Oral Levosalbutamol Dosage for Infants and Children

Dosing Guidelines by Age and Weight

The American Academy of Pediatrics recommends that for infants and children, levosalbutamol should be administered at half the dose of racemic albuterol 1, 2
For children under 4 years of age, levosalbutamol should be used with caution due to limited data available 2

The recommended dose is 0.075 mg/kg (minimum dose 1.25 mg) every 20 minutes for 3 doses during acute exacerbations, followed by 0.075-0.15 mg/kg up to 5 mg every 1-4 hours as needed for maintenance therapy 2
For optimal delivery, dilute aerosols to a minimum of 3 mL at a gas flow of 6-8 L/min 2
Oxygen is the preferred gas source for nebulization 3

Children should receive 4-8 puffs every 20 minutes for 3 doses, then every 1-4 hours as needed 2
Always use a valved holding chamber (spacer) with proper technique for optimal delivery 2
MDI delivery with proper technique is as effective as nebulized therapy for mild-to-moderate exacerbations 2

Monitor for common beta-agonist side effects including tachycardia, skeletal muscle tremor, hypokalemia, headache, and hyperglycemia 2
Increasing use or lack of expected effect indicates diminishing asthma control and need for medical attention 2

Regular use exceeding twice weekly for symptom control indicates poor asthma control and need for controller medication adjustment 2
Ipratropium bromide may be mixed with levosalbutamol in the same nebulizer for severe exacerbations 2

For children under 5 years, administer 0.31 mg/3 mL of levosalbutamol nebulizer solution every 4-6 hours as needed for bronchospasm, as recommended by guidelines from the American Academy of Pediatrics, with a strength of evidence based on clinical trials 4
Administer 1-2 puffs (45 mcg/puff) every 4-6 hours as needed for routine bronchospasm using a metered-dose inhaler with a spacer, following guidelines from pediatric respiratory societies 4
Levosalbutamol has FDA approval and safety data for children as young as 2 years via nebulization, but lacks FDA-approved labeling for children under 6 years, highlighting the need for careful dosing and monitoring 4