Tulobuterol Hydrochloride

Adults: Long-term clinical studies have shown that tulobuterol continues to be effective and does not lead to cumulative or toxic side effects. Because the disease varies from patient to patient and dosage needs must be individualized, flexibility in dosing is essential. Long-acting beta agonists should not be used without an asthma controller medication such as an inhaled corticosteroid, and they should be used for the shortest time needed to bring asthma symptoms under control, being discontinued if possible once control is achieved; the patient should then continue on a long-term asthma controller medication such as a corticosteroid. Tablets: the usual oral adult dose of tulobuterol is one 2 mg tablet twice a day. A convenient starting dose for children aged 12 years and over and for adults is 1 mg twice a day, particularly for elderly patients and those with a history of sensitivity to beta-adrenergic agents. Unless drug-related side effects rule it out, the dose may be increased after seven to ten days to 2 mg twice a day if a greater therapeutic response is needed. Although most patients can be maintained on 1 to 2 mg twice daily, differences in patient response and symptom severity may call for further dose adjustment, as with any bronchodilator treatment. If necessary, the adult dose of tulobuterol may therefore be increased to 6 mg a day in divided doses according to clinical response. Syrup: based on dose-ranging studies in children, the usual dose of tulobuterol syrup (1 mg/5 mL) for children is 40 to 80 mcg/kg/day in two divided doses. Clinical studies in children have found effective doses ranging from 20 to 100 mcg/kg/day. This gives the following age-based recommendations: for children aged one to six years, 0.25 tsp (1.25 mL) to 0.5 tsp (2.5 mL) bid; for children aged six to twelve years, 0.5 tsp (2.5 mL) to 1 tsp (5 mL) bid; for children over twelve years, 1 tsp (5 mL) to 2 tsp (10 mL) bid. These age-based doses may need to be adjusted according to how the patient responds.