From the FDA Drug Label
Directions Do not take more than directed (see overdose warning) Use the following dosage guidelines when using this product AGEDOSE Adults and children 12 years of age and over20.3 mL (650 mg) every 4 to 6 hours Not to exceed 6 doses in a 24-hour period Children 6 to under 12 years of age10.15 mL (325 mg) every 4 hours Not to exceed 5 doses in a 24-hour period Children 4 to under 6 years of age7.5 mL (240 mg) every 4 hours Not to exceed 5 doses in a 24-hour period Children 2 to under 4 years of age5 mL (160 mg) every 4 hours Not to exceed 5 doses in a 24-hour period Children under 2 years of ageConsult a doctor
The pediatric paracetamol dose calculation is based on the child's age. The recommended doses are:
- Children 12 years of age and over: 20.3 mL (650 mg) every 4 to 6 hours
- Children 6 to under 12 years of age: 10.15 mL (325 mg) every 4 hours
- Children 4 to under 6 years of age: 7.5 mL (240 mg) every 4 hours
- Children 2 to under 4 years of age: 5 mL (160 mg) every 4 hours
- Children under 2 years of age: consult a doctor 1
From the Research
The recommended pediatric dose of paracetamol (acetaminophen) is 10-15 mg/kg per dose given every 4-6 hours as needed, with a maximum of 5 doses (60-75 mg/kg/day) in a 24-hour period. To calculate the correct dose, multiply the child's weight in kilograms by the dose in mg/kg. For example, for a 20 kg child, the dose would be 200-300 mg per dose. Paracetamol comes in various formulations including liquid suspensions (typically 120 mg/5 mL or 250 mg/5 mL), tablets (500 mg), and suppositories (various strengths). Always check the concentration of the specific product being used to ensure accurate dosing. Measure liquid medications with a proper measuring device like an oral syringe or medicine cup, not household spoons.
Key Considerations
- Paracetamol works by inhibiting prostaglandin synthesis in the central nervous system and peripherally blocking pain impulse generation, effectively reducing fever and relieving pain 2.
- Overdosing can cause liver damage, so it's crucial to calculate doses carefully and not exceed the maximum daily dose.
- For infants under 3 months, consult a healthcare provider before administering paracetamol.
- Recent studies suggest that ibuprofen may be more effective than paracetamol in reducing fever and pain in children, but paracetamol is still a commonly used and effective option 2, 3.
Administration and Safety
- Always follow the recommended dosage and administration instructions for paracetamol.
- Monitor children for signs of overdose or adverse reactions, such as nausea, vomiting, or abdominal pain.
- Be aware of potential interactions with other medications, such as warfarin or aspirin.
Evidence-Based Recommendations
- The most recent and highest-quality study on this topic is a systematic review and meta-analysis published in 2020, which compared the efficacy and safety of acetaminophen and ibuprofen in children younger than 2 years 2.
- This study found that ibuprofen was associated with reduced temperature and less pain within the first 24 hours of treatment, with equivalent safety to acetaminophen. However, the recommended pediatric dose of paracetamol remains 10-15 mg/kg per dose given every 4-6 hours as needed, with a maximum of 5 doses (60-75 mg/kg/day) in a 24-hour period.