Dosage for Pseudoephedrine-Brompheniramine-DM Syrup in Adults
The recommended adult dosage for pseudoephedrine-brompheniramine-DM syrup is 10 mL (2 teaspoonfuls) every 4 hours, not to exceed 6 doses (60 mL total) in a 24-hour period. 1
Dosing Components and Rationale
- The FDA-approved adult dosing for brompheniramine formulations is 10 mL every 4 hours for adults and pediatric patients 12 years and older 1
- For pseudoephedrine, 60 mg (typically contained in a 10 mL dose of combination syrup) is considered the optimal single adult dose as it achieves maximal nasal decongestion without cardiovascular or other unwanted effects 2
- Studies have shown that pseudoephedrine 60 mg significantly reduces nasal airway resistance compared to placebo, while higher doses (120 mg, 180 mg) provide no additional decongestant benefit but increase risk of cardiovascular side effects 2
- Dextromethorphan (DM) is typically dosed every 4-6 hours in combination cold products to provide cough suppression 3
Administration Considerations
- The medication should be taken consistently at 4-hour intervals for optimal symptom control 1, 4
- Taking the medication with food may help reduce potential gastrointestinal side effects 3
- A single evening dose may be particularly beneficial for improving sleep quality when cold symptoms are present 3
Monitoring and Safety Considerations
Monitor for potential side effects including:
- Cardiovascular effects: Small but significant increases in pulse and systolic blood pressure may occur, particularly with higher doses of pseudoephedrine 2
- Central nervous system effects: Agitation, psychosis, or ataxia can occur, especially with overdose 5
- Anticholinergic effects: Dry mouth, urinary retention, and blurred vision from the brompheniramine component 1
Use caution in patients with:
Common Pitfalls and Caveats
- Exceeding the recommended dose does not provide additional therapeutic benefit but increases the risk of adverse effects 2
- Pseudoephedrine-containing products should not be used for more than 7 days for self-treatment of nasal congestion 4
- Patients should be advised not to combine with other antihistamine or decongestant products to avoid duplicate therapy and increased risk of side effects 5
- Overmedication in children can result in serious neurologic and cardiovascular abnormalities that can occasionally be life-threatening 5