Reswas Syrup Dosing for a 35kg Adolescent
Based on the formulation of Reswas syrup (containing levodropropizine and chlorpheniramine), a 35kg adolescent should receive 10 mL three times daily for the levodropropizine component, combined with 5 mg of chlorpheniramine every 6-8 hours as needed (not to exceed 4 doses in 24 hours). 1, 2
Levodropropizine Component
The standard adult dose of levodropropizine is 75 mg three times daily, which translates to approximately 10 mL of typical levodropropizine syrup formulations (usually 6 mg/mL concentration) 1
For a 35kg adolescent (approaching adult weight), the adult dosing regimen is appropriate, as levodropropizine demonstrates equal efficacy to other antitussives like dihydrocodeine with a favorable safety profile 1
Levodropropizine acts as a peripherally acting antitussive, avoiding the central nervous system and respiratory depression risks associated with codeine-containing products 1
Chlorpheniramine Component
For adolescents over 12 years old (which a 35kg patient typically is), the recommended chlorpheniramine dose is 5 mg every 6-8 hours as needed 2
The maximum daily dose should not exceed 4 doses in 24 hours (20 mg total daily) 2
Monitor for excessive somnolence, particularly after initial doses, as this is the primary dose-limiting side effect 2
Critical Safety Considerations
Avoid codeine-containing cough preparations entirely in pediatric populations, including adolescents, due to variable metabolism and risk of respiratory depression from ultra-rapid metabolizers 3
Dextromethorphan, while having a reassuring safety profile in adults and children, should be used cautiously and is not the active ingredient in Reswas 4, 5
The combination formulation in Reswas has been validated for stability and content uniformity, ensuring consistent dosing 6
Practical Administration
Administer levodropropizine component (10 mL) three times daily, preferably at consistent intervals throughout the day 1
Chlorpheniramine dosing should be spaced at minimum 6-hour intervals, with careful attention to not exceeding 4 doses daily 2
If excessive sedation occurs, consider reducing the chlorpheniramine frequency or dose while maintaining the levodropropizine component 2