What is the recommended dose of acetaminophen (Tylenol) for a 15-pound infant?

Acetaminophen Dosing for a 15-Pound Infant

The recommended dose of acetaminophen for a 15-pound infant is 10-15 mg/kg every 4-6 hours, which calculates to approximately 70-105 mg per dose, not exceeding 5 doses (525 mg) in 24 hours.

Dosage Calculation

To determine the appropriate acetaminophen dose:

1. Convert weight to kilograms:

   • 15 pounds = 6.8 kg (1 kg = 2.2 pounds)

2. Calculate dose using the recommended range:

   • At 10 mg/kg: 6.8 kg × 10 mg/kg = 68 mg
   • At 15 mg/kg: 6.8 kg × 15 mg/kg = 102 mg

3. Practical dosing (rounded for administration):

   • Appropriate dose range: 70-105 mg every 4-6 hours
   • Maximum daily doses: 5 doses in 24 hours

Evidence-Based Recommendations

The American Academy of Pediatrics supports the 10-15 mg/kg dosing regimen for acetaminophen in infants and children 1. This dosage has been demonstrated to provide effective fever reduction and pain relief while maintaining safety 2.

Research confirms that weight-based dosing (10-15 mg/kg) is more accurate and safer than age-based dosing, which can lead to underdosing or overdosing 3. The 10-15 mg/kg dose produces plasma concentrations that are therapeutic for antipyresis and analgesia 2.

Administration Considerations

• Use an infant-specific formulation (typically 160 mg/5 mL)
• Always use the measuring device provided with the medication
• Do not use household spoons for measurement (leads to dosing errors)
• For a 15-pound infant, the volume would be approximately:
  • At 70 mg: 2.2 mL of 160 mg/5 mL solution
  • At 105 mg: 3.3 mL of 160 mg/5 mL solution

Safety Considerations

• Do not exceed 5 doses in 24 hours
• Maintain at least 4-hour intervals between doses
• The total daily maximum should not exceed 75 mg/kg/day (approximately 525 mg for a 15-pound infant)
• Monitor for signs of liver toxicity, though rare at recommended doses

Common Pitfalls to Avoid

1. Dosing errors: Using adult formulations or "eyeballing" doses without proper measurement tools can lead to significant overdosing 4.

2. Combination products: Avoid giving multiple medications containing acetaminophen simultaneously, as this can lead to unintentional overdosing.

3. Extended use: Limit treatment to the minimum duration needed. Contact a healthcare provider if fever persists beyond 3 days or pain beyond 5 days in infants.

4. Concentration confusion: Different formulations have different concentrations. Always check the concentration before calculating the volume to administer.

By following these weight-based dosing guidelines, you can safely and effectively administer acetaminophen to a 15-pound infant for fever reduction or pain relief.