What are the maximum doses of continuous albuterol?
Inpatient asthma team recommendation:
EPR-3 (2007) recommends the following dosages for intermittent and continuous albuterol:
Child dose (≤ 12 years of age)—0.15 mg/kg (minimum dose 2.5 mg) every 20 minutes for 3 doses then 0.15 to 0.3 mg/kg up to 10 mg every 1 to 4 hours as needed, or 0.5 mg/kg/hour by continuous nebulization with a maximum of 10 mg/hour continuously.
Adult dose (> 12 years of age)—2.5 to 5 mg every 20 minutes for 3 doses, then 2.5 to 10 mg every 1 to 4 hours as needed, or 10 to 15 mg/hour continuously.
EPR-3 (2007) recommends only selective beta2-agonists (albuterol, levalbuterol, pirbuterol). For optimal delivery, dilute aerosols to minimum of 3 mL at gas flow of 6–8 L/min. Use large volume nebulizers for continuous albuterol administration. The inpatient asthma team concurs with these recommendations, including the use of 15 mg/hour as the maximum dose per hour of continuous albuterol. The inpatient asthma team values amelioration of symptoms while minimizing adverse effects of the medication. This is a strong recommendation based on high quality evidence (EPR-3, 2007).