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Brompheniramine Indications & Clinical Uses

Evidence-based guide for pediatric prescribing

Brompheniramine combinations provide short-term symptomatic relief of upper respiratory allergies and cold-related cough in older children.

Primary FDA-Approved Indications

Reserve for cases where non-sedating antihistamines and supportive care are insufficient. Avoid in children <2 years per FDA warning.

Allergic rhinitis with congestion and cough

FDA Approved
Children ≥6 years (clinician-directed for ages 2–5)Level C

Combination syrup provides antihistamine, decongestant, and antitussive effects. Consider for nighttime symptom relief when second-generation antihistamines fail.

Treatment Duration

Standard: Use for the shortest duration (≤5 days)

Evidence Sources

DailyMed Brompheniramine/Pseudoephedrine/Dextromethorphan ()

Common cold with troublesome cough and congestion

FDA Approved
Children ≥6 years (limit to ≥2 years with clinician oversight)Level C

Not curative—use as adjunct to saline, humidified air, and rest. Emphasize non-pharmacologic measures first.

Treatment Duration

Standard: 2–3 nights

Evidence Sources

FDA – Use Caution When Giving Cough and Cold Products to Kids ()

Clinical Decision Support

Quick Selection Guide

Symptom Cluster 1

Symptoms:

  • Nasal congestion
  • Cough disrupting sleep
  • Prior failure of loratadine/cetirizine

Likely Diagnosis:

Allergic rhinitis with post-nasal drip

Action:

Consider brompheniramine combo for short-term nighttime relief; counsel on sedation

Symptom Cluster 2

Symptoms:

  • Cold symptoms
  • Difficulty sleeping due to cough
  • Caregiver requesting multi-symptom product

Likely Diagnosis:

Viral URI

Action:

Discuss limited evidence, highlight risks <6 y, consider only if older child with significant nighttime distress

Red Flags & Warnings

Fever >3 days, wheezing, or difficulty breathing

Evaluate for secondary infection before giving combination product

Cardiac disease or arrhythmia history

Avoid due to pseudoephedrine component

Alternative Medication Options

Cetirizine or loratadine

Second-generation antihistamine

Daytime allergy symptoms requiring non-sedating relief

Advantages
  • Minimal sedation
  • Once-daily dosing
Disadvantages
  • Less impact on congestion

Supportive care

Non-pharmacologic

First-line for viral URIs (saline, humidifier, honey ≥1 year)

Advantages
  • Safe
  • Evidence-based for cough relief
Disadvantages
  • Requires caregiver effort

Parent Communication Guide

When This Medicine Helps

Understanding the Condition

Helps reduce congestion and cough so older children can rest.

Why We Choose This Medicine

Combines an antihistamine, decongestant, and cough suppressant in a single dose.

What to Expect

Relief within 30–60 minutes; reassess need daily.

Monitoring Your Child

Signs the Medicine is Working:

  • Less coughing at night
  • Easier breathing through the nose
  • Better sleep

When to Contact Your Doctor:

No improvement after: Symptoms unchanged after 2 nights or worsening daytime fatigue

Watch for these warning signs:

  • Fast or irregular heartbeat
  • Visual changes
  • Hallucinations or severe agitation
Last updated: 9/24/2025
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