What is the recommended dose of acetaminophen (Tylenol) via suppository for a 2-year-old child weighing 30 pounds?

Acetaminophen Dosing for a 2-Year-Old Child Weighing 30 Pounds (Suppository)

For a 2-year-old child weighing 30 pounds (13.6 kg), the recommended acetaminophen suppository dose is 10-15 mg/kg every 4-6 hours, which equals 136-204 mg per dose, with a maximum of 5 doses in 24 hours.

Dosing Calculation

The appropriate acetaminophen dosing should be calculated based on the child's weight:

• Child's weight: 30 pounds = 13.6 kg
• Recommended dosage range: 10-15 mg/kg 1, 2, 3
• Calculated dose range: 136-204 mg per dose

Available Suppository Strengths

Acetaminophen suppositories typically come in the following strengths:

• 80 mg (infant)
• 120 mg (infant/child)
• 325 mg (junior/adult)
• 650 mg (adult)

Specific Dosing Recommendation

For this 30-pound child:

• Use a 120 mg suppository, or
• Use a 160 mg suppository if available
• Do not exceed 5 doses in 24 hours
• Allow at least 4-6 hours between doses

Important Considerations

Efficacy

• Research shows that doses less than 10 mg/kg may be inadequate for fever reduction 2, 4
• A dose of 15 mg/kg has been shown to be more effective than 10 mg/kg for antipyretic effect 2
• Plasma concentrations between 10-20 μg/mL are required for optimal antipyretic effect 4

Administration

• Suppositories may have slightly less consistent absorption compared to oral suspension, but still provide effective antipyretic action 2
• If the exact calculated dose is not available in suppository form, select the closest available strength without exceeding the maximum recommended dose

Safety Precautions

• Never exceed 5 doses in 24 hours
• Keep track of all doses given to avoid accidental overdosing
• Acetaminophen toxicity can cause liver damage, so accurate dosing is essential

Common Pitfalls to Avoid

1. Using age-based rather than weight-based dosing (leads to dosing errors in up to 30% of cases) 4
2. Administering doses too frequently (less than 4 hours apart)
3. Using adult-strength suppositories cut in half (leads to inaccurate dosing)
4. Exceeding the maximum daily dose of 75 mg/kg/day

Alternative Options

If fever persists despite appropriate acetaminophen dosing, consult with a healthcare provider about alternating with ibuprofen (if appropriate for the child's condition), as research suggests this may provide additional fever-free time 5.