Brompheniramine Maleate / Pseudoephedrine Hydrochloride
Pronouncation: (brom-fen-AIR-uh-meen MAL-ee-ate/SUE-doe-eh-FED-rin HIGH-droe-KLOR-ide)Class: Respiratory agent
Trade Names:
Lodrane
- Liquid 4 mg brompheniramine/60 mg pseudoephedrine
Trade Names:
Lodrane 12 D
- Tablets 6 mg brompheniramine/45 mg pseudoephedrine
Trade Names:
Lodrane LD
- Capsules 6 mg brompheniramine/60 mg pseudoephedrine
Pharmacology
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Feedback for Brompheniramine Maleate/Pseudoephedrine Hydrochloride
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Competitively antagonizes histamine at H 1 receptor sites.
PseudoephedrineCauses vasoconstriction and subsequent shrinkage of nasal mucous membranes by alpha-adrenergic stimulation, which promotes nasal drainage.
Indications and Usage
Temporary relief of symptoms associated with seasonal and perennial allergic rhinitis and vasomotor rhinitis, including nasal congestion.
Contraindications
Hypersensitivity to any ingredients of product; nursing mothers, severe hypertension; severe coronary artery disease; narrow-angle glaucoma; urinary retention; peptic ulcer, asthma attack; MAOI therapy or for 2 wk after stopping MAOI therapy.
Dosage and Administration
Adults and Children over 12 yr of agePO Lodrane extended-release tablet 1 or 2 tablets every 12 h. Lodrane liquid: 1 tsp (5 mL) every 4 to 6 h (max, 4 doses/24 h).
Children 6 to 12 yr of agePO Lodrane extended-release tablet: 1 tablet every 12 h. Lodrane liquid: ½ tsp (2.5 mL) every 4 to 6 h (max, 4 doses/24 h).
Children 2 to 6 yr of agePO Lodrane liquid: ¼ tsp (1.25 mL) every 4 to 6 h (max, 4 doses/24 h).
Children less than 2 yr of agePO Lodrane liquid: as recommended by health care provider.
General Advice
- Use dosing spoon or syringe for pediatric doses of liquid.
- Do not cut, chew, or crush tablet. Swallow whole.
Storage/Stability
Store tablets and liquid at 59° to 86°F. Protect tablets from light and moisture. Keep liquid tightly closed.
Drug Interactions
Alcohol, barbiturates (eg, phenobarbital), tricyclic depressants (eg, amitriptyline), other CNS depressantsEffects may be enhanced by brompheniramine.
AntacidsRate of pseudoephedrine absorption may be increased.
Antidepressants, antihypertensivesDo not use in patients receiving antidepressants or antihypertensive agents or within 14 days of stopping such treatment.
DigitalisIncreased ectopic pacemaker activity can occur with pseudoephedrine.
MAOIs (eg, isocarboxazid)Do not use in patients receiving MAOI therapy or within 14 days of stopping such treatment. May prolong and intensify the effects of brompheniramine and increase the effects of pseudoephedrine.
Mecamylamine, methyldopa, reserpine, veratrum alkaloidsAntihypertensive effects may be reduced by pseudoephedrine.
Tricyclic antidepressants (eg, amitriptyline)May prolong or intensify the anticholinergic effects of brompheniramine.
Laboratory Test Interactions
May interfere with diagnostic test results for skin tests using allergen extracts.
Adverse Reactions
Cardiovascular
Palpitation; tachycardia; angina; elevated BP; circulatory collapse.
CNS
Drowsiness; confusion; restlessness; anorexia; dizziness; headache; insomnia; anxiety; tension; weakness; stimulation.
Dermatologic
Rash; sweating.
GI
Nausea; vomiting; gastric distress; abdominal cramps.
Genitourinary
Dysuria.
Miscellaneous
Vertigo; mydriasis.
Precautions
MonitorAssess for allergy symptoms (eg, rhinitis, nasal congestion, sneezing, itching, watery eyes) before and periodically throughout therapy. Monitor patient for nervousness, dizziness, and insomnia. If noted hold therapy and notify health care provider. |
Pregnancy
Category C .
Lactation
Undetermined.
Children
Lodrane extended-release tablets: Safety and efficacy in children less than 6 yr of age not established. Lodrane liquid: Safety and efficacy in children less than 2 yr of age not established.
Elderly
More likely to cause dizziness, sedation, hyperexcitability, anticholinergic side effects (eg, urinary retention), confusion, hallucinations, seizures, CNS depression, and hypotension in the elderly.
Special Risk Patients
Use with caution in patients with hypertension, heart disease, asthma, hyperthyroidism, increased intraocular pressure, diabetes mellitus, prostatic hypertrophy, bronchial asthma.
Abuse
Pseudoephedrine is a CNS stimulant and has been abused.
Overdosage
Symptoms
BrompheniramineHallucination, convulsions and death, dizziness, sedation, hypotension
PseudoephedrineCardiac arrhythmias, cerebral hemorrhage, pulmonary edema, palpitations, tremor, dizziness, vomiting, fear, labored breathing, headache, dryness of mouth, pallor, weakness, panic, anxiety, confusion, hallucination, delirium.
Patient Information
- Advise patient to take tablet dose every 12 h as needed with a full glass of water. Liquid dose is taken every 4 to 6 h as needed, up to 4 times daily.
- Advise caregiver to use dosing spoon or syringe when giving liquid dose to children.
- Advise patient to take with food or milk if GI upset occurs.
- Caution patient to not cut, chew, or crush tablet and to swallow whole.
- Advise patient to take last dose late in the afternoon or early evening to reduce chance of drug causing sleeplessness.
- Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient to not double the dose to catch up.
- Advise patient that if allergy symptoms are not controlled not to increase the dose of medication but to inform their health care provider.
- Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
- Advise patient to avoid alcohol and other CNS depressants due to risk of excessive sedation.
- Caution patient not to take any OTC antihistamines or decongestants while taking this medication unless advised to do so by their health care provider.
- If patient is to have allergy skin testing, advise to not take the medication for at least 6 days before the skin testing.
- Instruct patient to stop taking drug and immediately report any of these symptoms to health care provider: nervousness, dizziness, or sleeplessness.
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