From the FDA Drug Label
2.3 Recommended Dosage: Children Children 2 to 12 years of age: the recommended dosage of OFIRMEV is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of OFIRMEV of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of acetaminophen of 75 mg/kg per day.
2.4 Recommended Dosage For Treatment of Fever in Neonates and Infants Neonates, including premature neonates born at ≥ 32 weeks gestational age, up to 28 days chronological age: the recommended dosage of OFIRMEV is 12.5 mg/kg every 6 hours, to a maximum daily dose of acetaminophen of 50 mg/kg per day, with a minimum dosing interval of 6 hours. Infants 29 days to 2 years of age: the recommended dosage of OFIRMEV is 15 mg/kg every 6 hours, to a maximum daily dose of acetaminophen of 60 mg/kg per day, with a minimum dosing interval of 6 hours.
The dose of pediatric IV tylenol is:
- Children 2 to 12 years of age: 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of 15 mg/kg and a maximum daily dose of 75 mg/kg per day.
- Neonates (up to 28 days chronological age): 12.5 mg/kg every 6 hours, with a maximum daily dose of 50 mg/kg per day.
- Infants (29 days to 2 years of age): 15 mg/kg every 6 hours, with a maximum daily dose of 60 mg/kg per day. 1
From the Research
The recommended dose of intravenous (IV) acetaminophen (Tylenol) for pediatric patients is 15 mg/kg every 6 hours, with a maximum daily dose of 75 mg/kg (not to exceed 3,750 mg per day) for children weighing less than 50 kg, and 1,000 mg every 6 hours for children weighing 50 kg or more, with a maximum daily dose of 4,000 mg 2.
Key Considerations
- For neonates and infants up to 2 years, a reduced dose of 12.5 mg/kg every 6 hours is often recommended.
- IV acetaminophen should be administered as a 15-minute infusion.
- This medication works by inhibiting prostaglandin synthesis in the central nervous system and blocking pain impulse generation, providing antipyretic and analgesic effects without the gastrointestinal side effects associated with NSAIDs.
- Liver function should be monitored with prolonged use, and the medication should be used cautiously in patients with hepatic impairment.
Mechanism of Action
- Acetaminophen-induced liver injury is a major concern, and the mechanisms underlying this injury are complex, involving mitochondrial oxidative stress, phase I/II metabolism, and other cellular processes 3.
- However, the use of acetaminophen in patients with hepatic dysfunction is generally considered safe, especially when used at recommended doses and with careful monitoring of liver function 4.
Clinical Implications
- The choice of analgesic should be based on individual patient needs and medical history, taking into account the potential risks and benefits of each medication.
- In pediatric patients, the use of IV acetaminophen can provide effective pain relief and reduce the risk of gastrointestinal side effects associated with NSAIDs.
- Close monitoring of liver function and adjustment of the dose as needed can help minimize the risk of acetaminophen-induced liver injury.