Bromides have been used to treat epilepsy for over 100 years. They are
still used occasionally in severe cases, especially in children with underlying
brain damage. Bromides have traditionally been given in a solution consisting
of sodium, potassium and ammonium salts of bromide in equal amounts (by
weight) of each. The usual preparation contains 1200 mg (400 mg of each
salt) in 5 mL.
The base can be a syrup and water mix. A one month expiry date and refrigeration
children less than 6 years: 300 mg BD to 600 mg TID
children 6 years and older: 300 mg to 1000 mg TID
The half-life of bromide is about 12 days therefore steady state is not
reached for about one month. Toxicity (bromism) can occur and plasma concentrations
of bromide should be monitored. Increased sodium intake increases bromide
clearance and vice-versa.
Nahata and Hipple (Pediatric Drug Formulations 4 th edition) describe
Three Bromides Mixture prepared in a base of Ora-Plus. They suggest that
this is stable for 12 months but state that this is based on experience
rather than stability testing.
Levy R et
al (eds) Antiepileptic Drugs, 3rd Ed. Raven Press, New York, 1989.