Pediatric Paracetamol Dosing for a 13kg Child Using Suppository
The recommended dose of paracetamol suppository for a 13kg child is 15mg/kg, which equals 195mg per dose, given every 6 hours as needed, with a maximum of 60mg/kg/day (780mg total daily dose).
Dosing Calculation
For a child weighing 13kg:
- Single dose: 15mg/kg × 13kg = 195mg per dose
- Maximum daily dose: 60mg/kg/day × 13kg = 780mg per day
- Dosing interval: Every 6 hours (maximum 4 doses in 24 hours)
Practical Administration
When using suppositories, select the closest available strength to 195mg. Common pediatric suppository strengths include:
- 125mg suppository (slightly underdosed)
- 250mg suppository (slightly overdosed)
If using a 250mg suppository, consider:
- This provides approximately 19.2mg/kg per dose (slightly above the target dose)
- Still within safe dosing parameters
- Do not cut suppositories as this can lead to inaccurate dosing
Safety Considerations
- Do not exceed 4 doses in 24 hours
- Maintain minimum 6-hour intervals between doses
- Track administration times carefully to avoid accidental overdosing
- The total daily dose should never exceed 60mg/kg/day (780mg for this child)
Clinical Pearls
- Paracetamol suppositories have slower and more irregular absorption compared to oral forms 1
- Suppositories are particularly useful when oral administration is not possible (vomiting, NPO status)
- For fever, paracetamol should be used when the fever is causing discomfort, not solely to reduce temperature 2
- If inadequate response to paracetamol alone, ibuprofen may be considered as an alternative or adjunct therapy 2
Cautions
- Avoid exceeding recommended doses as paracetamol can cause hepatotoxicity in overdose
- Single ingestions of more than ten times the recommended dose are potentially toxic 3
- Exposures greater than 140mg/kg/day for several days carry risk of serious toxicity 3
- Document all doses given to avoid accidental overdosing
This dosing recommendation aligns with established pediatric dosing guidelines that recommend 15mg/kg every 6 hours, up to a maximum of 60mg/kg/day for children 1.