brompheniramine/pseudoephedrine/dextromethorphan

Action and Spectrum

Actions and Spectrum: 

brompheniramine competitively blocks the histamines from linking to H1 receptors. 

This causes an antimuscarinic activity that penetrates CNS, causing a pronounced potential to produce sedation. 

pseudoephedrine stimulates alpha-adrenergic receptors that cause vasoconstriction and bronchodilation. 

dextromethorphan suppresses cough and acts on the medullary cough center. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Drowsiness 

Dizziness 

Dry mouth, nose, or throat 

Arrhythmia 

Palpitations 

Thickening of mucus  

GI disturbances 

Convulsion 

Excitability 

Weakness 

Tremor 

Black Box Warning

Black Box Warning: 

None 

Contraindication / Caution

Contraindication/Caution: 

Contraindications 

• Hypersensitivity 
• Hypertension 
• MAOI use 

Cautions 

• Cardiovascular disease 
• Prostate hypertrophy 
• Glaucoma 
• Pregnancy 
• Lactation 

Pregnancy / Lactation

Pregnancy consideration:  

Category C 

Breastfeeding warnings:  

The drug is contraindicated during lactation as it is excreted in the breast milk. 

Pregnancy category: 

Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology:  

brompheniramine is an antihistamine drug that blocks the effects of histamine, a chemical released during allergic reactions. It acts as a competitive antagonist at histamine H1 receptors, preventing histamine from binding to and activating these receptors. 

pseudoephedrine stimulates the alpha-adrenergic receptors, which cause vasoconstriction and bronchodilation. dextromethorphan is a cough suppressant acting on the medullary cough center. 

pseudoephedrine acts as a selective alpha-1 adrenergic receptor agonist. It stimulates the alpha-1 adrenergic receptors on the smooth muscle lining the walls of blood vessels in the nasal passages. 

Pharmacodynamics: 

Pharmacodynamics includes histamine H1 receptor antagonism, anticholinergic effects, and sedative effects. 

Pharmacokinetics: 

Absorption 

The onset takes place in 15-30 min  

The duration of action is achieved in 3-9 hours (brompheniramine) and 3-8 hours for pseudoephedrine 

The peak plasma concentration is attained in 2-5 hr (brompheniramine) 

Distribution 

The volume of distribution is 11.7 L/kg for brompheniramine  

Metabolism 

MAO inhibitors metabolize brompheniramine in the liver and phenylephrine in the intestine. P450 metabolizes the drug and CYP2D6 hepatic enzymes  

Elimination and Excretion 

The half-life is 11.8-34.7 hours for brompheniramine and 2-4 hours in excreted in the urine 

Adminstartion

Administration: 

brompheniramine/pseudoephedrine dextromethorphan is administered through the oral route. It is provided in oral solutions, elixirs, and suspension. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: brompheniramine/pseudoephedrine/dextromethorphan 

Pronounced: brom-fen-EER-a-meen, soo-doe-e-FED-rin, dex-troe-me-THOR-fan 

Why do we use brompheniramine/pseudoephedrine/dextromethorphan 

This drug belongs to nasal decongestant used to relieve respiratory tract congestion, rhinitis, and allergic rhinitis.