brompheniramine/dextromethorphan/phenylephrine (OTC)

Brand and Other Names:Neo DM Suspension, Dimaphen DM, more...Children's Dimetapp Cold & Cough
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

brompheniramine/dextromethorphan/phenylephrine

oral solution

  • (1mg/5mg/2.5mg)/5mL
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Relief of Cold Symptoms

4 teaspoons (20 mL) PO q4hr; not to exceed 120 mL/24 hr

Dosage Forms & Strengths

brompheniramine/dextromethorphan/phenylephrine

oral solution

  • (1mg/5mg/2.5mg)/5mL
more...

Relief of Cold Symptoms

<6 years

  • Not recommended

6-12 years

  • 2 teaspoons (10 mL) PO q4hr

>12 years

  • 4 teaspoons (20 mL) PO q4hr
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Interactions

Interaction Checker

and brompheniramine/dextromethorphan/phenylephrine

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            Adverse Effects

            Frequency Not Defined

            Dizziness

            Drowsiness

            Dry mouth, throat, and nose

            Thickening of mucus in nose or throat GI disturbances

            Reflex tachycardia

            Excitability

            Restlessness

            Headache

            Hypertension

            Severe peripheral and visceral vasoconstriction

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            Warnings

            Contraindications

            Hypersensitivity

            Asthma

            < 2 years of age

            Severe hypertension

            Narrow-angle glaucoma

            Symptomatic prostate hypertrophy

            Bladder-neck obstruction

            Stenosing peptic ulcer

            Use within 14 days of MAO inhibitor therapy

            Cautions

            Brompheniramine: May cause significant confusional symptoms; not for administration to premature or full-term neonates

            Dextromethorphan: Do not take for persistent or chronic cough associated with smoking, asthma, or emphysema, or if it is accompanied by excessive phlegm unless directed by a healthcare provider; may decrease respiration rate

            Phenylephrine: Caution in elderly patients, hyperthyroidism, myocardial disease, bradycardia, partial heart block or severe arteriosclerosis

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: excreted in breast milk; use caution

            Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

            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.

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            Pharmacology

            Mechanism of Action

            Brompheniramine: Competitively blocks histamine from binding to H1 receptors; significant antimuscarinic activity and penetrates CNS, which causes pronounced tendency to induce sedation

            Dextromethorphan: Cough suppressant that acts centrally on the cough center in medulla

            Phenylephrine: Vasoconstrictor & decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue; shrinks swollen mucous membranes, reduces nasal congestion and tissue hyperemia

            Pharmacokinetics

            Brompheniramine

            • Onset: 15-30 min
            • Duration: 3-9 hr, may last 48 hr
            • Peak Plasma Time: 2-5 hr
            • Vd: 11.7 L/kg (adults); 20 L/kg (children)
            • Protein binding: 39-49%
            • Metabolism: Mainly liver; metabolites include propionic acid derivative conjugated with glycine
            • Half-Life: 11.8 (children); 25 hr (adults)
            • Excretion: Urine

            Dextromethorphan

            • Onset: 15-30 min
            • Duration: 3-6 hr
            • Metabolism: Hepatic P450 enzyme CYP2D6
            • Excretion: Urine
            • Half-life: 2-4 hr (extensive metabolizers); 24 hr (poor metabolizers)
            • Peak plasma time: 2-3 hr

            Phenylephrine

            • Half-life: 2-3 hr
            • Onset: 10-15 min
            • Duration: 15 min
            • Bioavailability: < 38%
            • Excretion: Urine (80-90%)
            • Peak plasma time: 0.75-2 hr
            • Vd: 26-61 L
            • Vdss: 340 L
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