What is the recommended dose of Bromfed DM (Brompheniramine, Dextromethorphan, and Guaifenesin) for a 63-pound pediatric patient?

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Bromfed DM Dosing for a 63-Pound Pediatric Patient

For a 63-pound (28.6 kg) child, the appropriate dose of Bromfed DM is 5 mL (1 teaspoonful) every 4 hours, not to exceed 6 doses in 24 hours, as this weight falls within the 6 to under 12 years age category for standard dosing. 1

Weight-Based Dosing Determination

  • A 63-pound child (approximately 28.6 kg) falls well below the 40 kg threshold where adult dosing would be considered 2, 3
  • The FDA-approved dosing for brompheniramine (the antihistamine component in Bromfed DM) specifies that children 6 to under 12 years of age should receive 5 mL (1 teaspoonful) every 4 hours 1
  • Since most children weighing 63 pounds are typically in the 6-12 year age range, this dosing category is appropriate 1

Specific Dosing Instructions

The recommended dose is 5 mL (1 teaspoonful) administered every 4 hours, with a maximum of 6 doses in any 24-hour period. 1

  • Use an appropriate measuring device for liquid formulations to ensure accurate dosing 3
  • This dose should not be exceeded without physician consultation 1

Critical Safety Considerations

  • Pediatric medication dosing is a particularly high-risk activity that requires careful calculation and verification, as standardized unit doses are rarely used in children 2
  • The act of calculating dosing equations has been identified as a high-error activity in pediatric emergency settings 2
  • Children are not simply "small adults," and dosing should never be scaled down directly from adult doses using weight alone, as this approach is unreliable and potentially dangerous 4, 5

Common Pitfalls to Avoid

  • Do not use adult dosing (10 mL every 4 hours) for this patient, even though the weight approaches the typical range for older children 1
  • Do not calculate doses using simple weight-based rules (such as Clark's weight rule or Young's age rule), as these have been shown to differ significantly from appropriate actual doses and are not considered responsible approaches to pediatric dosing 6
  • Ensure the caregiver understands that "teaspoonful" means 5 mL measured with a proper dosing device, not a household teaspoon 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Acetaminophen Dosing Guidelines for Children

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Dosing considerations in the pediatric patient.

Clinical therapeutics, 1991

Research

Pediatric dosing--the pharmacist's dilemma.

Contemporary pharmacy practice, 1980

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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