What is the recommended dosage for ibuprofen (Nonsteroidal Anti-Inflammatory Drug) in a pediatric patient?

From the Guidelines

The recommended dosage of ibuprofen for pediatric patients is 7.5–10 mg/kg once a day (oral) as stated in the British Thoracic Society guidelines 1. This dosage is recommended for children, and it's essential to note that the dosing should be based on the child's weight rather than age whenever possible for accuracy.

• For infants under 6 months, it's crucial to consult a healthcare provider before administration.
• Ibuprofen should be given with food to minimize stomach upset.
• Parents should not exceed the recommended dose or frequency, as this can increase the risk of side effects including stomach irritation, kidney problems, or rarely, liver issues.
• Ibuprofen works by inhibiting prostaglandin synthesis, which reduces inflammation, pain, and fever.
• If fever persists beyond 3 days or pain beyond 5 days, medical evaluation is recommended.
• Ibuprofen should not be given if the child is dehydrated or has certain medical conditions like bleeding disorders or kidney disease. It's also important to use the measuring device provided with the medication to ensure accurate dosing, as stated in general pediatric guidelines, although not explicitly mentioned in 1, this is a standard practice to avoid dosing errors. The evidence from 1 is more recent and specific to the dosage of ibuprofen in pediatric patients, making it the most relevant and reliable source for this recommendation.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION ... Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain. The recommended dosage for ibuprofen in a pediatric patient is not explicitly stated in the provided drug label.

• Pediatric dosage is not directly mentioned in the label.
• The label provides dosage information for rheumatoid arthritis, osteoarthritis, mild to moderate pain, and dysmenorrhea, but does not specify pediatric dosages. 2

From the Research

Recommended Dosage for Ibuprofen in Pediatric Patients

The recommended dosage for ibuprofen in pediatric patients can be found in several studies:

• The study 3 recommends a dose of 10 mg/kg per dose, with a maximum of three doses in 24 hours, for children aged between 6 months and 6 years.
• Another study 4 suggests that the effective dose range for ibuprofen in children is 7.5-10 mg/kg, with a linear relationship between dose and response.

Key Points to Consider

Some key points to consider when administering ibuprofen to pediatric patients include:

• The dose of ibuprofen should be determined by the child's weight, with a recommended dose of 10 mg/kg per dose 3.
• The maximum number of doses of ibuprofen in 24 hours should not be exceeded, with a recommended maximum of three doses in 24 hours 3.
• Ibuprofen has been shown to be effective in reducing fever and relieving pain in children, with a longer duration of action compared to paracetamol 4.
• The adverse effects of ibuprofen are similar to those of other non-steroidal anti-inflammatory drugs, but clinical experience suggests that ibuprofen is better tolerated by children than adults 4.

Comparison with Other Medications

Ibuprofen has been compared to other medications in several studies:

• A study 3 found that ibuprofen was superior to paracetamol in reducing fever and relieving pain in children.
• Another study 4 found that ibuprofen was equally as effective as or more effective than paracetamol as an analgesic and antipyretic, with a longer duration of action.
• A study 5 found that ibuprofen 400 mg was as effective as aspirin 600 or 900 mg/day in models of moderate pain, but superior to aspirin or paracetamol in more sensitive models such as dental pain.