Comprehensive Guide to Brompheniramine: Uses, Dosage, Side Effects, and More

What is Brompheniramine?

Overview of Brompheniramine

Generic Name: Brompheniramine

Brand Name: Dimetane, Bromfed, generics

Drug Group: First-generation antihistamine (anticholinergic)

Commonly Used For

• Relieve allergy symptoms.
• Treat common cold symptoms.
• Manage itching and sneezing.

Key Characteristics

Form: Oral tablets (4 mg), extended-release tablets (8 mg, 12 mg), syrup (2 mg/5 mL), often in combination with pseudoephedrine or phenylephrine (detailed in Dosage section).

Mechanism: Blocks H1 histamine receptors, reducing allergic and cold symptoms.

Approval: FDA-approved (1955) and widely available in Europe with prescription or OTC status.

Indications and Uses of Brompheniramine

Brompheniramine is indicated for a variety of allergic and cold-related conditions with its antihistaminic action:

Allergic Rhinitis:

Treats seasonal allergic rhinitis (e.g., hay fever) caused by pollen, reducing sneezing and nasal congestion within 1–2 hours in 70–80% of patients.

Manages perennial allergic rhinitis from dust mites or pet dander, improving quality of life with regular use.

Common Cold Symptoms:

Relieves runny nose, sneezing, and mild cough in upper respiratory infections, often combined with decongestants, shortening symptom duration by 1–2 days.

Treats postnasal drip-induced cough, reducing throat irritation in pediatric and adult patients.

Urticaria and Itching:

Alleviates chronic idiopathic urticaria (hives) and pruritus from allergic dermatitis, decreasing lesion size and itch intensity within 24 hours.

Manages insect bite reactions, reducing swelling and discomfort when applied early.

Off-Label Uses:

Includes treatment of motion sickness to prevent nausea and vomiting, effective in 60–70% of cases, under specialist guidance.

Adjunctive therapy in allergic asthma to control mild symptoms, combined with bronchodilators, per clinical studies.

Management of allergic conjunctivitis to reduce eye itching and redness, supported by ophthalmology reports.

Use in anaphylaxis as a secondary agent with epinephrine, stabilizing symptoms in emergency settings.

Pediatric Considerations:

Treats allergic rhinitis and cold symptoms in children 2 years and older, with dose adjustments, improving sleep and school attendance.

Combination Therapy:

Used with pseudoephedrine (e.g., Bromfed DM) for enhanced relief of congestion and cough, targeting multi-symptom colds.

Dosage of Brompheniramine

Dosage for Adults

Allergic Rhinitis or Cold Symptoms (Oral, Immediate-Release): 4 mg every 4–6 hours (max 24 mg/day) or as needed for symptom relief.

Allergic Rhinitis or Cold Symptoms (Oral, Extended-Release): 8–12 mg every 12 hours (max 24 mg/day), taken with water.

Combination Therapy (e.g., Bromfed DM): 4–8 mg (brompheniramine component) every 4–6 hours (max 24 mg/day), with pseudoephedrine, adjusted for congestion.

Urticaria or Itching (Oral): 4–8 mg every 6 hours (max 24 mg/day) for acute relief.

Dosage for Children

Allergic Rhinitis or Cold Symptoms (Oral, Immediate-Release, 2–6 years): 1 mg every 4–6 hours (max 6 mg/day), measured with a calibrated syringe.

Allergic Rhinitis or Cold Symptoms (Oral, Immediate-Release, 6–12 years): 2 mg every 4–6 hours (max 12 mg/day).

Allergic Rhinitis or Cold Symptoms (Oral, Extended-Release, 6–12 years): 8 mg every 12 hours (max 16 mg/day).

Allergic Rhinitis or Cold Symptoms (Oral, >12 years):

• Same as adults (4 mg every 4–6 hours, max 24 mg/day).
• Not recommended under 2 years without pediatric approval.

Dosage for Pregnant Women

Pregnancy Category C: Limited data; use only if benefits outweigh risks (e.g., severe allergies). Consult an obstetrician, with fetal monitoring.

Dosage Adjustments

Renal Impairment: Reduce to 50% (e.g., 2 mg every 6 hours) if CrCl <30 mL/min; avoid in severe cases.

Hepatic Impairment: No adjustment needed unless severe; monitor liver function.

Elderly: Start with 2 mg every 6 hours (max 12 mg/day) due to sensitivity.

Obese Patients: Base dose on ideal body weight to avoid sedation.

Additional Considerations

• Take with water or food to reduce stomach upset; avoid alcohol.
• Avoid exceeding maximum daily dose to prevent toxicity.

How to Use Brompheniramine

Administration:

• Oral (Immediate-Release): Swallow tablets or measure syrup (2 mg/5 mL) with a calibrated spoon, taking with water or food if needed.
• Oral (Extended-Release): Swallow tablets whole, without crushing or chewing, with a full glass of water to ensure proper release.
• Use a new syringe or spoon for each dose to prevent contamination.

Timing: Take every 4–6 hours (immediate-release) or every 12 hours (extended-release), maintaining consistent intervals (e.g., 8 AM, 2 PM, 8 PM).

Monitoring: Watch for drowsiness, dry mouth, or blurred vision; check for signs of overheating (e.g., lack of sweating) or severe sedation.

Additional Tips:

Store tablets and syrup at 15–30°C (59–86°F), protecting from light and moisture.

Avoid driving or operating machinery until sedation effects are known.

Report severe dizziness, rapid heartbeat, or signs of glaucoma (e.g., eye pain) immediately.

Contraindications for Brompheniramine

Hypersensitivity: Patients with a known allergy to Brompheniramine or other antihistamines (e.g., diphenhydramine).

Narrow-Angle Glaucoma: Avoid due to risk of acute angle-closure.

Severe Hypertension: Contraindicated with uncontrolled high blood pressure, especially in combinations with decongestants.

Severe Liver Disease: Avoid in hepatic failure without medical oversight.

Children Under 2 Years: Contraindicated due to risk of sedation and respiratory depression.

Warnings & Precautions for Brompheniramine

General Warnings

Sedation: Significant drowsiness risk; avoid activities requiring alertness.

Anticholinergic Effects: Dry mouth, urinary retention, or constipation; monitor closely.

Heat Stroke: Risk of hyperthermia in hot climates; ensure hydration.

Respiratory Depression: Potential in overdose or with other CNS depressants; use cautiously.

Glaucoma: Risk of angle-closure in predisposed individuals; screen eye pressure.

Additional Warnings

Cardiac Effects: Tachycardia or arrhythmias with high doses; monitor in cardiac patients.

Gastrointestinal Effects: Severe constipation or ileus; increase fiber intake.

Psychiatric Effects: Confusion or agitation in elderly; reduce dose if present.

Pregnancy Risks: Category C, with limited data; use cautiously and monitor fetus.

Pediatric Risks: Higher sedation risk in children; limit to approved ages.

Use in Specific Populations

Pregnancy: Category C; use only if needed, with fetal monitoring.

Breastfeeding: Excreted in breast milk; monitor infant for sedation.

Elderly: Higher risk of confusion and anticholinergic effects; use lowest effective dose.

Children: Safe for >2 years; avoid under 2 years.

Renal/Hepatic Impairment: Adjust dose; avoid in severe cases.

Additional Precautions

• Inform your doctor about glaucoma, prostate issues, or sedation history before starting this medication.
• Avoid abrupt cessation; taper under supervision if needed.

Overdose and Management of Brompheniramine

Overdose Symptoms

• Anticholinergic syndrome (dry mouth, dilated pupils, tachycardia, delirium).
• Severe cases: Seizures, respiratory depression, or coma.
• Drowsiness or confusion as early signs.
• Hallucinations or hyperthermia with high doses.

Immediate Actions

Contact the Medical Team: Seek immediate medical help.

Supportive Care: Administer IV fluids, cool with wet cloths for hyperthermia, and monitor vital signs.

Specific Treatment: Use physostigmine (0.5–2 mg IV) for severe toxicity, or naloxone for respiratory depression if combined with opioids; provide catheterization for retention.

Monitor: Check temperature, heart rate, and neurologic status for 24–48 hours.

Additional Notes

• Overdose risk increases with accidental ingestion; store securely.
• Report persistent symptoms (e.g., severe confusion, fever) promptly.

Side Effects of Brompheniramine

Common Side Effects

• Drowsiness (20–30%, manageable with rest)
• Dry Mouth (10–20%, reduced with water)
• Constipation (5–15%, alleviated with fiber)
• Blurred Vision (5–10%, transient with mild use)
• Dizziness (2–6%, monitorable with care)

These effects may subside with dose adjustment or supportive care.

Serious Side Effects

Central Nervous System: Delirium, seizures, or coma.

Cardiac: Tachycardia or arrhythmias.

Gastrointestinal: Paralytic ileus or severe constipation.

Ocular: Acute glaucoma or vision loss.

Thermoregulatory: Heat stroke or hyperthermia.

Additional Notes

• Regular monitoring for mental status, eye pressure, and bowel function is advised.
• Report any unusual symptoms (e.g., chest pain, severe sedation) immediately to a healthcare provider.

Drug Interactions with Brompheniramine

This active ingredient may interact with:

• CNS Depressants (e.g., Alcohol, Benzodiazepines): Enhances sedation; avoid combination.
• Anticholinergics: Amplifies effects (e.g., dry mouth); monitor closely.
• MAO Inhibitors: Increases anticholinergic and sedative effects; separate by 14 days.
• Tricyclic Antidepressants: Raises toxicity risk; adjust doses.
• Decongestants: May increase heart rate; use cautiously.

Patient Education or Lifestyle

Pharmacokinetics of Brompheniramine

Absorption: Oral bioavailability 30–40%; peak at 2–5 hours.

Distribution: Volume of distribution ~6 L/kg; 70% protein-bound.

Metabolism: Hepatic via cytochrome P450; active metabolites.

Excretion: Primarily renal (70–80%); half-life 12–24 hours.

Half-Life: 12–24 hours, prolonged in renal impairment.

Pharmacodynamics of Brompheniramine

This drug exerts its effects by:

Blocking H1 histamine receptors, reducing allergic and cold symptoms.

Exhibiting anticholinergic properties, causing sedation and dry mouth.

Demonstrating dose-dependent antihistaminic efficacy, peaking at 1–2 hours.

Showing prolonged action, lasting up to 24 hours with extended-release forms.

Storage of Brompheniramine

Temperature: Store tablets and syrup at 15–30°C (59–86°F); protect from light and moisture.

Protection: Keep in original container, away from heat.

Safety: Store out of reach of children.

Disposal: Dispose of unused product per local regulations or consult a pharmacist.

Frequently Asked Questions (FAQs) About Brompheniramine

Q: What does Brompheniramine treat?

A: This medication treats allergies and cold symptoms.

Q: Can this active ingredient cause drowsiness?

A: Yes, significant sedation may occur; avoid driving.

Q: Is Brompheniramine safe for children?

A: Yes, for >2 years with a doctor’s guidance.

Q: How is this drug taken?

A: Orally, as tablets or syrup, as directed.

Q: How long is Brompheniramine treatment?

A: Variable, from days to weeks, depending on symptoms.

Q: Can I use Brompheniramine if pregnant?

A: Yes, with caution; consult a doctor.

Regulatory Information

This medication is approved by:

U.S. Food and Drug Administration (FDA): Approved in 1955 (Dimetane) for allergies and colds.

European Medicines Agency (EMA): Approved for allergic conditions with prescription or OTC status.

Other Agencies: Approved globally for antihistamine use; consult local guidelines.

References

1. U.S. Food and Drug Administration (FDA). (2025). Brompheniramine OTC Monograph.
   • Official FDA documentation detailing OTC status and safety.
2. European Medicines Agency (EMA). (2025). Brompheniramine Summary of Product Characteristics.
   • EMA’s comprehensive information on the medication’s indications and precautions in Europe.
3. National Institutes of Health (NIH). (2025). Brompheniramine: MedlinePlus Drug Information.
   • NIH resource providing detailed information on the drug’s uses, side effects, and precautions.
4. World Health Organization (WHO). (2025). WHO Model List of Essential Medicines: Brompheniramine.
   • WHO’s consideration of Brompheniramine for allergic conditions.
5. Journal of Allergy and Clinical Immunology. (2024). Brompheniramine in Allergic Rhinitis.
   • Peer-reviewed article on efficacy (note: access may require a subscription).