Brompheniramine/Dextromethorphan/ Pseudoephedrine

Medically Reviewed on 5/18/2022

Generic Name: brompheniramine/dextromethorphan/pseudoephedrine

Brand Names: Bromfed DM, Bromaline DM, Bromdex D

Drug Class: Cough/Cold, Non-narcotic Combos, Antihistamine/Antitussive/Decongestant Combos

What is brompheniramine/ dextromethorphan/ pseudoephedrine, and what is it used for?

Brompheniramine/dextromethorphan/pseudoephedrine is a combination medication used to control cough and relieve symptoms of common cold, hay fever, and respiratory allergies.

The combo medication temporarily relieves symptoms such as runny nose, nasal congestion, sneezing, itchy nose or throat, itchy/watery eyes, and cough due to minor throat and bronchial irritation, and is available over-the-counter (OTC) and on prescription.

Each of the three medications in the combination works in a different way, and together they are more effective in relieving symptoms, than with the use of any one of the drugs in the combo.

  • Brompheniramine works by blocking the activity of histamine, a natural compound in the body that causes allergy symptoms. Histamine is released by mast cells and basophils, types of immune cells, in response to allergen exposure. Brompheniramine binds to histamine H1 receptors in blood vessels, respiratory tract and gastrointestinal tract, preventing their activation by histamine and the resultant allergic reaction.
  • Dextromethorphan suppresses cough by reducing the sensitivity of cough receptors in the brain region that stimulate the cough reflex and preventing the transmission of cough impulses. Dextromethorphan is a non-opioid drug derived from levorphanol, an opioid painkiller (analgesic), and is structurally similar to opioid drugs such as codeine, however, it does not have analgesic or addictive properties.
  • Pseudoephedrine works by stimulating alpha and beta receptors that regulate contraction of the smooth muscles of the bronchial passage and blood vessels. This results in dilation of the bronchial passage and constriction of blood vessels, reducing congestion and making breathing easier.

Warnings

SLIDESHOW

Cold and Flu: Finding Fast Cough Relief See Slideshow

What are the side effects of brompheniramine/dextromethorphan/ pseudoephedrine?

Side effects of brompheniramine/dextromethorphan/pseudoephedrine include:

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

What are the dosages of brompheniramine/dextromethorphan/ pseudoephedrine?

Oral Syrup

  • (2 mg/10mg/30mg)/5mL (Bromfed DM)
  • (3 mg/30mg/50mg)/5mL (Bromdex D)

Oral Elixir

  • (1 mg/5mg/15mg)/5mL (Bromaline DM)

Relief of Nasal Congestion and Cough

Adult:

  • Bromfed DM: 2 teaspoonfuls (10 mL) orally every 4 hours; not to exceed 6 doses/day
  • Bromdex D: 1 teaspoonful (5 mL) orally every 4 hours; not to exceed 4 doses/day
  • Bromaline DM: 4 teaspoonfuls (20 mL) orally every 4-6 hours; not to exceed 4 doses/day

Pediatric:

Bromfed DM:

  • Children under 6 months: Safety and efficacy not established
  • Children 6 months to 2 years: As directed by the physician
  • Children 2-6 years: 1/2 teaspoonful (2.5 mL) orally every 4 hours; not to exceed 6 doses/day
  • Children 6-12 years: 1 teaspoonful (5 mL) orally every 4 hours; not to exceed 6 doses/day
  • Children over 12 years: 2 teaspoonfuls (10 mL) orally every 4 hours; not to exceed 6 doses/day

Bromdex D:

  • Children under 6 years: As directed by the physician
  • Children 6-12 years: 2.5 mL orally every 6 hours prn; not to exceed 4 doses/24 hours
  • Children over 12 years: 5 mL orally every 6 hours prn; not to exceed 4 doses/24 hours

Bromaline DM:

  • Children under 6 years: As directed by the physician
  • Children 6-12 years: 2 teaspoonfuls (10 mL) orally every 4 hours; not to exceed 4 doses/day
  • Children over 12 years: 4 teaspoonfuls (20 mL) orally every 4-6 hours; not to exceed 4 doses/day

Overdose

  • Overdose of brompheniramine/dextromethorphan/pseudoephedrine can cause severe adverse reactions, particularly in children and elderly patients.
  • In case of overdose, seek medical help or contact Poison Control.

What drugs interact with brompheniramine/dextromethorphan/ pseudoephedrine?

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

  • Severe interactions of brompheniramine/dextromethorphan/pseudoephedrine include:
  • Brompheniramine/dextromethorphan/pseudoephedrine has serious interactions with at least 54 different drugs.
  • Brompheniramine/dextromethorphan/pseudoephedrine has moderate interactions with at least 273 different drugs.
  • Mild interactions of brompheniramine/dextromethorphan/pseudoephedrine include:

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

Pregnancy and breastfeeding

  • There are no well-controlled studies on the safety of the combo medication brompheniramine/dextromethorphan/pseudoephedrine in pregnant women; use with caution if maternal benefits outweigh possible risks to the fetus
  • Brompheniramine/dextromethorphan/pseudoephedrine is present in breast milk; avoid use
  • Pregnant and breastfeeding women should consult their healthcare providers before taking any OTC drug

What else should I know about brompheniramine/dextromethorphan/ pseudoephedrine?

  • Follow package instructions exactly while taking OTC drugs; do not take higher or more frequent doses than recommended
  • Store brompheniramine/dextromethorphan/pseudoephedrine out of reach of children
  • Do not administer OTC brompheniramine/dextromethorphan/pseudoephedrine to children younger than 2 years of age
  • Stop taking the medication and see your doctor if:
  • May impair physical and mental abilities. Avoid activities such as driving and operating heavy machinery.
  • Avoid alcohol while taking brompheniramine/dextromethorphan/pseudoephedrine

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Summary

Brompheniramine/dextromethorphan/pseudoephedrine is a combination medication used to control cough and relieve symptoms of common cold, hay fever, and respiratory allergies. Side effects include impaired coordination, balance and speech (ataxia), insomnia, dizziness, drowsiness (somnolence), feeling of unease (dysphoria), euphoria, irritability, nervousness, tremor, weakness (asthenia), seizure, headache, dry nose, dry throat, wheezing, thickening of bronchial secretions, shortness of breath (dyspnea), and others. Avoid use if breastfeeding.

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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Medically Reviewed on 5/18/2022
References
https://www.rxlist.com/consumer_bromfed-dm/drugs-condition.htm

https://reference.medscape.com/drug/bromfed-dm-brompheniramine-dextromethorphan-pseudoephedrine-999395#0

https://www.uptodate.com/contents/brompheniramine-pseudoephedrine-and-dextromethorphan-drug-information