy. For children weighing between 22-55 pounds (10-25 kg), which includes our 30-pound patient, the following principles apply:

• Brompheniramine component: The typical pediatric dose is 0.5 mg/kg/day divided into 3-4 doses 1
• Pseudoephedrine component: The standard pediatric dosing is 4 mg/kg/day divided into 4-6 doses

Age and Weight Considerations

Weight-based dosing is preferred over age-based dosing for accuracy in pediatric medication administration 2. For a 30-pound child:

• Falls within the 22-55 pound (10-25 kg) weight range where standard pediatric dosing applies
• Requires careful attention to avoid both underdosing (reduced efficacy) and overdosing (increased risk of adverse effects)

Safety Considerations

Several important safety considerations should be kept in mind when administering Bromfed to children:

• Avoid in children under 2 years: Bromfed is generally not recommended for children under 2 years of age due to risk of adverse effects
• Monitor for side effects: Common side effects include drowsiness, excitability, dry mouth, and tachycardia
• Potential for toxicity: Case reports have documented serious toxicity and even fatality from cold medication overdose in children, particularly with combinations containing pseudoephedrine and brompheniramine 3
• Drug interactions: Avoid combining with MAO inhibitors or other medications that may interact with antihistamines or decongestants

Administration Guidelines

• Administer with food to minimize gastrointestinal upset
• Use a calibrated measuring device (not household spoons) to ensure accurate dosing
• Do not exceed the recommended dose or frequency
• Ensure adequate hydration during treatment
• Discontinue if significant adverse effects occur

Duration of Therapy

• Limit use to 3-5 days for acute symptoms
• Consult healthcare provider if symptoms persist beyond 5 days or worsen
• Avoid prolonged use due to potential for tachyphylaxis (decreased effectiveness over time) with pseudoephedrine

Alternative Considerations

For children with certain conditions (cardiac issues, hypertension, diabetes, thyroid disorders), alternative medications without pseudoephedrine may be safer. Consider consulting with the child's healthcare provider about alternatives if these conditions are present.

Monitoring

Monitor the child for:

• Relief of symptoms (congestion, rhinorrhea)
• Adverse effects (excessive sedation, agitation, tachycardia)
• Adequate hydration and urine output
• Sleep disturbances

The pharmacokinetic profile of brompheniramine in children shows a half-life of approximately 15 hours, which supports the 4-6 hour dosing interval while maintaining therapeutic effect 1.