Brompheniramine/dextromethorphan/phenylephrine: Cold Uses (original) (raw)
- Uses
- Warnings
- Side Effects
- Dosage
- Overdose
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
- Comments
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Generic Name: brompheniramine/dextromethorphan/phenylephrine
Brand Names: Neo DM Suspension, Dimaphen DM, Children's Dimetapp Cold and Cough
Drug Class: Cough/Cold, Non-narcotic Combos; Antihistamine/Antitussive/Decongestant Combos
What is brompheniramine/dextromethorphan/phenylephrine, and what is it used for?
Brompheniramine/dextromethorphan/phenylephrine is a combination drug used to relieve symptoms of the common cold, flu, hay fever, allergies, and respiratory conditions such as sinusitis and bronchitis. The combo medication temporarily relieves symptoms such as cough, runny nose, nasal congestion, sneezing, itchy nose or throat, and itchy/watery eyes due to minor throat and bronchial irritation, and makes breathing easier. The drug is available over the counter (OTC) in the U.S.
Each medication in the combination works in a different way, and when combined they are more effective in relieving symptoms than with monotherapy of just one of the drugs.
- Brompheniramine works by blocking the activity of histamine, a natural compound in the body that causes allergy symptoms. Histamine is released by mast cells and basophils, types of immune cells, in response to allergen exposure. Brompheniramine binds to histamine H1 receptors in blood vessels, respiratory tract, and gastrointestinal tract, preventing their activation by histamine and the resultant allergic reaction.
- Dextromethorphan suppresses cough by reducing the sensitivity of cough receptors in the brain region that stimulate the cough reflex and prevent the transmission of cough impulses. Dextromethorphan is a non-opioid drug derived from levorphanol, an opioid painkiller (analgesic), and is structurally similar to opioid drugs such as codeine, however, it does not have analgesic or addictive properties.
- Phenylephrine is an alpha1 agonist that works by stimulating the activity of alpha1 adrenergic receptors, protein molecules that signal to the smooth muscles around blood vessels to contract. The smooth muscle contraction narrows the blood vessels, limiting blood flow to the swollen respiratory mucous tissue, reducing nasal and bronchial congestion, and making breathing easier.
Warnings
- Do not use brompheniramine/dextromethorphan/phenylephrine in patients with hypersensitivity to brompheniramine, dextromethorphan, phenylephrine or any of the components in the formulation.
- Do not use brompheniramine/dextromethorphan/phenylephrine in patients with any of the following conditions:
- Severe hypertension, coronary artery disease or ischemic heart disease
- During an acute asthma attack
- Treatment of asthma or other lower respiratory tract conditions
- Narrow-angle glaucoma, an eye condition with high intraocular pressure that progressively damages the optic nerve
- Urinary retention
- Peptic ulcer
- Do not use brompheniramine/dextromethorphan/phenylephrine to treat nursing mothers.
- Do not use to treat full term or premature newborn infants.
- Use with caution in children and do not use the drug to make children sleepy, misuse can result in death in young children.
- Use with caution in children who are prone to allergic reactions (atopic).
- At doses higher than the recommended dose, nervousness, dizziness, or sleeplessness may occur, especially in infants and small children. Antihistamine overdose may cause hallucinations, convulsions, and death.
- Do not use concurrently or within 14 days of treatment with monoamine oxidase inhibitors (MAOIs), a class of antidepressants.
- Use with caution in patients with:
- Chronic obstructive pulmonary disease (COPD)
- Shortness of breath or difficulty breathing
- High blood pressure
- Cardiovascular disease
- Diabetes mellitus
- Thyroid disease
- Difficulty in urination due to prostate enlargement
- History of bronchial asthma, narrow-angle glaucoma, gastrointestinal obstruction, or urinary bladder-neck obstruction
- Use with caution in patients with persistent cough related to smoking, asthma or emphysema, or cough with excessive phlegm. A persistent cough may indicate a serious condition that should be appropriately diagnosed and treated.
- In case a hypertensive crisis occurs, discontinue the drug immediately and institute therapy to lower blood pressure.
- Do not use concurrently with other sedative drugs or alcohol.
QUESTION The common cold is one of the most common illnesses in the world. See Answer
What are the side effects of brompheniramine/dextromethorphan/phenylephrine?
Common side effects of brompheniramine/dextromethorphan/phenylephrine include:
- Dry mouth, nose and throat
- Thickening of mucus in nose and throat
- Drowsiness
- Dizziness
- Headache
- Excitability
- Restlessness
- High blood pressure (hypertension)
- Reflex increase in heart rate (tachycardia)
- Constriction of peripheral and abdominal (visceral) blood vessels
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
Health News
What are the dosages of brompheniramine/dextromethorphan/phenylephrine?
Oral Solution
- 1 mg/5 mg/2.5 mg/5 mL
Relief of Cold Symptoms
Adult:
4 teaspoons (20 mL) orally every 4 hours; not to exceed 120 mL/24 hours
Pediatric:
Children below 6 years
- Not recommended
Children 6-12 years
- 2 teaspoons (10 mL) orally every 4 hours
Children above 12 years
- 4 teaspoons (20 mL) orally every 4 hours
Overdose
- Brompheniramine/dextromethorphan/phenylephrine overdose can cause severe adverse reactions with symptoms that include agitation, confusion, flushing, hallucinations, large pupils, muscle twitching, and seizures.
- In children, the drug may initially have an excitatory effect, which may be followed by loss of coordination, drowsiness, loss of consciousness and seizures.
- Overdose treatment may be supportive and symptomatic care.
What drugs interact with brompheniramine/dextromethorphan/phenylephrine?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Severe interactions of brompheniramine/dextromethorphan/phenylephrine include:
- iobenguane I 123
- isocarboxazid
- linezolid
- phenelzine
- phenelzine
- procarbazine
- rasagiline
- selegiline transdermal
- safinamide
- selegiline
- tranylcypromine
- Brompheniramine/dextromethorphan/phenylephrine has serious interactions with at least 58 different drugs.
- Brompheniramine/dextromethorphan/phenylephrine has moderate interactions with at least 303 different drugs.
- Brompheniramine/dextromethorphan/phenylephrine has mild interactions with at least 36 different drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Neither animal reproductive studies nor controlled studies in pregnant women have been conducted on the safety of brompheniramine/dextromethorphan/phenylephrine use during pregnancy. It is not known if the combination drug can cause fetal harm or affect reproductive capacity. Use with caution in pregnant women only if maternal benefits clearly outweigh possible risk to the fetus.
- The combination drug contains brompheniramine, an antihistamine. There is a higher risk of antihistamine intolerance in small infants, avoid use in nursing mothers.
- If you are pregnant or breastfeeding, consult your healthcare provider before taking any OTC drug.
What else should I know about brompheniramine/dextromethorphan/phenylephrine?
- Take brompheniramine/dextromethorphan/phenylephrine exactly as prescribed, or as per label instructions if taking OTC drug. Do not take higher or more frequent doses than recommended.
- Stop taking the medication and see your physician if:
- Your symptoms include fever, rash, or persistent headache or do not get better within 7 days
- Cough persists for more than 1 week, tends to recur, or is accompanied by fever, rash, or persistent headache,
- You develop sleeplessness, nervousness, or dizziness
- The antihistamine component in the drug may impair physical and mental abilities; avoid activities such as driving and operating heavy machinery.
- Tell your doctor ahead of time if you have taken this drug within the previous a few days, if surgery or medical tests need to be performed.
- This combo medication can reduce sweating. Avoid becoming overheated or dehydrated during exercise and hot weather, it may increase the risk of heat stroke.
- Avoid drinking alcohol while taking brompheniramine/dextromethorphan/phenylephrine.
- Do not administer OTC brompheniramine/dextromethorphan/phenylephrine to children younger than 2 years.
- Store safely out of reach of children.
- In case of overdose, seek medical help or call Poison Control.
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Summary
Brompheniramine/dextromethorphan/phenylephrine is an over-the-counter (OTC) cold medication used to relieve symptoms of the common cold, flu, hay fever, allergies, and respiratory conditions such as sinusitis and bronchitis. The combo medication temporarily relieves symptoms such as cough, runny nose, nasal congestion, sneezing, itchy nose or throat, and itchy/watery eyes due to minor throat and bronchial irritation, and makes breathing easier. Do not use concurrently with other sedative drugs or alcohol. Common side effects of brompheniramine/dextromethorphan/phenylephrine include dry mouth, nose, and throat; thickening of mucus in nose and throat, drowsiness, dizziness, headache, excitability, restlessness, high blood pressure (hypertension), reflex increase in heart rate (tachycardia), and constriction of peripheral and abdominal (visceral) blood vessels.
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- Children's Cough Causes and Treatments Children's cough causes include infection, acid reflux, asthma, allergies or sinus infection, whooping cough, and exposure to irritants. Treatment for a child's cough include cough medicine for children over the age of four.
- How Cold Is Too Cold to Go Outside? Human body is capable of maintaining a steady core temperature between 97°F and 99°F. However, it is essential to layer up in cold weather and wear comfortable clothes in warm weather, so that we stay protected from extremes of temperature.
- How Can I Stop My Child From Coughing? Treatment for cough is not recommended unless the cough interferes with the child’s sleep or activity or is accompanied by a fever. Different age groups of children require different therapies to stop them from coughing. Some good home remedies to treat cough in children include honey, warm milk, hydration, steam inhalation, resting, saline nose drops and other strategies.
- Are Cold Sores the Same as Herpes? What is the difference between cold sores and herpes? Cold sores are painful, unsightly sores that usually pop up around your mouth. Certain medications, home care and alternative therapies may help you get rid of cold sores fast.
- What Happens if a Pregnant Woman Gets a Cold? Having an ordinary cold shouldn't be harmful to the baby or mother. Pregnant women are highly likely to pick up a cold at some time during pregnancy because it's normal to catch two or three colds a year. A healthy lifestyle is a must to keep the immune system strong and to prevent colds.
- Why Won’t My Allergy Symptoms Go Away? Allergies happen when your body's immune system reacts to certain substances as though they are harmful. Allergy symptoms may not go away unless you avoid your triggers, stick to your medications, find the right combination of medications, and consider surgery.
- How Long Is a Cold or Flu Contagious? Viruses cause the common cold and the flu. Early symptoms and signs for a cold and the flu are similar, however, flu symptoms are typically more severe than cold symptoms. Cold and flu viruses are transmitted typically via coughing or sneezing.
- Allergic Cascade The allergic cascade refers to allergic reactions that happen in the body in response to allergens. A variety of immune cells and chemical messengers participate in the allergic cascade. Symptoms of the allergic cascade range from mild swelling and itching to full-blown anaphylactic shock. Allergen avoidance and medications are used to prevent or treat allergies.
- Sinus Infection vs. Cold Viruses cause the common cold and most sinus infections. Bacterial and fungal infections may also cause a sinus infection. Signs and symptoms of colds and sinus infections include nasal irritation or dryness, sore throat, stuffy nose, nasal discharge/congestion, sneezing, and cough. Additional symptoms of sinus infections include sinus pressure behind the cheeks or eyes, facial pain when pressure is applied, bad breath, and thick yellow or green mucus. Treatment focuses on symptom relief.
- COVID-19 vs. Flu vs. Cold When you're feeling sick, it can be difficult to distinguish the symptoms of a COVID-19 infection from the symptoms of the common cold or the flu (influenza). While fever is common with the flu and COVID-19, sneezing is typically only associated with colds. Though sore throats are typical with colds, they are uncommon with COVID-19 infections and the flu.
- How Do You Know if You Have a Sinus Infection (Sinusitis) or COVID-19 Coronavirus? Learn how the signs and symptoms of a sinus infection are different from those caused by COVID-19.
- Is Whooping Cough (Pertussis) Contagious? Whooping cough (pertussis) is a highly contagious respiratory infection caused by Bordetella pertussis. Whooping cough symptoms include severe coughing fits and whooping sound produced during inhalation. The bacteria spreads via airborne droplets produced during sneezing or coughing. There is a whooping cough vaccine that is typically administered during childhood vaccinations.
- What Can You Take for a Cold While Pregnant? You may take over-the-counter (OTC) treatment after consulting with the physician because these are generally safe. OTC medications for colds and flus include acetaminophen, guaifenesin syrup and saline nasal drops or spray. You can also use natural remedies to treat a cold during pregnancy.
- What Is the Fastest Way to Fix Seasonal Allergies? Seasonal allergies are common and tend to ramp up during the spring and summer. Learn about how to get rid of seasonal allergies fast with these 13 home remedies.
- Emphysema, Chronic Bronchitis, and Colds If you have a COPD such as emphysema, avoiding chronic bronchitis and colds is important to avoid a more severe respiratory infection such as pneumonia. Avoiding cigarette smoking, practice good hygeine, stay away from crowds, and alerting your healthcare provider if you have a sinus infection or cold or cough that becomes worse. Treatment options depend upon the severity of the emphysema, bronchitis, or cold combination.
- Cold vs. Flu Though different viruses cause the common cold and influenza, the two respiratory illnesses share many signs and symptoms. Flu symptoms tend to cause more serious, harmful problems than a cold.
- Sinus Infection vs. Allergies Both sinus infections and allergies (allergic rhinitis) cause symptoms such as runny or stuffy nose and fatigue. Sinus infection (known as sinusitis) is inflammation of the sinuses, caused by infection from bacteria, viruses, and/or fungi (molds). Allergic rhinitis occurs when certain allergies cause nasal symptoms. When a person with allergies breathes in an allergen, such as pollen, dust, or animal dander, symptoms such as runny or stuffy nose, itching, sneezing, and fatigue occur.
- What Are the Best Treatments for Allergic Conjunctivitis? Learn what medical treatments can ease allergic conjunctivitis symptoms and help speed up your eye allergy recovery.
- What Happens if You Let a Sinus Infection Go Untreated? If you let sinus infection go untreated, it could lead to rare but serious complications such as chronic sinusitis that spreads to the surrounding areas and the larynx, eyes, and brain.
- Allergy Treatment Begins at Home Avoiding allergy triggers at home is one of the best ways to prevent allergy symptoms. Controlling temperature, humidity, and ventilation are a few ways to allergy-proof the home. Cleaning, vacuuming, and using HEPA air filters also helps control allergies.
- Is Allergic Conjunctivitis the Same as Conjunctivitis? Allergic conjunctivitis may occur along with sneezing, runny nose, or sinus headache. Many people also find that they are tired and feel agitated.
- COVID-19 vs. Allergies Though there is some overlap in allergy and COVID-19 signs and symptoms there are also significant differences. Symptoms that they have in common include headache, fatigue, tiredness, shortness of breath, wheezing, and sore throat. Fever does not occur with allergies but is one of the defining symptoms of COVID-19 infections.
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Medically Reviewed on 11/10/2022
References
https://www.rxlist.com/consumer\_dimetapp/drugs-condition.htm
https://www.webmd.com/drugs/2/drug-32665/brompheniramine-phenylephrine-dm-oral/details
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=404ef5f4-7b7b-4c08-b159-9175a91be132
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ff712454-32df-4839-98d1-a6844a1bba96
https://www.fda.gov/drugs/special-features/use-caution-when-giving-cough-and-cold-products-kids