Generic Name: brompheniramine/dextromethorphan/phenylephrine
Brand Names: Neo DM Suspension, Dimaphen DM, Children's Dimetapp Cold and Cough
Drug Class: Cough/Cold, Non-narcotic Combos; Antihistamine/Antitussive/Decongestant Combos
What is brompheniramine/dextromethorphan/phenylephrine, and what is it used for?
Brompheniramine/dextromethorphan/phenylephrine is a combination drug used to relieve symptoms of the common cold, flu, hay fever, allergies, and respiratory conditions such as sinusitis and bronchitis. The combo medication temporarily relieves symptoms such as cough, runny nose, nasal congestion, sneezing, itchy nose or throat, and itchy/watery eyes due to minor throat and bronchial irritation, and makes breathing easier. The drug is available over the counter (OTC) in the U.S.
Each medication in the combination works in a different way, and when combined they are more effective in relieving symptoms than with monotherapy of just one of the drugs.
- 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 prevent 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.
- Phenylephrine is an alpha1 agonist that works by stimulating the activity of alpha1 adrenergic receptors, protein molecules that signal to the smooth muscles around blood vessels to contract. The smooth muscle contraction narrows the blood vessels, limiting blood flow to the swollen respiratory mucous tissue, reducing nasal and bronchial congestion, and making breathing easier.
Warnings
- Do not use brompheniramine/dextromethorphan/phenylephrine in patients with hypersensitivity to brompheniramine, dextromethorphan, phenylephrine or any of the components in the formulation.
- Do not use brompheniramine/dextromethorphan/phenylephrine in patients with any of the following conditions:
- Severe hypertension, coronary artery disease or ischemic heart disease
- During an acute asthma attack
- Treatment of asthma or other lower respiratory tract conditions
- Narrow-angle glaucoma, an eye condition with high intraocular pressure that progressively damages the optic nerve
- Urinary retention
- Peptic ulcer
- Do not use brompheniramine/dextromethorphan/phenylephrine to treat nursing mothers.
- Do not use to treat full term or premature newborn infants.
- Use with caution in children and do not use the drug to make children sleepy, misuse can result in death in young children.
- Use with caution in children who are prone to allergic reactions (atopic).
- At doses higher than the recommended dose, nervousness, dizziness, or sleeplessness may occur, especially in infants and small children. Antihistamine overdose may cause hallucinations, convulsions, and death.
- Do not use concurrently or within 14 days of treatment with monoamine oxidase inhibitors (MAOIs), a class of antidepressants.
- Use with caution in patients with:
- Chronic obstructive pulmonary disease (COPD)
- Shortness of breath or difficulty breathing
- High blood pressure
- Cardiovascular disease
- Diabetes mellitus
- Thyroid disease
- Difficulty in urination due to prostate enlargement
- History of bronchial asthma, narrow-angle glaucoma, gastrointestinal obstruction, or urinary bladder-neck obstruction
- Use with caution in patients with persistent cough related to smoking, asthma or emphysema, or cough with excessive phlegm. A persistent cough may indicate a serious condition that should be appropriately diagnosed and treated.
- In case a hypertensive crisis occurs, discontinue the drug immediately and institute therapy to lower blood pressure.
- Do not use concurrently with other sedative drugs or alcohol.
SLIDESHOW
How to Get Rid of a Cold: Natural Remedies See SlideshowWhat are the side effects of brompheniramine/dextromethorphan/phenylephrine?
Common side effects of brompheniramine/dextromethorphan/phenylephrine include:
- Dry mouth, nose and throat
- Thickening of mucus in nose and throat
- Drowsiness
- Dizziness
- Headache
- Excitability
- Restlessness
- High blood pressure (hypertension)
- Reflex increase in heart rate (tachycardia)
- Constriction of peripheral and abdominal (visceral) blood vessels
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
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.
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What are the dosages of brompheniramine/dextromethorphan/phenylephrine?
Oral Solution
- 1 mg/5 mg/2.5 mg/5 mL
Relief of Cold Symptoms
Adult:
4 teaspoons (20 mL) orally every 4 hours; not to exceed 120 mL/24 hours
Pediatric:
Children below 6 years
- Not recommended
Children 6-12 years
- 2 teaspoons (10 mL) orally every 4 hours
Children above 12 years
- 4 teaspoons (20 mL) orally every 4 hours
Overdose
- Brompheniramine/dextromethorphan/phenylephrine overdose can cause severe adverse reactions with symptoms that include agitation, confusion, flushing, hallucinations, large pupils, muscle twitching, and seizures.
- In children, the drug may initially have an excitatory effect, which may be followed by loss of coordination, drowsiness, loss of consciousness and seizures.
- Overdose treatment may be supportive and symptomatic care.
What drugs interact with brompheniramine/dextromethorphan/phenylephrine?
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/phenylephrine include:
- iobenguane I 123
- isocarboxazid
- linezolid
- phenelzine
- phenelzine
- procarbazine
- rasagiline
- selegiline transdermal
- safinamide
- selegiline
- tranylcypromine
- Brompheniramine/dextromethorphan/phenylephrine has serious interactions with at least 58 different drugs.
- Brompheniramine/dextromethorphan/phenylephrine has moderate interactions with at least 303 different drugs.
- Brompheniramine/dextromethorphan/phenylephrine has mild interactions with at least 36 different drugs.
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 about 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 healthcare provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Neither animal reproductive studies nor controlled studies in pregnant women have been conducted on the safety of brompheniramine/dextromethorphan/phenylephrine use during pregnancy. It is not known if the combination drug can cause fetal harm or affect reproductive capacity. Use with caution in pregnant women only if maternal benefits clearly outweigh possible risk to the fetus.
- The combination drug contains brompheniramine, an antihistamine. There is a higher risk of antihistamine intolerance in small infants, avoid use in nursing mothers.
- If you are pregnant or breastfeeding, consult your healthcare provider before taking any OTC drug.
What else should I know about brompheniramine/dextromethorphan/phenylephrine?
- Take brompheniramine/dextromethorphan/phenylephrine exactly as prescribed, or as per label instructions if taking OTC drug. Do not take higher or more frequent doses than recommended.
- Stop taking the medication and see your physician if:
- Your symptoms include fever, rash, or persistent headache or do not get better within 7 days
- Cough persists for more than 1 week, tends to recur, or is accompanied by fever, rash, or persistent headache,
- You develop sleeplessness, nervousness, or dizziness
- The antihistamine component in the drug may impair physical and mental abilities; avoid activities such as driving and operating heavy machinery.
- Tell your doctor ahead of time if you have taken this drug within the previous a few days, if surgery or medical tests need to be performed.
- This combo medication can reduce sweating. Avoid becoming overheated or dehydrated during exercise and hot weather, it may increase the risk of heat stroke.
- Avoid drinking alcohol while taking brompheniramine/dextromethorphan/phenylephrine.
- Do not administer OTC brompheniramine/dextromethorphan/phenylephrine to children younger than 2 years.
- Store safely out of reach of children.
- In case of overdose, seek medical help or call Poison Control.
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Summary
Brompheniramine/dextromethorphan/phenylephrine is an over-the-counter (OTC) cold medication used to relieve symptoms of the common cold, flu, hay fever, allergies, and respiratory conditions such as sinusitis and bronchitis. The combo medication temporarily relieves symptoms such as cough, runny nose, nasal congestion, sneezing, itchy nose or throat, and itchy/watery eyes due to minor throat and bronchial irritation, and makes breathing easier. Do not use concurrently with other sedative drugs or alcohol. Common side effects of brompheniramine/dextromethorphan/phenylephrine include dry mouth, nose, and throat; thickening of mucus in nose and throat, drowsiness, dizziness, headache, excitability, restlessness, high blood pressure (hypertension), reflex increase in heart rate (tachycardia), and constriction of peripheral and abdominal (visceral) blood vessels.
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How Long Does It Take for Allergic Conjunctivitis to Go Away?Without treatment, allergic conjunctivitis symptoms could last the entire time that your critical allergen is present — which can vary greatly.
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Whooping Cough (Pertussis)Whooping cough (pertussis) is a highly contagious respiratory infection caused by the bacteria Bordetella pertussis. Early whooping cough symptoms are a runny nose, sneezing, low-grade fever, a mild cough with the cough gradually becoming more severe. Whooping cough commonly affects infants and young children but can be prevented with vaccine immunization.
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How Do I Get Rid of a Cold Sore Overnight?You cannot get rid of cold sores overnight. There is no cure for cold sores. However, to speed up the healing time of a cold sore, you can consult with your doctor and take prescription medications such as antiviral tablets and creams. A cold sore may go away without treatment within a week or two.
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What Happens if a Pregnant Woman Gets a Cold?Having an ordinary cold shouldn't be harmful to the baby or mother. Pregnant women are highly likely to pick up a cold at some time during pregnancy because it's normal to catch two or three colds a year. A healthy lifestyle is a must to keep the immune system strong and to prevent colds.
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How Is Frontal Sinusitis Treated?The sinuses are cavities present in the facial bones. Frontal sinusitis is the swelling or infection of the frontal sinuses. The frontal sinuses are located just behind the eyes. All the sinuses produce mucus that drains into the nasal cavities.
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What Can You Take for a Cold While Pregnant?You may take over-the-counter (OTC) treatment after consulting with the physician because these are generally safe. OTC medications for colds and flus include acetaminophen, guaifenesin syrup and saline nasal drops or spray. You can also use natural remedies to treat a cold during pregnancy.
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Is It Possible to Be Allergic to Cinnamon?Cinnamon is a popular spice in many dishes. Cinnamon gives dishes a distinct flavor. Only a small percent of people experience allergic reactions after ingesting or coming into contact with cinnamon.
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How Do You Get Rid of a Cold Overnight?Cold symptoms are part of your body’s healing processes. Most of the time, it does not require any help. However, you can get rid of a cold faster, even overnight, by resting, drinking hot fluids, blowing your nose, gargling with salt water, taking a hot shower, using a humidifier and taking OTC pain relievers and decongestants.
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What Happens if You Let a Sinus Infection Go Untreated?If you let sinus infection go untreated, it could lead to rare but serious complications such as chronic sinusitis that spreads to the surrounding areas and the larynx, eyes, and brain.
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Does Being Cold Make Your Muscles Ache?Cold weather can tighten the muscles and joints, leading to muscle aches and pain.
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How Do You Know if You Have a Sinus Infection (Sinusitis) or COVID-19 Coronavirus?Learn how the signs and symptoms of a sinus infection are different from those caused by COVID-19.
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Allergy Treatment Begins at HomeAvoiding allergy triggers at home is one of the best ways to prevent allergy symptoms. Controlling temperature, humidity, and ventilation are a few ways to allergy-proof the home. Cleaning, vacuuming, and using HEPA air filters also helps control allergies.
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Sinus Infection vs. AllergiesBoth sinus infections and allergies (allergic rhinitis) cause symptoms such as runny or stuffy nose and fatigue. Sinus infection (known as sinusitis) is inflammation of the sinuses, caused by infection from bacteria, viruses, and/or fungi (molds). Allergic rhinitis occurs when certain allergies cause nasal symptoms. When a person with allergies breathes in an allergen, such as pollen, dust, or animal dander, symptoms such as runny or stuffy nose, itching, sneezing, and fatigue occur.
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What Is the Fastest Way to Fix Seasonal Allergies?Seasonal allergies are common and tend to ramp up during the spring and summer. Learn about how to get rid of seasonal allergies fast with these 13 home remedies.
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What Are the Best Treatments for Allergic Conjunctivitis?Learn what medical treatments can ease allergic conjunctivitis symptoms and help speed up your eye allergy recovery.
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Is Whooping Cough (Pertussis) Contagious?Whooping cough (pertussis) is a highly contagious respiratory infection caused by Bordetella pertussis. Whooping cough symptoms include severe coughing fits and whooping sound produced during inhalation. The bacteria spreads via airborne droplets produced during sneezing or coughing. There is a whooping cough vaccine that is typically administered during childhood vaccinations.
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Why Won’t My Allergy Symptoms Go Away?Allergies happen when your body's immune system reacts to certain substances as though they are harmful. Allergy symptoms may not go away unless you avoid your triggers, stick to your medications, find the right combination of medications, and consider surgery.
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COVID-19 vs. AllergiesThough there is some overlap in allergy and COVID-19 signs and symptoms there are also significant differences. Symptoms that they have in common include headache, fatigue, tiredness, shortness of breath, wheezing, and sore throat. Fever does not occur with allergies but is one of the defining symptoms of COVID-19 infections.
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Is Allergic Conjunctivitis the Same as Conjunctivitis?Allergic conjunctivitis may occur along with sneezing, runny nose, or sinus headache. Many people also find that they are tired and feel agitated.
Treatment & Diagnosis
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- Are Hives Always Caused by an Allergy?
- How Long Does It Take Strep to Go Away?
- Is There a Direct Relationship Between Sinusitis and Muscle Pain?
- Do Allergy Drugs Interact with Synthroid?
- Cold Sore Treatment
- OTC Cold and Cough Medications
- When to Call the Doctor for Fever, Nausea, Diarrhea, Colds, and Coughs
- Air Travel, Colds, and Sinus Infections
Medications & Supplements
- cetirizine (Zyrtec, Zyrtec Allergy, Zyrtec Hives)
- fexofenadine (Allegra, Mucinex Allergy)
- fluticasone
- loratadine and pseudoephedrine (Alavert Allergy & Sinus, Claritin-D, Claritin-D 24 hour)
- budesonide nasal inhaler (Rhinocort Allergy, Rhinocort Aqua)
- Nasal Allergy Medications
- acetaminophen/diphenhydramine/dextromethorphan
- Does Immunotherapy Work for Allergies?
Prevention & Wellness
Report Problems to the Food and Drug Administration
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.
https://reference.medscape.com/drug/neo-dm-suspension-brompheniramine-dextromethorphan-phenylephrine-iv-999394
https://www.webmd.com/drugs/2/drug-32665/brompheniramine-phenylephrine-dm-oral/details
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=404ef5f4-7b7b-4c08-b159-9175a91be132
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ff712454-32df-4839-98d1-a6844a1bba96
https://www.fda.gov/drugs/special-features/use-caution-when-giving-cough-and-cold-products-kids
