Bromfed Dm (brompheniramine maleate/pseudoephedrine HCl/dextromethorphan)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Dextromethorphan, a derivative of levorphanol, is an antitussive agent.
Brompheniramine and dexbrompheniramine are alkylamine (propylamine)-derivative first generation antihistamines.
Pseudoephedrine is a sympathomimetic agent that occurs naturally in plants of the genus Ephedra; the drug acts directly on both alpha- and, to a lesser degree, beta-adrenergic receptors.
Dextromethorphan is used for the temporary relief of coughs caused by minor throat and bronchial irritation such as may occur with common colds or with inhaled irritants. Dextromethorphan is most effective in the treatment of chronic, nonproductive cough. The drug is a common ingredient in commercial cough mixtures available without prescription.
Generic name: brompheniramine maleate/pseudoephedrine HCl/dextromethorphan
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Bromfed Dm
Indications
The following indications are listed for Bromfed Dm:
- Allergic Rhinitis
- Cold Symptoms
- Cough
- Nasal Congestion
- Rhinorrhea
- Vasomotor Rhinitis
Also known as: Nasal Stuffiness.
Dosing
Dosages of dextromethorphan hydrobromide and dextromethorphan polistirex are expressed in terms of dextromethorphan hydrobromide.
The usual dosage of dextromethorphan hydrobromide for adults and children 12 years of age or older is 10-20 mg every 4 hours or 30 mg every 6-8 hours, not to exceed 120 mg daily, or as directed by a clinician. The usual dosage for children 6 to younger than 12 years of age is 5-10 mg every 4 hours or 15 mg every 6-8 hours, not to exceed 60 mg daily, or as directed by a clinician. Children 2 to younger than 6 years of age may receive 2.5-5 mg every 4 hours or 7.5 mg every 6-8 hours, not to exceed 30 mg daily, or as directed by a clinician. Dosage in children younger than 2 years of age must be individualized. Suggested dosages for children younger than 2 years of age+ for some cough and cold preparations have been published in various references for prescribing and parenting. Using recommended dosages for adults and older children, some clinicians have extrapolated dosages for these preparations based on the weight or age of children younger than 2 years of age. However, these extrapolations were based on assumptions that pathology of the disease and pharmacology of the drugs are similar in adults and pediatric patients. There currently are no specific dosage recommendations (i.e., approved by the US Food and Drug Administration (FDA)) for cough and cold preparations for this patient population. (See Cautions: Pediatric Precautions.)
The usual dosage of dextromethorphan hydrobromide as the extended-release oral suspension containing the polistirex for adults and children 12 years of age or older is 60 mg twice daily. The usual dosage as the extended-release oral suspension for children 6 to younger than 12 years of age is 30 mg twice daily; children 2 to younger than 6 years of age may receive 15 mg twice daily.
Dosage of brompheniramine maleate and dexbrompheniramine maleate is expressed in terms of the salt. Dosage of brompheniramine maleate and dexbrompheniramine maleate should be individualized according to the patient's response and tolerance.
Fixed-ratio combination preparations do not permit individual titration of dosages; if a fixed combination is used, the precautions and contraindications associated with each drug must be considered.
Dextromethorphan preparations are administered orally. Lozenges containing dextromethorphan hydrobromide should not be used in children younger than 6 years of age and liquid-filled capsules containing the drug should not be used in children younger than 12 years of age, unless otherwise directed by a clinician.
Brompheniramine maleate and dexbrompheniramine maleate are administered orally. These agents should be administered with food, water, or milk to minimize gastric irritation.
Doses of brompheniramine maleate oral solution should be measured using the measuring device (e.g., calibrated dropper, cup, spoon) provided by the manufacturer.
Pseudoephedrine hydrochloride and sulfate are administered orally.
Pseudoephedrine hydrochloride 240-mg extended-release tablets should be administered orally once daily and swallowed whole with water; the extended-release tablets should not be divided, crushed, chewed, or dissolved. Patients should be advised that the tablet does not completely dissolve and may be passed in the stool.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
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There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
There is no enhanced messaging for this drug.
There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
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There is inadequate experience with use of brompheniramine or dexbrompheniramine in pregnant women to determine whether the potential for harm to the fetus exists. Because of the risk of severe reactions (e.g., seizures) to antihistamines in neonates, brompheniramine or dexbrompheniramine should not be used during the third trimester; the drugs should be used during the first 2 trimesters only when the potential benefits justify the possible risks to the fetus.
It is not known if brompheniramine is distributed into milk. Because of the potential for serious adverse reactions to antihistamines in nursing infants, a decision should be made whether to discontinue nursing or brompheniramine or dexbrompheniramine, taking into account the importance of the drug to the woman. Excessive crying, irritability, and sleep disturbances occurred in one breast-fed infant whose mother was receiving dexbrompheniramine combined with pseudoephedrine; normal behavior in the infant resumed within 12 hours after the mother discontinued the drug and the infant received 2 formula feedings.
No enhanced messaging available.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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