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
- Do not use brompheniramine/dextromethorphan/pseudoephedrine in the following conditions:
- Hypersensitivity to brompheniramine, dextromethorphan, pseudoephedrine or any of the components in the formulation
- Severe hypertension or coronary artery disease
- Acute asthma attack or other lower respiratory tract conditions
- Narrow-angle glaucoma, an eye condition with high intraocular pressure that progressively damages the optic nerve
- Symptomatic prostate enlargement (hypertrophy)
- Bladder neck obstruction
- Stenosing peptic ulcer
- Do not use brompheniramine/dextromethorphan/pseudoephedrine to treat full term or premature newborn infants
- Do not use concurrently with monoamine oxidase inhibitors, a class of antidepressants
- Use with caution in patients with:
- May cause depression of central nervous system; advise patients appropriately
- Do not use concurrently with other sedative drugs
- Brompheniramine is a first generation antihistamine that also has effects on the central nervous system and can cause drowsiness, confusion, dry mouth and constipation, particularly in geriatric patients; avoid use in patients older than 65 years of age
QUESTION
Which illness is known as a viral upper respiratory tract infection? See AnswerWhat are the side effects of brompheniramine/dextromethorphan/ pseudoephedrine?
Side effects of brompheniramine/dextromethorphan/pseudoephedrine 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)
- Chest tightness
- Palpitations
- Irregular heart rhythm (arrhythmia)
- Increase or decrease in blood pressure (hypertension or hypotension)
- Skin reactions that include:
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Upper abdominal (epigastric) discomfort
- Loss of appetite (anorexia)
- Dry mouth (xerostomia)
- Visual disturbance
- Blood disorders such as:
- Low count of granulocyte immune cells (agranulocytosis)
- Low red blood cell count due to rapid destruction (hemolytic anemia)
- Low platelet count (thrombocytopenia)
- Urinary frequency
- Urinary difficulties
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/ 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:
- dihydroergotamine
- dihydroergotamine inhaled
- dihydroergotamine intranasal
- ergoloid mesylates
- ergonovine
- ergotamine
- isocarboxazid
- linezolid
- methylergonovine
- phenelzine
- procarbazine
- rasagiline
- selegiline
- selegiline transdermal
- tranylcypromine
- 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:
- ashwagandha
- brimonidine
- desmopressin
- eucalyptus
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:
- Symptoms do not get better within 7 days
- Symptoms include fever, rash, or persistent headache
- You develop sleeplessness, nervousness, or dizziness
- 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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What Is the Treatment for Asthmatic Bronchitis?Asthmatic bronchitis refers to inflammation of the bronchial tubes carrying air inside the lungs that occurs because of asthma. Treatment for asthmatic bronchitis involves bronchodilators, steroids, treating secretions, leukotriene inhibitors, antibiotics, oxygen administration and avoiding triggers.
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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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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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Is Drinking Cold Water Bad?About 60 percent of the body is made up of water. It forms a major part of the blood. The cells and the body cannot function right if the water levels go down. Drinking cold water often causes “cold stress” in the body.
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What Part of the Body Loses the Most Heat in Cold Water?Due to a higher blood flow in the head and neck than in the rest of the body, 40 to 45 percent of body heat is lost through the head and neck.
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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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Asthma in ChildrenAsthma in children manifests with symptoms such as coughing and wheezing. Rates of asthma in children are increasing. Asthma in children is usually diagnosed based on the description of symptoms. Lung function tests may also be used. A variety of medications are used for the treatment of childhood asthma.
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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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Asthma ComplexitiesThere are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
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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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Can Fall Allergies Cause Sinus Headaches?Fall allergies can cause symptoms such as sneezing, congestion, and sinus headache. Learn more about causes, treatment, and prevention of fall allergies.
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Can Congestion Be the Only Symptom of COVID-19?Congestion can be the only symptom of COVID-19 in some cases.
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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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Adult-Onset AsthmaAdult-onset asthma is asthma that is diagnosed in people over 20 years of age. Symptoms include wheezing, coughing, shortness of breath and difficulty breathing. Treatment may involve anti-inflammatory medications or bronchodilators.
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What Are the Symptoms of Eosinophilic Asthma?Eosinophilic asthma is a type of asthma that is hard to manage and quite severe. Here are the symptoms of this respiratory condition.
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What Class Is Severe Asthma?Asthma is termed as a chronic inflammatory lung disease caused by the airway’s hypersensitive response to allergic stimuli (dust, pollen, pollution, smoke or unhygienic conditions). This results in the narrowing of airway passages, making it hard to breathe. It is often genetic and passed down from families and precipitated during childhood.
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What Is Severe Asthma?Asthma is a chronic inflammatory lung disease caused due to the airway’s hypersensitive response to allergic stimuli. Severe asthma or status asthmaticus is defined as asthma that is uncontrolled, despite adherence with maximal optimized therapy and treatment of contributory factors or asthma that worsens when high dose treatment is decreased.
Treatment & Diagnosis
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- Asthma in Women, Asthma in Pregnancy
- Methotrexate Spares Steroids in Asthmatics
- Colds: 10 Tips to Prevent The Common Cold
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- What Is Exercise-Induced Asthma?
- What Are the Side Effects of Asthma Inhalers?
- What Is the Treatment for Hay Fever?
- Best Exercises for Asthma: Yoga, Swimming, Biking, and Walking
- 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
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/bromfed-dm-brompheniramine-dextromethorphan-pseudoephedrine-999395#0
https://www.uptodate.com/contents/brompheniramine-pseudoephedrine-and-dextromethorphan-drug-information