How many times a day can a child take acetaminophen (paracetamol)?

Acetaminophen Dosing for Children

Children should receive acetaminophen at a dose of 10-15 mg/kg every 4-6 hours, with no more than 5 doses in 24 hours. 1

Recommended Dosing Schedule

The appropriate dosing of acetaminophen for children depends on the child's weight rather than age, though age-based dosing is often provided on commercial products:

• Dose calculation: 10-15 mg/kg per dose 2, 3
• Frequency: Every 4-6 hours as needed 3
• Maximum doses per day: No more than 5 doses in 24 hours 3
• Maximum daily dose: Should not exceed 75 mg/kg/day or 4000 mg/day, whichever is less

Administration Guidelines

For Infants and Young Children

• Use weight-based dosing whenever possible (10-15 mg/kg)
• Use appropriate measuring devices for liquid formulations
• Do not use adult formulations for children under 12 years
• For infants under 3 months, consult a healthcare provider before administering

For Children 12 Years and Older

• Follow adult dosing instructions: 2 caplets (325 mg each) every 8 hours
• Do not exceed 6 caplets in 24 hours 1
• Do not use for more than 10 days unless directed by a doctor

Common Dosing Errors to Avoid

Research shows that dosing errors are common with acetaminophen administration:

• Up to 51% of parents give inaccurate doses of antipyretics 4
• 62% of acetaminophen doses given by parents are inaccurate 4
• Infants under 1 year are at highest risk for receiving incorrect doses (40% higher risk) 4

Common Pitfalls:

1. Using age-based rather than weight-based dosing
2. Using kitchen spoons instead of calibrated measuring devices
3. Confusing different formulation concentrations
4. Administering doses too frequently
5. Exceeding the maximum daily dose

Safety Considerations

• Exceeding recommended doses can lead to liver toxicity
• Parents should record all dose times to avoid accidental overdosing
• When using multiple antipyretics (like acetaminophen and ibuprofen), carefully track each medication separately
• If fever persists beyond 72 hours despite appropriate dosing, seek medical attention

Alternative Options

If acetaminophen alone is insufficient for fever control, ibuprofen may be considered:

• Ibuprofen dosing: 10 mg/kg every 6-8 hours 5
• Some evidence suggests ibuprofen may be more effective for fever reduction 5
• In certain cases, alternating acetaminophen and ibuprofen may provide additional fever-free time, but requires careful tracking of doses 5

Remember that the goal of treatment is symptom relief and improved comfort, not necessarily normalization of temperature. Always consult a healthcare provider if fever is accompanied by concerning symptoms or persists despite appropriate treatment.