Bromfed Dosing for a 12-Year-Old
For a 12-year-old patient, administer 10 mL (2 teaspoonfuls) of Bromfed every 4 hours, not exceeding 6 doses in 24 hours. 1
Standard Dosing Protocol
- Patients 12 years and older receive the adult dose: 10 mL (2 teaspoonfuls) every 4 hours 1
- This formulation contains brompheniramine (antihistamine) and pseudoephedrine (decongestant) in combination 1
- The maximum frequency is 6 doses per 24-hour period 1
Age-Based Dosing Context
The FDA-approved dosing for Bromfed is age-based rather than weight-based: 1
- Ages 12 years and over: 10 mL every 4 hours 1
- Ages 6 to under 12 years: 5 mL every 4 hours 1
- Ages 2 to under 6 years: 2.5 mL every 4 hours 1
Since your patient is exactly 12 years old, they qualify for the adult dosing regimen of 10 mL per dose 1
Critical Safety Considerations
Brompheniramine has a prolonged half-life of approximately 25 hours in adults, which means the drug accumulates with repeated dosing 2. This extended half-life supports:
- Strict adherence to the maximum 6 doses per 24 hours 1
- Monitoring for cumulative sedative effects, as brompheniramine demonstrates prolonged antihistaminic activity lasting 24-48 hours 2
Pseudoephedrine toxicity is a serious concern in pediatric patients, particularly with overdosing 3. Fatal cases have been reported in infants with blood concentrations of 14.4 mg/L 3. Therefore:
- Never exceed the recommended dose or frequency 1
- Monitor for sympathomimetic effects (tachycardia, hypertension, agitation) 3
Common Pitfalls to Avoid
- Do not use weight-based calculations for this combination product—the FDA label specifies age-based dosing only 1
- Do not give more than 6 doses in 24 hours regardless of symptom severity 1
- Avoid use in children with underlying cardiac conditions due to pseudoephedrine's sympathomimetic effects 3
- Be aware of substantial sedation risk (60-73% with first-generation antihistamines like brompheniramine) 4
Monitoring Parameters
Watch for adverse effects including: 4, 2
- Excessive sedation (most common with first-generation antihistamines) 4
- Anticholinergic effects (dry mouth, urinary retention, constipation) 4
- Cardiovascular stimulation from pseudoephedrine (elevated heart rate, blood pressure) 3
- Acute dystonic reactions (rare but possible; treat with diphenhydramine 1-2 mg/kg if occurs) 4