Dosing & Uses
Dosage Forms & Strengths
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 & Cough
Bromfed DM: 2 teaspoonfuls (10 mL) PO q4hr; not to exceed 6 doses/day
Bromdex D: 1 teaspoonful (5 mL) PO q4hr; not to exceed 4 doses/day
Bromaline DM: 4 teaspoonfuls (20 mL) PO q4-6hr; not to exceed 4 doses/day
Dosage Forms & Strengths
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 & Cough
Bromaline DM
- <6 years: As directed by physician
- 6-12 years: 2 teaspoonful (10 mL) PO q4hr; not to exceed 4 doses/day
- >12 years: 4 teaspoonfuls (20 mL) PO q4-6hr; not to exceed 4 doses/day
Bromfed-DM
- <6 months: Safety and efficacy not established
- 6 months to 2 years: As directed by physician
- 2-6 years: 1/2 teasponful (2.5 mL) PO q4hr; not to exceed 6 doses/day
- 6-12 years: 1 teaspoonful (5 mL) PO q4hr; not to exceed 6 doses/day
- >12 years: 2 teaspoonfuls (10 mL) PO q4hr; not to exceed 6 doses/day
Bromdex D
- <6 years: As directed by physician
- 6-12 years: 2.5 mL PO q6hr prn; not to exceed 4 doses/24 hr
- >12 years: 5 mL PO q6hr prn; not to exceed 4 doses/24 hr
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (15)
- dihydroergotamine
dihydroergotamine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- dihydroergotamine inhaled
dihydroergotamine inhaled increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- dihydroergotamine intranasal
dihydroergotamine intranasal increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- ergoloid mesylates
ergoloid mesylates increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- ergonovine
ergonovine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- ergotamine
ergotamine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- isocarboxazid
isocarboxazid increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- linezolid
linezolid increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- methylergonovine
methylergonovine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Ergot derivatives may enhance the vasoconstricting effect of pseudoephedrine and eventually significantly increasing blood pressure.
- phenelzine
phenelzine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- procarbazine
procarbazine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- rasagiline
rasagiline increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- selegiline
selegiline increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- selegiline transdermal
selegiline transdermal increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
- tranylcypromine
tranylcypromine increases effects of pseudoephedrine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.
Serious - Use Alternative (33)
- amitriptyline
amitriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- amoxapine
amoxapine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- cabergoline
cabergoline, pseudoephedrine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.
- calcium/magnesium/potassium/sodium oxybates
brompheniramine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- clomipramine
clomipramine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- cocaine topical
cocaine topical increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- desipramine
desipramine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- desvenlafaxine
desvenlafaxine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- doxapram
doxapram increases effects of pseudoephedrine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.
- doxepin
doxepin increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- duloxetine
duloxetine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- eluxadoline
brompheniramine, eluxadoline. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that cause constipation. Increases risk for constipation related serious adverse reactions.
- imipramine
imipramine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- iobenguane I 123
pseudoephedrine decreases effects of iobenguane I 123 by receptor binding competition. Avoid or Use Alternate Drug. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results. Do not administer pseudoephedrine until at least 7 days after each iobenguane dose.
- iobenguane I 131
pseudoephedrine decreases effects of iobenguane I 131 by receptor binding competition. Avoid or Use Alternate Drug. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results. Do not administer pseudoephedrine until at least 7 days after each iobenguane dose.
- isocarboxazid
isocarboxazid increases effects of brompheniramine by Other (see comment). Avoid or Use Alternate Drug. Comment: Isocarboxazid should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .
- isoflurane
isoflurane increases toxicity of pseudoephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- levomilnacipran
levomilnacipran increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- lofepramine
lofepramine, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- maprotiline
maprotiline, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- methoxyflurane
methoxyflurane increases toxicity of pseudoephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- metoclopramide intranasal
brompheniramine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- milnacipran
milnacipran increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug.
- nortriptyline
nortriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- olopatadine intranasal
brompheniramine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- ozanimod
ozanimod increases toxicity of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.
- pitolisant
brompheniramine decreases effects of pitolisant by Other (see comment). Avoid or Use Alternate Drug. Comment: Pitolisant increases histamine levels in the brain; therefore, H1 receptor antagonists that cross the blood-brain barrier may reduce the efficacy of pitolisant.
- protriptyline
protriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- selinexor
selinexor, brompheniramine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- sevoflurane
sevoflurane increases toxicity of pseudoephedrine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.
- sodium oxybate
brompheniramine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tranylcypromine
tranylcypromine increases effects of brompheniramine by Other (see comment). Avoid or Use Alternate Drug. Comment: Tranylcypromine should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .
- trazodone
trazodone, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
Monitor Closely (258)
- acetazolamide
acetazolamide will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- acrivastine
acrivastine and brompheniramine both increase sedation. Use Caution/Monitor.
- albuterol
albuterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - alfentanil
brompheniramine and alfentanil both increase sedation. Use Caution/Monitor.
- alfuzosin
pseudoephedrine decreases effects of alfuzosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- alprazolam
brompheniramine and alprazolam both increase sedation. Use Caution/Monitor.
- aluminum hydroxide
aluminum hydroxide will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor. Caution advised with frequent or high dose antacids
- amifampridine
brompheniramine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.
- amisulpride
amisulpride and brompheniramine both increase sedation. Use Caution/Monitor.
- amitriptyline
brompheniramine and amitriptyline both increase sedation. Use Caution/Monitor.
- ammonium chloride
ammonium chloride decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.
- amobarbital
brompheniramine and amobarbital both increase sedation. Use Caution/Monitor.
- amoxapine
brompheniramine and amoxapine both increase sedation. Use Caution/Monitor.
- apomorphine
brompheniramine and apomorphine both increase sedation. Use Caution/Monitor.
- arformoterol
arformoterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - aripiprazole
brompheniramine and aripiprazole both increase sedation. Use Caution/Monitor.
- benzphetamine
benzphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- armodafinil
brompheniramine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- asenapine
asenapine and brompheniramine both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and brompheniramine both increase sedation. Use Caution/Monitor.
- avapritinib
avapritinib and brompheniramine both increase sedation. Use Caution/Monitor.
- azelastine
azelastine and brompheniramine both increase sedation. Use Caution/Monitor.
- baclofen
brompheniramine and baclofen both increase sedation. Use Caution/Monitor.
- belladonna and opium
brompheniramine and belladonna and opium both increase sedation. Use Caution/Monitor.
- benperidol
brompheniramine and benperidol both increase sedation. Use Caution/Monitor.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and brompheniramine both increase sedation. Use Caution/Monitor.
- benzphetamine
brompheniramine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brexanolone
brexanolone, brompheniramine. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and brompheniramine both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and brompheniramine both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and brompheniramine both increase sedation. Use Caution/Monitor.
- bromocriptine
bromocriptine, pseudoephedrine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Hypertension, V tach.
- buprenorphine
brompheniramine and buprenorphine both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
brompheniramine and buprenorphine buccal both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
buprenorphine subdermal implant and brompheniramine both increase sedation. Use Caution/Monitor.
- buprenorphine transdermal
buprenorphine transdermal and brompheniramine both increase sedation. Use Caution/Monitor.
- butabarbital
brompheniramine and butabarbital both increase sedation. Use Caution/Monitor.
- butalbital
brompheniramine and butalbital both increase sedation. Use Caution/Monitor.
- butorphanol
brompheniramine and butorphanol both increase sedation. Use Caution/Monitor.
- caffeine
brompheniramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbinoxamine
brompheniramine and carbinoxamine both increase sedation. Use Caution/Monitor.
- carisoprodol
brompheniramine and carisoprodol both increase sedation. Use Caution/Monitor.
- cenobamate
cenobamate, brompheniramine. Either increases effects of the other by sedation. Use Caution/Monitor.
- chloral hydrate
brompheniramine and chloral hydrate both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
brompheniramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.
- chlorpheniramine
brompheniramine and chlorpheniramine both increase sedation. Use Caution/Monitor.
- chlorpromazine
chlorpromazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use.
brompheniramine and chlorpromazine both increase sedation. Use Caution/Monitor. - chlorzoxazone
brompheniramine and chlorzoxazone both increase sedation. Use Caution/Monitor.
- dexfenfluramine
dexfenfluramine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- cinnarizine
brompheniramine and cinnarizine both increase sedation. Use Caution/Monitor.
- clemastine
brompheniramine and clemastine both increase sedation. Use Caution/Monitor.
- clobazam
brompheniramine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
- clomipramine
brompheniramine and clomipramine both increase sedation. Use Caution/Monitor.
- clonazepam
brompheniramine and clonazepam both increase sedation. Use Caution/Monitor.
- clorazepate
brompheniramine and clorazepate both increase sedation. Use Caution/Monitor.
- clozapine
brompheniramine and clozapine both increase sedation. Use Caution/Monitor.
- codeine
brompheniramine and codeine both increase sedation. Use Caution/Monitor.
- cyclizine
brompheniramine and cyclizine both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
brompheniramine and cyclobenzaprine both increase sedation. Use Caution/Monitor.
- cyproheptadine
brompheniramine and cyproheptadine both increase sedation. Use Caution/Monitor.
- dantrolene
brompheniramine and dantrolene both increase sedation. Use Caution/Monitor.
- daridorexant
brompheniramine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- desflurane
desflurane and brompheniramine both increase sedation. Use Caution/Monitor.
- desipramine
brompheniramine and desipramine both increase sedation. Use Caution/Monitor.
- deutetrabenazine
brompheniramine and deutetrabenazine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
brompheniramine and dexchlorpheniramine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
brompheniramine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
brompheniramine and dexmedetomidine both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
dexmethylphenidate and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - dextroamphetamine
dextroamphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - dextromoramide
brompheniramine and dextromoramide both increase sedation. Use Caution/Monitor.
- diethylpropion
diethylpropion and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- diamorphine
brompheniramine and diamorphine both increase sedation. Use Caution/Monitor.
- diazepam
brompheniramine and diazepam both increase sedation. Use Caution/Monitor.
- diazepam intranasal
diazepam intranasal, brompheniramine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.
- diethylpropion
brompheniramine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and brompheniramine both increase sedation. Use Caution/Monitor.
- difenoxin hcl
brompheniramine and difenoxin hcl both increase sedation. Use Caution/Monitor.
- dimenhydrinate
brompheniramine and dimenhydrinate both increase sedation. Use Caution/Monitor.
- diphenhydramine
brompheniramine and diphenhydramine both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
brompheniramine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dipipanone
brompheniramine and dipipanone both increase sedation. Use Caution/Monitor.
- dobutamine
brompheniramine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
dobutamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - donepezil transdermal
donepezil transdermal, brompheniramine. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.
- dopamine
dopamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- dopamine
brompheniramine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
dopexamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - dosulepin
brompheniramine and dosulepin both increase sedation. Use Caution/Monitor.
- doxazosin
pseudoephedrine decreases effects of doxazosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- doxepin
brompheniramine and doxepin both increase sedation. Use Caution/Monitor.
- doxylamine
brompheniramine and doxylamine both increase sedation. Use Caution/Monitor.
- droperidol
brompheniramine and droperidol both increase sedation. Use Caution/Monitor.
- droxidopa
pseudoephedrine and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertension
- ephedrine
ephedrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
ephedrine, pseudoephedrine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. - epinephrine
epinephrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - epinephrine inhaled
pseudoephedrine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- epinephrine racemic
brompheniramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
epinephrine racemic and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, brompheniramine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
esketamine intranasal, pseudoephedrine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. . - estazolam
brompheniramine and estazolam both increase sedation. Use Caution/Monitor.
- fenfluramine
fenfluramine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- ethanol
brompheniramine and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and brompheniramine both increase sedation. Use Caution/Monitor.
- fenfluramine
brompheniramine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fentanyl
fentanyl, brompheniramine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
fentanyl and brompheniramine both increase sedation. Use Caution/Monitor. - fentanyl intranasal
fentanyl intranasal, brompheniramine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
fentanyl intranasal and brompheniramine both increase sedation. Use Caution/Monitor. - fentanyl iontophoretic transdermal system
fentanyl iontophoretic transdermal system and brompheniramine both increase sedation. Use Caution/Monitor.
- fentanyl transdermal
fentanyl transdermal, brompheniramine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
fentanyl transdermal and brompheniramine both increase sedation. Use Caution/Monitor. - fentanyl transmucosal
fentanyl transmucosal, brompheniramine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- flibanserin
brompheniramine and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.
- fluphenazine
brompheniramine and fluphenazine both increase sedation. Use Caution/Monitor.
fluphenazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use. - flurazepam
brompheniramine and flurazepam both increase sedation. Use Caution/Monitor.
- formoterol
formoterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- formoterol
brompheniramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- gabapentin
gabapentin, brompheniramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- gabapentin enacarbil
gabapentin enacarbil, brompheniramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- ganaxolone
brompheniramine and ganaxolone both increase sedation. Use Caution/Monitor.
- glycopyrronium tosylate topical
glycopyrronium tosylate topical, brompheniramine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.
- gotu kola
gotu kola increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- haloperidol
brompheniramine and haloperidol both increase sedation. Use Caution/Monitor.
- hawthorn
hawthorn increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- hops
hops increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- hyaluronidase
brompheniramine decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Antihistamines, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect.
- hydralazine
hydralazine, pseudoephedrine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.
- hydromorphone
brompheniramine and hydromorphone both increase sedation. Use Caution/Monitor.
- hydroxyzine
brompheniramine and hydroxyzine both increase sedation. Use Caution/Monitor.
- iloperidone
brompheniramine and iloperidone both increase sedation. Use Caution/Monitor.
- imipramine
brompheniramine and imipramine both increase sedation. Use Caution/Monitor.
- insulin degludec
pseudoephedrine decreases effects of insulin degludec by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin degludec/insulin aspart
pseudoephedrine decreases effects of insulin degludec/insulin aspart by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin detemir
pseudoephedrine decreases effects of insulin detemir by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin glargine
pseudoephedrine decreases effects of insulin glargine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin inhaled
pseudoephedrine decreases effects of insulin inhaled by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- insulin regular human
pseudoephedrine decreases effects of insulin regular human by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.
- isoproterenol
brompheniramine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
isoproterenol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - kava
kava increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- levalbuterol
levalbuterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- ketamine
ketamine and brompheniramine both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
brompheniramine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- lasmiditan
lasmiditan, brompheniramine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant, brompheniramine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- levalbuterol
brompheniramine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levorphanol
brompheniramine and levorphanol both increase sedation. Use Caution/Monitor.
- lisdexamfetamine
lisdexamfetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - lofepramine
brompheniramine and lofepramine both increase sedation. Use Caution/Monitor.
- metaproterenol
metaproterenol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- lofexidine
brompheniramine and lofexidine both increase sedation. Use Caution/Monitor.
- loprazolam
brompheniramine and loprazolam both increase sedation. Use Caution/Monitor.
- lorazepam
brompheniramine and lorazepam both increase sedation. Use Caution/Monitor.
- lormetazepam
brompheniramine and lormetazepam both increase sedation. Use Caution/Monitor.
- loxapine
brompheniramine and loxapine both increase sedation. Use Caution/Monitor.
- loxapine inhaled
brompheniramine and loxapine inhaled both increase sedation. Use Caution/Monitor.
- lurasidone
lurasidone, brompheniramine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
brompheniramine and maprotiline both increase sedation. Use Caution/Monitor.
- marijuana
brompheniramine and marijuana both increase sedation. Use Caution/Monitor.
- melatonin
brompheniramine and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
brompheniramine and meperidine both increase sedation. Use Caution/Monitor.
- meprobamate
brompheniramine and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
brompheniramine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
brompheniramine and metaxalone both increase sedation. Use Caution/Monitor.
- methadone
brompheniramine and methadone both increase sedation. Use Caution/Monitor.
- methamphetamine
methamphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - methenamine
methenamine decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.
- methocarbamol
brompheniramine and methocarbamol both increase sedation. Use Caution/Monitor.
- methyldopa
methyldopa increases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor.
- methylenedioxymethamphetamine
methylenedioxymethamphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - midazolam
brompheniramine and midazolam both increase sedation. Use Caution/Monitor.
- midodrine
midodrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, brompheniramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
brompheniramine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mirtazapine
brompheniramine and mirtazapine both increase sedation. Use Caution/Monitor.
- modafinil
brompheniramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
brompheniramine and morphine both increase sedation. Use Caution/Monitor.
- motherwort
brompheniramine and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
brompheniramine and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
brompheniramine and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
brompheniramine and nalbuphine both increase sedation. Use Caution/Monitor.
- nateglinide
pseudoephedrine decreases effects of nateglinide by pharmacodynamic antagonism. Use Caution/Monitor. Coadministration may reduce nateglinide's hypoglycemic action.
- norepinephrine
norepinephrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - nortriptyline
brompheniramine and nortriptyline both increase sedation. Use Caution/Monitor.
- olodaterol inhaled
pseudoephedrine and olodaterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Caution with coadministration of adrenergic drugs by any route because of additive sympathetic effects
- olanzapine
brompheniramine and olanzapine both increase sedation. Use Caution/Monitor.
- opium tincture
brompheniramine and opium tincture both increase sedation. Use Caution/Monitor.
- orphenadrine
brompheniramine and orphenadrine both increase sedation. Use Caution/Monitor.
- oxazepam
brompheniramine and oxazepam both increase sedation. Use Caution/Monitor.
- oxycodone
brompheniramine and oxycodone both increase sedation. Use Caution/Monitor.
- oxymorphone
brompheniramine and oxymorphone both increase sedation. Use Caution/Monitor.
- oxytocin
oxytocin increases effects of pseudoephedrine by pharmacodynamic synergism. Use Caution/Monitor.
- paliperidone
brompheniramine and paliperidone both increase sedation. Use Caution/Monitor.
- papaveretum
brompheniramine and papaveretum both increase sedation. Use Caution/Monitor.
- papaverine
brompheniramine and papaverine both increase sedation. Use Caution/Monitor.
- passion flower
passion flower increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- pentazocine
brompheniramine and pentazocine both increase sedation. Use Caution/Monitor.
- pentobarbital
brompheniramine and pentobarbital both increase sedation. Use Caution/Monitor.
- perampanel
perampanel and brompheniramine both increase sedation. Use Caution/Monitor.
- perphenazine
perphenazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use.
brompheniramine and perphenazine both increase sedation. Use Caution/Monitor. - phendimetrazine
brompheniramine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
phendimetrazine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - phenelzine
phenelzine increases effects of brompheniramine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Coadministration of phenelzine and antihistamines may result in additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .
- phentermine
phentermine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- phenobarbital
brompheniramine and phenobarbital both increase sedation. Use Caution/Monitor.
- phentermine
brompheniramine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
brompheniramine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
phenylephrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - phenylephrine PO
brompheniramine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
phenylephrine PO and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - pholcodine
brompheniramine and pholcodine both increase sedation. Use Caution/Monitor.
- pirbuterol
pirbuterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- pimozide
brompheniramine and pimozide both increase sedation. Use Caution/Monitor.
- pirbuterol
brompheniramine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- potassium phosphate
potassium phosphate decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.
- pregabalin
pregabalin, brompheniramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- primidone
brompheniramine and primidone both increase sedation. Use Caution/Monitor.
- prochlorperazine
prochlorperazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use.
brompheniramine and prochlorperazine both increase sedation. Use Caution/Monitor. - promazine
promazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.
- promethazine
brompheniramine and promethazine both increase sedation. Use Caution/Monitor.
- promethazine
promethazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.
- propofol
propofol and brompheniramine both increase sedation. Use Caution/Monitor.
- propylhexedrine
propylhexedrine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - protriptyline
brompheniramine and protriptyline both increase sedation. Use Caution/Monitor.
- safinamide
pseudoephedrine and safinamide both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Monitor patients for hypertension if safinamide is prescribed concomitantly with prescription or nonprescription sympathomimetics, including nasal, oral, or ophthalmic decongestants and cold remedies.
- quazepam
brompheniramine and quazepam both increase sedation. Use Caution/Monitor.
- quetiapine
brompheniramine and quetiapine both increase sedation. Use Caution/Monitor.
- ramelteon
brompheniramine and ramelteon both increase sedation. Use Caution/Monitor.
- risperidone
brompheniramine and risperidone both increase sedation. Use Caution/Monitor.
- salmeterol
salmeterol and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - scullcap
brompheniramine and scullcap both increase sedation. Use Caution/Monitor.
- serdexmethylphenidate/dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate and pseudoephedrine both decrease sedation. Use Caution/Monitor.
serdexmethylphenidate/dexmethylphenidate and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - secobarbital
brompheniramine and secobarbital both increase sedation. Use Caution/Monitor.
- sevoflurane
sevoflurane and brompheniramine both increase sedation. Use Caution/Monitor.
- shepherd's purse
brompheniramine and shepherd's purse both increase sedation. Use Caution/Monitor.
- silodosin
pseudoephedrine decreases effects of silodosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- sodium bicarbonate
sodium bicarbonate will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor. Caution advised with frequent or high dose antacids
- sodium citrate/citric acid
sodium citrate/citric acid will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- sodium lactate
sodium lactate will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- sodium phosphates, IV
sodium phosphates, IV decreases effects of pseudoephedrine by unknown mechanism. Use Caution/Monitor. Urinary excretion of indirect acting alpha/beta agonists (eg, pseudoephedrine) may increase when administered concomitantly with urinary acidifying agents, resulting in lower serum concentrations.
- solriamfetol
pseudoephedrine and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- spironolactone
spironolactone decreases effects of pseudoephedrine by pharmacodynamic antagonism. Use Caution/Monitor.
- sufentanil
brompheniramine and sufentanil both increase sedation. Use Caution/Monitor.
- tamsulosin
pseudoephedrine decreases effects of tamsulosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- tapentadol
brompheniramine and tapentadol both increase sedation. Use Caution/Monitor.
- temazepam
brompheniramine and temazepam both increase sedation. Use Caution/Monitor.
- terazosin
pseudoephedrine decreases effects of terazosin by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
- terbutaline
brompheniramine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
terbutaline and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. - thioridazine
brompheniramine and thioridazine both increase sedation. Use Caution/Monitor.
thioridazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use. - thiothixene
brompheniramine and thiothixene both increase sedation. Use Caution/Monitor.
- trifluoperazine
trifluoperazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use.
- topiramate
brompheniramine and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
brompheniramine and tramadol both increase sedation. Use Caution/Monitor.
- trazodone
brompheniramine and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
brompheniramine and triazolam both increase sedation. Use Caution/Monitor.
- triclofos
brompheniramine and triclofos both increase sedation. Use Caution/Monitor.
- trifluoperazine
brompheniramine and trifluoperazine both increase sedation. Use Caution/Monitor.
- trimipramine
brompheniramine and trimipramine both increase sedation. Use Caution/Monitor.
- triprolidine
brompheniramine and triprolidine both increase sedation. Use Caution/Monitor.
- valerian
valerian increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- xylometazoline
pseudoephedrine and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.
brompheniramine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - yohimbine
brompheniramine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
brompheniramine and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
brompheniramine and ziprasidone both increase sedation. Use Caution/Monitor.
- zotepine
brompheniramine and zotepine both increase sedation. Use Caution/Monitor.
Minor (4)
- ashwagandha
ashwagandha increases effects of brompheniramine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.
- brimonidine
brimonidine increases effects of brompheniramine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- desmopressin
desmopressin increases effects of pseudoephedrine by pharmacodynamic synergism. Minor/Significance Unknown.
- eucalyptus
brompheniramine and eucalyptus both increase sedation. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Dizziness
Drowsiness
Dry mouth, throat, and nose
Thickening of mucus in nose or throat
GI disturbances
Arrhythmia
Palpitations
Convulsion
Excitability
Tremor
Weakness
Warnings
Contraindications
Hypersensitivity
Acute asthma attack
Severe hypertension
Coronary artery disease
Narrow-angle glaucoma
Symptomatic prostate hypertrophy
Bladder-neck obstruction
Stenosing peptic ulcer
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
Pseudoephedrine: Caution in cardiovascular disease, diabetes mellitus, prostatic hypertrophy and increased intraocular pressure
Pregnancy & Lactation
Pregnancy category: C
Lactation: excreted in breast milk/not recommended
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.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
Pseudoephedrine: Stimulates alpha-adrenergic receptors causing bronchodilation & vasoconstriction
Dextromethorphan: Cough suppressant that acts centrally on the cough center in medulla
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
Pseudoephedrine
- Half-Life: 3 hr (children); 9-16 hr (adults)
- Onset: 30 min (decongestant)
- Duration: 3-8 hr
- Peak PlasmaTime: 1.97 hr
- Concentration: 422 ng/mL
- Metabolism: Liver, by N-demethylation
- Metabolites: Inactive
- Clearance: 7.3-7.6 mL/min/kg
- Excretion: Urine (43-96%)
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
Images
Formulary
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