Pseudoephedrine Dosing for a 12-Year-Old Girl Weighing 90 Pounds
For a 12-year-old girl weighing 90 pounds (approximately 41 kg), the recommended dose of pseudoephedrine is 1 tablet (30 mg) every 4 to 6 hours, not exceeding 4 tablets in 24 hours. 1
Dosing Guidelines
The FDA-approved labeling for pseudoephedrine provides clear guidance for pediatric dosing:
- Ages 12 years and older: 2 tablets (60 mg) every 4-6 hours, maximum 8 tablets in 24 hours
- Ages 6-11 years: 1 tablet (30 mg) every 4-6 hours, maximum 4 tablets in 24 hours
- Under 6 years: Not recommended 1
While this patient is 12 years old (which would typically place her in the adult dosing category), her weight of 90 pounds (41 kg) is more consistent with the typical weight of a younger child. Given her weight, the more appropriate dose would be the 6-11 years recommendation of 1 tablet (30 mg) every 4-6 hours.
Safety Considerations
When administering pseudoephedrine to pediatric patients, several important safety considerations should be kept in mind:
Cardiovascular effects: Pseudoephedrine can cause mild increases in heart rate, though research shows that at standard doses, it does not significantly affect blood pressure even in patients with controlled hypertension 2
CNS stimulation: As a sympathomimetic amine, pseudoephedrine may cause central nervous system stimulation, potentially resulting in insomnia, irritability, or restlessness 3
Timing of doses: Avoid administering pseudoephedrine in the evening as it may interfere with sleep
Duration of use: Limit use to the shortest duration necessary to control symptoms, typically no more than 3-5 days
Efficacy
Pseudoephedrine is effective for treating nasal congestion associated with common cold, allergies, and sinusitis. Research demonstrates that it significantly reduces nasal airway resistance compared to placebo, with effects beginning within hours of administration 4.
Contraindications and Precautions
Pseudoephedrine should be used with caution in patients with:
- Hypertension
- Cardiovascular disease
- Hyperthyroidism
- Diabetes
- Closed-angle glaucoma
- Prostatic hypertrophy
Additionally, pseudoephedrine should not be used concurrently with MAO inhibitors or within 14 days of stopping such treatment.
Regulatory Considerations
Due to its potential for misuse as a precursor in methamphetamine production, pseudoephedrine is subject to sales restrictions in many jurisdictions 3. Parents should be advised that identification may be required for purchase, and quantities may be limited.
Alternative Options
If pseudoephedrine is contraindicated or not well-tolerated, consider:
- Saline nasal sprays
- Nasal irrigation
- Topical intranasal corticosteroids (for allergic rhinitis)
- Antihistamines (for allergic symptoms)
Remember that pseudoephedrine treats only the symptom of nasal congestion and not the underlying cause of the condition.