Ascoril LS Syrup Dosage
Ascoril LS syrup should be dosed at 5-10 mL three times daily for adults and 2.5-5 mL three times daily for children over 6 years, based on the levosalbutamol component dosing of 0.075 mg/kg (minimum 1.25 mg) per dose. 1
Understanding Ascoril LS Components
Ascoril LS contains levosalbutamol (a bronchodilator) and guaifenesin (an expectorant). The dosing is primarily determined by the levosalbutamol component, which requires careful weight-based calculation. 1, 2
Pediatric Dosing (Children ≥6 years)
- Weight-based calculation: 0.075 mg/kg of levosalbutamol per dose, with an absolute minimum of 1.25 mg regardless of calculated dose 1, 2
- Practical dosing: This typically translates to 2.5-5 mL three times daily, depending on the specific formulation concentration 1
- Frequency: Administer every 6-8 hours (three times daily) for routine management 1, 2
- Maximum daily doses: Up to 5 mg of levosalbutamol per dose in severe cases, though this is reserved for acute exacerbations under medical supervision 2
Adult Dosing
- Standard dose: 5-10 mL three times daily 1, 2
- Levosalbutamol content: Adults typically require 1.25-2.5 mg per dose 1
- Frequency: Every 6-8 hours for maintenance therapy 2
Acute Exacerbation Dosing
For acute respiratory symptoms requiring more aggressive treatment:
- Initial phase: The levosalbutamol component can be given every 20 minutes for up to 3 doses, then adjusted to every 1-4 hours based on clinical response 1, 2
- Severe cases: Consider nebulized levosalbutamol (0.25 mg for children <12 years, 0.5 mg for ≥12 years) every 20 minutes for 3 doses instead of oral syrup 2
- Critical point: Oral/syrup formulations are NOT recommended for acute asthma exacerbations—nebulized or inhaled routes are strongly preferred due to faster onset and better efficacy 3
Administration Guidelines
- With or without food: Can be administered with meals to improve gastrointestinal tolerability 4
- Dilution: Not typically required for oral syrup formulations 1
- Duration: Treatment courses typically last 5-7 days for acute respiratory infections, though chronic conditions may require longer therapy 5, 6
Critical Pitfalls to Avoid
- Do not confuse with salbutamol dosing: Levosalbutamol requires HALF the milligram dose of regular salbutamol (2:1 conversion ratio) 1, 3
- Never use oral formulations for acute severe asthma: Nebulized or MDI delivery is mandatory for acute exacerbations, as oral routes are slower and less effective 3
- Monitor for side effects: Watch for tachycardia, tremor, and hypokalemia, especially with frequent dosing 1, 3
- Age restrictions: Most formulations are not recommended for children under 6 years without specific medical supervision 1, 2
Monitoring Parameters
- Clinical response: Assess cough severity, sputum production, and breathlessness after each dose 6, 7
- Cardiovascular effects: Monitor heart rate, especially in patients with pre-existing cardiac conditions 1
- Respiratory status: Track respiratory rate, work of breathing, and oxygen saturation if available 3
Special Populations
- Cardiovascular disease: Use with caution and consider lower doses 1
- Diabetes mellitus: Monitor blood glucose as beta-agonists can cause hyperglycemia 1
- Hyperthyroidism: Use cautiously due to potential for increased sympathetic activity 1
Evidence Quality Note
The specific dosing for Ascoril LS syrup is derived from levosalbutamol dosing guidelines established by the American Academy of Pediatrics and other major respiratory societies 1, 2. The guaifenesin component (typically 50-100 mg per 5 mL) has established safety at doses of 200-400 mg every 4 hours in adults 8. Clinical studies demonstrate good efficacy and tolerability of combination formulations containing levosalbutamol with mucolytics/expectorants 7, 9.