Bromfed (Brompheniramine) Pediatric Dosing
For pediatric patients, brompheniramine dosing is age and weight-based: children 6 to under 12 years receive 5 mL (1 teaspoonful) every 4 hours, children 2 to under 6 years receive 2.5 mL (½ teaspoonful) every 4 hours, and infants 6 months to under 2 years require physician-established dosing, with a maximum of 6 doses in 24 hours. 1
Age-Based Dosing Algorithm
Children 6 to Under 12 Years
- Dose: 5 mL (1 teaspoonful) every 4 hours 1
- Maximum: 6 doses per 24-hour period 1
- This corresponds to approximately 1-4 mg per dose depending on formulation concentration 2
Children 2 to Under 6 Years
- Dose: 2.5 mL (½ teaspoonful) every 4 hours 1
- Maximum: 6 doses per 24-hour period 1
- Lower doses are appropriate given pharmacokinetic differences in younger children 3
Infants 6 Months to Under 2 Years
- Dosage must be established by a physician 1
- This age group requires individualized assessment due to immature organ systems and unpredictable pharmacokinetics 3
- Sedation appears more prevalent in the youngest age groups (2-5 years), suggesting caution with dosing in infants 2
Adolescents ≥12 Years
- Dose: 10 mL (2 teaspoonfuls) every 4 hours 1
- Maximum: 6 doses per 24-hour period 1
- Adult dosing applies to this age group 1
Pharmacokinetic Considerations
Brompheniramine demonstrates prompt onset and prolonged duration in children:
- Peak plasma concentrations occur at approximately 3.2 hours after oral administration 4
- Terminal elimination half-life is approximately 12.4 hours in children 4
- Peripheral H1-blockade begins within 0.5 hours and persists for 30 hours after a single 4 mg dose 4
- Maximum wheal inhibition occurs at 12 hours (52%) and flare inhibition at 6 hours (72%) 4
Age-related pharmacokinetic differences:
- Oral clearance and volume of distribution increase with age, but after allometric scaling, no significant age-related differences exist 2
- Cmax remains similar across age groups, though it tends to occur earlier in younger children 2
- AUC is approximately 15-30% higher in older children compared to younger age groups 2
Critical Safety Considerations
Common pitfalls to avoid:
- Never exceed 6 doses in 24 hours regardless of age group 1
- Sedation is the most common adverse effect and appears more prevalent in children aged 2-5 years 2
- Dosing should not be based on simple "small adult" calculations but rather on age-specific pharmacokinetic parameters 3
- For infants under 6 months, brompheniramine is not recommended without explicit physician guidance 1
Monitoring requirements: