brompheniramine/phenylephrine (Brovex PB, Respahist-II, Vazotab Chewable, Children's Dimetapp Cold and Allergy)
Classes: Antihistamine/Decongestant Combos
Dosing and uses of Brovex PB, Respahist-II (brompheniramine/phenylephrine)
Adult dosage forms and strengths
brompheniramine/phenylephrine
tablet, chewable
- 6mg/15mg
capsule, extended-release
- 6mg/7.5mg
- 12mg/15mg
oral suspension
- (6mg/10mg)/5mL
- (4mg/10mg)/5mL
oral solution
- (1mg/2.5mg)/5mL
- (2mg/5mg)/5mL
oral drops
- (0.4mg/1mg)/1mL
tablet, sustained-release
- 6mg/18mg
- 6mg/7.5mg
tablet
- 4mg/10mg
- 6mg/30mg
- 4mg/10mg
Congestion
Sustained/Extended release products: 1-2 tablets PO q8-12hr PRN, not to exceed recommended maximum dosage
Tablets: 1-2 tablets PO q4-6hr PRN, not to exceed recommended maximum dosage
Liquids: 5-10 mL PO q4-6hr PRN, not to exceed recommended maximum dosage
Recommended maximum dosages
- Brompheniramine: 24 mg PO in 24 hr
- Phenylephrine: 60 mg PO in 24 hr
Other Information
Refer to manufacturer information for dosing details; multiple strengths available
Administer liquids with special measuring device for accurate dose
Pediatric dosage forms and strengths
brompheniramine/phenylephrine
tablet, chewable
- 1mg/2.5mg
- 6mg/15mg
capsule, extended-release
- 6mg/7.5mg
- 12mg/15mg
oral suspension
- (6mg/10mg)/5mL
- (4mg/10mg)/5mL
oral solution
- (1mg/2.5mg)/5mL
- (2mg/5mg)/5mL
oral drops
- (0.4mg/1mg)/1mL
tablet, sustained-release
- 6mg/18mg
- 6mg/7.5mg
tablet
- 4mg/10mg
- 6mg/30mg
- 4mg/10mg
Congestion
Refer to manufacturer information for dosing details; multiple strengths available
Do not exceed recommended maximum dosages
Recommended maximum dosages
- Neonates: Do not use
- Infants: Must individualize dosage, under health care professional direction
- 12-24 months: Must individualize dosage, under health care professional direction
- 2-6 years: 6 mg/15 mg PO in 24 hr
- 6-12 years: 12 mg/30 mg PO in 24 hr
- >12 years: 24 mg/60 mg PO in 24 hr
Brovex PB, Respahist-II (brompheniramine/phenylephrine) adverse (side) effects
Phenylephrine
Brompheniramine (Common)
- Anticholinergic effects (blurred vision, dry mouth/nose, throat)
- Drowsiness, dizziness, decreased coordination, headache
- Constipation, stomach upset
Phenylephrine (Common)
- Hypertension, reflex bradycardia
- Anxiety, dizziness, excitability, headache, nervousness, restlessness
- Rebound congestion, sneezing, pulmonary edema
Warnings
Contraindications
Phenylephrine
- Hypersensitivity to phenylephrine or sulfites; severe HTN, VTach, closed angle glaucoma
- See Interactions below
Cautions
Phenylephrine
- Cerebrovascular insufficiency, CVD, HTN, DM, thyroid dz, prostatic hypertrophy, geriatrics
Pregnancy and lactation
Pregnancy category: C; not recommended in first tri-mester or last 2 weeks of pregnancy
Lactation: Contraindicated
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Brovex PB, Respahist-II (brompheniramine/phenylephrine)
Mechanism of action
Brompheniramine: Histamine H1-receptor antagonist; elicits high antihistamine activity, low sedative effects, and moderate anticholinergic effects
Phenylephrine: Strong alpha effects resulting in increased PVR and BP and decreased CO and renal perfusion
Absorption
Onset: 15-30 min
Duration: 3-9 hr, may last 48 hr (brompheniramine); 2-4 hr (phenylephrine)
Peak Plasma Time: 2-5 hr (brompheniramine)
Distribution
Vd: 11.7 L/kg (brompheniramine)
Metabolism
Brompheniramine: Mainly liver; metabolites include propionic acid derivative conjugated with glycine
Phenylephrine: Liver and intestine by MAO
Elimination
Half-Life: 11.8-34.7 hr (brompheniramine)
Excretion: Urine