What is the appropriate acetaminophen (paracetamol) dosing for pediatric patients?

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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 recommended paracetamol dosing for kids is as follows:

  • Children 6 to under 12 years of age: 10.15 mL (325 mg) every 4 hours, not to exceed 5 doses in a 24-hour period
  • Children 4 to under 6 years of age: 7.5 mL (240 mg) every 4 hours, not to exceed 5 doses in a 24-hour period
  • Children 2 to under 4 years of age: 5 mL (160 mg) every 4 hours, not to exceed 5 doses in a 24-hour period
  • Children under 2 years of age: consult a doctor 1

From the Research

Paracetamol dosing for children should be based on the child's weight rather than age for accuracy, with a recommended dose of 10-15 mg per kilogram of body weight every 4-6 hours, as supported by the most recent and highest quality study 2. The recommended dose is based on the child's weight to ensure accurate dosing.

  • The dose should not exceed 60 mg/kg/day or 4,000 mg per day (whichever is less) 3.
  • Children's paracetamol is available in various forms including liquid suspensions (typically 120 mg/5 mL or 250 mg/5 mL), chewable tablets, and suppositories.
  • Always use the measuring device provided with liquid formulations to ensure accurate dosing.
  • Paracetamol works by inhibiting prostaglandin synthesis in the central nervous system, reducing fever and pain.
  • If your child's fever persists beyond 3 days, or if pain continues beyond 5 days despite paracetamol use, consult a healthcare provider 2.
  • Always store medication out of children's reach and check expiration dates before administration. The most recent study 2 compared acetaminophen with ibuprofen for the treatment of fever or pain in children younger than 2 years and found that ibuprofen resulted in reduced temperature and less pain within the first 24 hours of treatment, with equivalent safety.
  • However, the study also noted that acetaminophen is still a commonly used and effective medication for fever and pain in children.
  • The study's findings support the use of paracetamol as a first-line treatment for fever and pain in children, with a recommended dose of 10-15 mg per kilogram of body weight every 4-6 hours.

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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