Bromfed Dosing
Bromfed (brompheniramine/pseudoephedrine) is dosed as 5 mL (containing brompheniramine 2 mg and pseudoephedrine 30 mg) every 4-6 hours for adults and children over 12 years, with pediatric dosing requiring weight-based calculation and caution due to limited safety data in young children. 1
Standard Adult Dosing
- Each 5 mL (1 teaspoonful) contains brompheniramine maleate 2 mg and pseudoephedrine hydrochloride 30 mg 1
- Administer every 4-6 hours as needed for nasal congestion and allergic symptoms 1, 2
- The pseudoephedrine component (60 mg per 10 mL dose) demonstrates significant decongestant efficacy with objective reduction in nasal airway resistance within 0-4 hours after administration 2
Pediatric Considerations
- Brompheniramine 4 mg produces prompt onset (within 0.5 hours) and sustained H1-blockade lasting up to 30 hours in children, with peak plasma concentrations at approximately 3 hours 3
- The terminal elimination half-life in children is 12.4 hours, suggesting once or twice daily dosing may be more appropriate than the traditional every 4-6 hour regimen 3
- Exercise extreme caution in infants and young children—fatal intoxications have been reported with cold medication combinations containing these ingredients 4
- Dosing in children should be weight-based and significantly reduced from adult doses, though specific pediatric dosing for this combination is not well-established in the provided evidence 3, 4
Pharmacokinetic Profile
- Brompheniramine achieves maximum wheal suppression at 12 hours (52% inhibition) and maximum flare suppression at 6 hours (72% inhibition) in children 3
- Pseudoephedrine demonstrates consistent bioavailability with mean biological half-life of 8 hours 5
- The combination maintains therapeutic levels when dosed every 6-12 hours depending on formulation 5
Critical Safety Warnings
- Monitor heart rate—pseudoephedrine increases heart rate by 2-4 beats per minute on average 2
- Avoid use in infants due to documented fatal overdoses with this drug combination 4
- The narrow therapeutic index in pediatric patients requires precise dosing and parental education on proper measurement 4
- Do not exceed recommended dosing intervals or amounts, as toxic concentrations can accumulate rapidly in small children 4