Recommended Dosing of Ibuprofen in Pediatric Patients
For pediatric patients, ibuprofen should be dosed at 10 mg/kg every 6-8 hours, with a maximum of 40 mg/kg per day or 1200-1500 mg daily (whichever is less). 1
Age-Specific Dosing Guidelines
Infants (3-6 months)
- Dose: 5-10 mg/kg per dose 2
- Frequency: Every 6-8 hours as needed
- Maximum daily dose: 30-40 mg/kg/day
- Important: Only use in infants >3 months weighing >5-6 kg with adequate hydration 2
Children (6 months to 12 years)
- Dose: 10 mg/kg per dose
- Frequency: Every 6-8 hours (maximum 3-4 doses per 24 hours)
- Maximum daily dose: 40 mg/kg/day, not to exceed 1200 mg/day
Adolescents (>12 years)
- Dose: 10 mg/kg per dose (typically 400-500 mg)
- Frequency: Every 6-8 hours as needed
- Maximum daily dose: 1200-1500 mg/day 1
Weight-Based Dosing Chart
- <15 kg: 60 mg per dose
- 15-23 kg: 90 mg per dose
- 23-40 kg: 120 mg per dose
40 kg: 150-200 mg per dose (not exceeding adult dosing)
Administration Guidelines
- Administer with food to minimize gastrointestinal side effects
- Available formulations:
- Oral suspension: 100 mg/5 mL (infant/children's formulation)
- Chewable tablets: 50 mg, 100 mg
- Tablets/capsules: 200 mg, 400 mg
Clinical Efficacy
- Onset of action: 30-60 minutes
- Duration of action: 6-8 hours for analgesia, 4-8 hours for antipyresis 3
- Maximum temperature reduction occurs 3-4 hours after administration 3
- Studies show ibuprofen is equally or more effective than acetaminophen as both an analgesic and antipyretic 4
Common Dosing Errors to Avoid
- Underdosing: Over 50% of caregivers administer inaccurate doses, particularly with acetaminophen (62%) and in infants under 1 year (higher risk) 5
- Frequency errors: Exceeding the recommended maximum number of doses in 24 hours (observed in 11% of children) 4
- Calculation errors: Weight-based dosing is more accurate than age-based dosing 5
Safety Considerations
- Pharmacokinetics in children 3-10 years appear consistent across the 5-10 mg/kg dose range 6
- Ibuprofen is generally better tolerated by children than adults 3
- Ensure adequate hydration while taking ibuprofen
- Contraindications: hypersensitivity to NSAIDs, active GI bleeding, severe renal impairment
Monitoring
- For fever: If no improvement within 48-72 hours of adequate therapy, further investigation should be performed 7
- For pain: Regular dosing provides better symptom control than as-needed dosing for acute pain 1
When treating pediatric patients with ibuprofen, weight-based dosing is the most accurate method, and parents should be educated about proper dosing to avoid both underdosing and exceeding maximum recommended doses.