• Klaus Bønnelykke, Jakob Jessing Jespersen, and Hans Bisgaard.
• Danish Pediatric Asthma Center; Copenhagen University Hospital, Gentofte, Copenhagen, Denmark. kb@copsac.dk
• Br J Clin Pharmacol. 2007 Aug 1; 64 (2): 241-4.

AimsTo determine the effect of age on systemic exposure to inhaled salbutamol in children.MethodsFifty-eight asthmatic children, aged 3-16 years, inhaled 400 microg of salbutamol from a pressurized metered dose inhaler with spacer. The 20 min serum profile was analyzed.ResultsPrescribing a dose on a microg kg(-1) basis caused reduced systemic exposure in young children (Y) compared with older children (O) (C(max-microg kg(-1)-adjusted) Y : O ratio (95%CI) = 0.55 (0.47, 0.65)) whereas a fixed nominal dose irrespective of age caused increased exposure in young children (C(max) Y : O ratio (95%CI) = 1.7 (1.3, 2.2)).ConclusionsFor similar systemic exposure, dosing should be adjusted to age or size but not on a fixed microg kg(-1) basis, which may lead to unnecessary suboptimal dosing.

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