Bromfed Should Not Be Used in a 5-Year-Old Child
Bromfed (brompheniramine/pseudoephedrine combination) is contraindicated in children under 6 years of age due to significant safety concerns, including risk of fatal overdose and lack of proven efficacy in this age group.
Critical Safety Concerns
Fatal toxicity has been documented in infants receiving cold medications containing brompheniramine and pseudoephedrine, with postmortem blood concentrations of pseudoephedrine reaching 14.4 mg/L and brompheniramine 0.40 mg/L 1
The combination of an antihistamine (brompheniramine) with a decongestant (pseudoephedrine) poses particular risks in young children, where dosing errors can result in serious—sometimes fatal—complications 2
Age-Appropriate Alternative Management
For a 5-year-old with respiratory symptoms, the following supportive measures are recommended instead:
- Adequate hydration to help thin secretions 3
- Humidification of room air to ease breathing 3
- Nasal saline drops and gentle suction for nasal congestion 3
- Age-appropriate doses of acetaminophen or ibuprofen for fever or discomfort only 3
When to Seek Medical Attention
- If symptoms persist beyond 48-72 hours without improvement 3
- If fever is present, especially requiring evaluation in young children 3
- If there are signs of respiratory distress such as rapid breathing, retractions, or cyanosis 3
- If the child shows decreased feeding or activity 3
Important Clinical Caveat
Children are not small adults and should never receive scaled-down adult doses without proper pediatric dosing guidelines 2, 4. The absence of FDA-approved pediatric dosing for many combination cold medications, including Bromfed, in children under 6 years reflects both safety concerns and lack of efficacy data in this population.