Recommended Pediatric Dosage of Diclofenac (Rofenac)
The recommended pediatric dosage of diclofenac (Rofenac) is 1-3 mg/kg/day divided into 2-3 doses, with a maximum daily dose not exceeding 150 mg for children.
Dosage Guidelines by Age and Weight
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) of the phenylacetic acid class used for its analgesic and anti-inflammatory properties. When prescribing diclofenac to pediatric patients, dosing should be carefully calculated based on weight:
Weight-Based Dosing
- Children ≤15 kg: 1 mg/kg/day divided into 2-3 doses
- Children >15-30 kg: 1-2 mg/kg/day divided into 2-3 doses
- Children >30 kg: 2-3 mg/kg/day divided into 2-3 doses (not to exceed 150 mg daily)
Age-Based Considerations
- Children <1 year: Not recommended due to limited safety and efficacy data
- Children 1-12 years: Weight-based dosing as above
- Children >12 years: Adult dosing may be appropriate (50-75 mg 2-3 times daily)
Administration Recommendations
Diclofenac should be administered with food or milk to minimize gastrointestinal side effects. The medication is available in various formulations:
- Tablets (25 mg, 50 mg, 75 mg)
- Enteric-coated tablets
- Suppositories (for children who cannot take oral medication)
- Injectable forms (for hospital use)
Clinical Considerations and Precautions
Important Monitoring Parameters
- Renal function
- Hepatic function
- Gastrointestinal symptoms
- Blood pressure
Contraindications
- History of hypersensitivity to diclofenac or other NSAIDs
- Active peptic ulcer disease
- Severe renal or hepatic impairment
- History of asthma exacerbated by NSAIDs
Common Side Effects in Pediatric Population
- Gastrointestinal disturbances (nausea, vomiting, abdominal pain)
- Headache
- Dizziness
- Rash
Special Considerations
Unlike some medications that have established pediatric dosing guidelines published by major health organizations, diclofenac dosing for children must be carefully calculated based on weight and clinical situation 1. The pharmacokinetics of diclofenac in children is similar to adults, with rapid absorption and a relatively short half-life of approximately 1.5 hours 1, 2.
For children with renal impairment, dose adjustment may be necessary. However, for most children with normal renal function, standard weight-based dosing is appropriate 1.
Alternative Calculation Method
For practitioners who prefer an alternative calculation method:
- For children up to 30 kg: Use (weight × 2)% of adult dose
- For children over 30 kg: Use (weight + 30)% of adult dose 3
This method follows the body surface area curve more closely than strict mg/kg dosing and may help prevent prescription errors.
Remember that diclofenac, like all NSAIDs, carries risks of gastrointestinal, renal, and cardiovascular adverse effects. The lowest effective dose should be used for the shortest duration necessary to control symptoms.