Bromfed Dosing
Bromfed (brompheniramine 2 mg/pseudoephedrine 30 mg per 5 mL) is dosed at 5 mL (1 teaspoonful) every 4-6 hours in adults and children over 12 years, with pediatric dosing requiring weight-based calculation and typically given every 6 hours. 1
Standard Adult Dosing
- Adults and children ≥12 years: 5 mL (containing brompheniramine 2 mg and pseudoephedrine 30 mg) every 4-6 hours 1
- Maximum frequency should not exceed every 4 hours to avoid excessive sympathomimetic effects from pseudoephedrine 2
- The pseudoephedrine component (30 mg per dose) provides effective nasal decongestion for 4-6 hours 2
Pediatric Dosing Considerations
- Children require weight-based dosing of brompheniramine at approximately 0.5 mg/kg/day divided into 3-4 doses 3
- For a child weighing 20 kg, this translates to approximately 2.5 mL of Bromfed every 6-8 hours 3
- Brompheniramine demonstrates a 12.4-hour elimination half-life in children, supporting twice-daily dosing in some cases, though the pseudoephedrine component necessitates more frequent administration 3
Pharmacokinetic Rationale
- Brompheniramine reaches peak plasma concentrations at 3.2 hours and provides H1-receptor blockade for up to 30 hours after a single 4 mg dose in children 3
- Pseudoephedrine has an 8-hour half-life and maintains decongestant efficacy for 4-6 hours per dose 4
- The combination requires dosing frequency based on the shorter-acting pseudoephedrine component 4
Critical Safety Warnings
- Monitor for sympathomimetic adverse effects including tachycardia (2-4 beats/min increase expected), hypertension, and CNS stimulation 2
- Antihistamines like brompheniramine cause sedation and respiratory depression, particularly when combined with other CNS depressants 5
- Fatal overdoses have occurred in infants with blood concentrations of brompheniramine 0.40 mg/L and pseudoephedrine 14.4 mg/L 6
- Never exceed recommended dosing intervals or total daily doses 6
Common Pitfalls to Avoid
- Do not use in children under 4 years without specific physician guidance due to overdose risk 6
- Avoid combining with other antihistamine or decongestant products to prevent inadvertent overdose 7
- The sedating effects of brompheniramine may impair activities requiring alertness 3
- Pseudoephedrine is contraindicated in uncontrolled hypertension, severe coronary artery disease, and concurrent MAOI use 2