Brompheniramine/Dextromethorphan/ Pseudoephedrine

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 any one of the drugs alone.

• Brompheniramine blocks the activity of histamine, a natural compound that causes allergy symptoms. It prevents the activation of histamine receptors, reducing allergic reactions.
• Dextromethorphan reduces cough sensitivity in the brain and prevents cough impulses from being transmitted. It is a non-opioid drug with no analgesic or addictive properties.
• Pseudoephedrine stimulates receptors that regulate smooth muscle contraction in the bronchial passage and blood vessels. This reduces congestion and improves breathing.

Warnings

• Do not use brompheniramine/dextromethorphan/pseudoephedrine if you are hypersensitive to any of its components, have severe hypertension or coronary artery disease, acute asthma attack or other lower respiratory tract conditions, narrow-angle glaucoma, symptomatic prostate enlargement, bladder neck obstruction, or stenosing peptic ulcer.
• Avoid the medication if you have diabetes mellitus, thyroid dysfunction, high intraocular pressure, persistent cough related to smoking, asthma, or emphysema, risk for seizures, cardiovascular disease, or gastrointestinal obstruction.

Side Effects

Side effects of brompheniramine/dextromethorphan/pseudoephedrine include impaired coordination, insomnia, dizziness, drowsiness, dysphoria, euphoria, irritability, nervousness, tremor, weakness, seizure, headache, dry nose, dry throat, wheezing, thickening of bronchial secretions, dyspnea, chest tightness, palpitations, arrhythmia, hypertension or hypotension, skin reactions such as rash, hives, itching, and light sensitivity, low count of immune cells, low red blood cell count, and low platelet count.

This is not an exhaustive list of side effects or adverse reactions. Consult your doctor for medical advice.

Dosages

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:

• 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
• 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
• 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, especially in children and elderly patients.
• In case of overdose, seek medical help or contact Poison Control.

Drug Interactions

Inform your doctor of all medications you are currently taking to check for possible interactions. Do not change your medication without your doctor’s recommendation.

• Severe interactions may occur with dihydroergotamine, ergoloid mesylates, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

For a full list of drug interactions, consult the RxList Drug Interaction Checker.

Always inform your healthcare providers about all medications you are using, including prescription and over-the-counter drugs.

Pregnancy and Breastfeeding

• Use brompheniramine/dextromethorphan/pseudoephedrine in pregnant women only if the benefits outweigh the risks.
• Avoid using the medication if breastfeeding.
• Consult your healthcare provider before taking any OTC drug during pregnancy or breastfeeding.

Additional Information

• Follow package instructions and do not exceed recommended dosages.
• Keep the medication out of reach of children.
• Avoid giving OTC brompheniramine/dextromethorphan/pseudoephedrine to children under 2 years of age.
• See your doctor if symptoms do not improve within 7 days, if you experience new symptoms, or if you have any concerns.

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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, insomnia, dizziness, drowsiness, dysphoria, euphoria, irritability, nervousness, tremor, weakness, seizure, headache, dry nose, dry throat, wheezing, thickening of bronchial secretions, shortness of breath, among others. Avoid use if breastfeeding.