Recommended Dose of Levolin (Levosalbutamol) Nebulizer Solution
The recommended dose of Levolin (levosalbutamol) nebulizer solution for children is 0.075 mg/kg (minimum dose 1.25 mg) administered every 20 minutes for the first 3 doses, then every 1-4 hours as needed, up to a maximum of 5 mg per dose. 1
Dosing Guidelines by Age
- For children aged 3-11 years with acute asthma exacerbations, the initial dose is 0.075 mg/kg (minimum dose 1.25 mg) via nebulizer 1
- For very young children (under 5 years), half doses may be appropriate when initiating therapy 1
- For children under 12 years old, 0.25 mg nebulized every 20 minutes for up to 3 doses is recommended 2
- For children 12 years and older, 0.5 mg nebulized every 20 minutes for up to 3 doses is recommended 2
Administration Guidelines
- Levosalbutamol nebulizer solution should be delivered via oxygen-driven nebulizer when possible, especially in acute severe asthma 2, 1
- A gas flow of 6-8 L/min with a minimum dilution of 3 mL should be used for optimal delivery 1
- The solution can be mixed with ipratropium bromide for nebulization in cases of severe asthma 2
Special Situations
- For severe or life-threatening asthma exacerbations, consider more frequent administration (up to every 20 minutes) 1
- In severe cases, combining with ipratropium bromide (250 μg every 20 minutes for 3 doses) is recommended 1
- For patients with brittle asthma who develop sudden severe attacks, a higher dose of 5 mg may be required 2
Important Considerations
- Monitor for side effects including tremor (1%), palpitation (0.9%), and vomiting (0.7%), which are typically mild and transient 3
- Levosalbutamol has been shown to have a more favorable safety profile compared to racemic albuterol, with fewer effects on heart rate, QTc interval, and glucose levels at lower doses 4
- For regular treatment at home, consider alternative delivery methods such as metered dose inhaler with spacer before resorting to nebulizer therapy 1
Clinical Efficacy
- Levosalbutamol at lower doses (0.31 mg and 0.63 mg) has demonstrated efficacy comparable to 4-8 fold higher doses of racemic albuterol in children with asthma 4
- In children with severe asthma, a dose-response relationship has been observed for levosalbutamol, indicating that higher doses may be more effective 4
This dosing recommendation is based on guidelines from the American Academy of Allergy, Asthma, and Immunology and the British Thoracic Society, which provide evidence-based guidance for the use of levosalbutamol in pediatric patients with respiratory conditions requiring bronchodilator therapy.