Pheniramine Maleate Dosing in Children
Recommended Dosing by Age
For children 6 to under 12 years of age, administer 1 teaspoonful (5 mL) every 4 to 6 hours, not exceeding 6 teaspoonfuls (30 mL) in 24 hours. 1
For children 12 years and older, use adult dosing: 2 teaspoonfuls (10 mL) every 4 to 6 hours, not exceeding 12 teaspoonfuls (60 mL) in 24 hours. 1
For children under 6 years of age, pheniramine maleate should not be used without consulting a physician, as safety and efficacy data are insufficient in this age group. 1
Key Dosing Parameters
Weight-Based Considerations
- Children weighing more than 40 kg may be dosed using adult recommendations 2
- The standard pediatric formulation is a liquid suspension/elixir requiring appropriate measuring devices 2
Dosing Interval and Maximum Daily Dose
- Dosing interval: Every 4 to 6 hours 1
- Maximum daily dose (ages 6-11 years): 30 mL (6 teaspoonfuls) 1
- Maximum daily dose (ages ≥12 years): 60 mL (12 teaspoonfuls) 1
Route of Administration
- Oral administration is the standard route for pediatric patients 1
- Intravenous formulations exist but are not routinely used in outpatient pediatric settings 3
Pharmacokinetic Considerations in Children
Age-Related Differences
- Chlorpheniramine (a closely related alkylamine antihistamine) demonstrates higher serum clearance in children (234-470 mL/hr/kg) compared to adults, resulting in a shorter elimination half-life of approximately 9.6 hours in pediatric patients 4
- Peak concentrations occur 1-2.5 hours after oral administration 3
- The terminal half-life ranges from 8-19 hours depending on route and individual variation 3
Clinical Implications
- The 4-6 hour dosing interval aligns with the drug's pharmacokinetic profile, ensuring sustained H1-receptor blockade 5
- Age/weight-based dosing nomograms achieve similar maximum concentrations (Cmax) and area under the curve (AUC) across pediatric age groups 6
Critical Safety Warnings
Overdose Risk
- Overdose can cause life-threatening toxicity including ventricular tachycardia, rhabdomyolysis with myoglobinuria, acute kidney injury, seizures, and antimuscarinic effects (hallucinations, blurred vision, mucosal dryness). 7
- Strict adherence to maximum daily doses is essential to prevent serious adverse events 7
Common Adverse Effects
- Sedation is the most prevalent adverse effect and appears more common in children aged 2-5 years. 6
- Central nervous system effects may include irritability and insomnia at therapeutic doses 7
Practical Pitfalls to Avoid
- Do not exceed the recommended maximum daily dose: 30 mL for ages 6-11 years or 60 mL for ages ≥12 years 1
- Do not use in children under 6 years without physician consultation due to lack of safety data 1
- Use calibrated measuring devices for liquid formulations to ensure accurate dosing 2
- Monitor for excessive sedation, particularly in younger children (ages 2-5 years) who may be more susceptible 6
- Avoid combining with other sedating medications without medical supervision, as additive CNS depression may occur
Age Restrictions Summary
| Age Group | Dose | Frequency | Maximum Daily Dose |
|---|---|---|---|
| <6 years | Consult physician | N/A | N/A |
| 6 to <12 years | 5 mL (1 teaspoonful) | Every 4-6 hours | 30 mL (6 teaspoonfuls) |
| ≥12 years | 10 mL (2 teaspoonfuls) | Every 4-6 hours | 60 mL (12 teaspoonfuls) |