What is the appropriate salbutamol syrup dose for an 11‑month‑old infant?

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Salbutamol Syrup Dosing for 11-Month-Old Infant

For an 11-month-old infant, salbutamol syrup should be dosed at 0.1 mg/kg per dose (equivalent to approximately 0.4 mL/kg of standard 2 mg/5 mL syrup), given 3-4 times daily as needed for bronchospasm. 1

Weight-Based Dosing Approach

  • For infants under 1 year, weight-based dosing is essential rather than fixed doses, as elimination pathways differ significantly from older children and adults 2
  • For a typical 11-month-old weighing approximately 9-10 kg, this translates to 0.9-1.0 mg per dose (approximately 2.25-2.5 mL of 2 mg/5 mL syrup) 1
  • The dose can be administered every 4-6 hours as needed for routine bronchospasm 1

Acute Exacerbation Dosing

  • For acute severe bronchospasm or wheezing, the dose is higher: 0.15 mg/kg (minimum 2.5 mg) every 20 minutes for 3 doses, then every 1-4 hours as needed 1
  • This would be approximately 1.5 mg (3.75 mL of 2 mg/5 mL syrup) for a 10 kg infant during acute episodes 1

Administration Considerations

  • Use an accurate measuring device such as a 3-mL or 5-mL oral syringe for precise measurement in infants, rather than household spoons 3
  • Nebulized salbutamol (0.63 mg/3 mL) may be preferred over syrup for children under 5 years with acute symptoms, as it provides more rapid bronchodilation with fewer systemic side effects 1, 4

Important Clinical Caveats

  • Monitor for dose-related side effects including tachycardia, tremor, and irritability, which increase with higher doses 4
  • Infants have prolonged elimination half-lives compared to adults, necessitating careful dose titration based on clinical response 2
  • Nebulized formulations are generally preferred over oral syrup in this age group when available, as they provide superior bronchodilation with reduced systemic absorption 4, 5

References

Guideline

Duoneb Dosing in Pediatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Lactulose Administration in Infants

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Salbutamol: tablets, inhalational powder, or nebuliser?

British medical journal (Clinical research ed.), 1981

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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