What is the recommended dose of ibuprofen (nonsteroidal anti-inflammatory drug (NSAID)) for children?

Recommended Ibuprofen Dosage for Children

For children, the recommended ibuprofen dosage is 5-10 mg/kg per dose given every 6-8 hours, not to exceed 40 mg/kg per day. 1

Dosage Guidelines by Age and Weight

Infants 3-6 months

• Dosage: 5-10 mg/kg per dose
• Frequency: Every 6-8 hours as needed
• Maximum daily dose: 30-40 mg/kg
• Important: Only use in infants >3 months with body weight above 5-6 kg, with special attention to hydration 1

Children 6 months to 12 years

• Dosage: 5-10 mg/kg per dose
• Frequency: Every 6-8 hours (maximum 3-4 doses per day)
• Maximum daily dose: 40 mg/kg or 2400 mg, whichever is less

Weight-based dosing for children

• <15 kg (33 lb): 30 mg per dose
• 15-23 kg (33-50.6 lb): 45 mg per dose
• 23-40 kg (50.6-88 lb): 60 mg per dose
• >40 kg (88 lb): 75 mg per dose or adult dosing 2

Administration Considerations

• Oral route is preferred over rectal administration, as rectal absorption can be erratic, especially in young infants 1
• Take with food to minimize gastrointestinal side effects
• Liquid formulations are preferred for younger children for dosing accuracy
• Maximum effect occurs 3-4 hours after administration 3

Clinical Efficacy

Ibuprofen has been shown to be:

• As effective or more effective than acetaminophen for fever reduction and pain relief
• Longer duration of action compared to acetaminophen
• Maximum fever reduction occurs 3-4 hours after administration 3

Safety Considerations

• Ibuprofen is generally well-tolerated in children and appears to have better tolerance in children than adults 3
• Short-term use is considered safe in infants older than 3 months weighing more than 5-6 kg 1
• Avoid in children with:
  • Dehydration
  • Renal impairment
  • Bleeding disorders
  • Aspirin/NSAID-induced asthma 4
  • History of gastrointestinal bleeding

Common Pitfalls to Avoid

1. Dosing errors: Always calculate dose based on weight, not just age
2. Dehydration risk: Ensure adequate hydration, especially in febrile children
3. Exceeding maximum doses: Studies show 11% of children receive excessive ibuprofen doses 2
4. Combining with other NSAIDs: Avoid giving multiple NSAID medications simultaneously
5. Prolonged use: Ibuprofen is intended for short-term use; consult healthcare provider for use >3 days

Pharmacokinetics in Children

• Absorption is rapid with peak serum concentrations reached within 1.1-1.2 hours
• Elimination half-life is approximately 1.6 hours
• Clearance is about 1.2-1.4 ml/min/kg
• Pharmacokinetics appear similar between 5 mg/kg and 10 mg/kg doses 5
• No significant relationship between age (3-10 years) and ibuprofen kinetics 5

Ibuprofen's favorable pharmacokinetic profile, including short half-life and lack of toxic metabolites, contributes to its good safety profile when used appropriately in pediatric patients 6.