What is the recommended dose of paracetamol (acetaminophen) for a 10 kg, 2-year-old child?

Paracetamol Dosing for a 10 kg, 2-Year-Old Child

The recommended dose of paracetamol for a 10 kg, 2-year-old child is 160 mg (5 mL) every 4 hours, not to exceed 5 doses in a 24-hour period. 1

Dosing Guidelines

The FDA-approved dosing for paracetamol (acetaminophen) in children 2 to under 4 years of age is:

• 160 mg (5 mL) every 4 hours
• Maximum of 5 doses in a 24-hour period
• Total maximum daily dose: 800 mg

This dosing aligns with the weight-based recommendation of 10-15 mg/kg every 4-6 hours:

• For a 10 kg child at 15 mg/kg: 150 mg per dose
• For a 10 kg child at 10 mg/kg: 100 mg per dose

Administration Considerations

• Oral liquid formulations are most appropriate for this age group
• Ensure proper measuring device is used (oral syringe or dosing cup)
• Do not use household teaspoons as they are inaccurate
• Administer with or without food

Safety Considerations

Potential Risks

• Hepatotoxicity is the primary concern with overdosage
• Single ingestions of more than ten times the recommended dose (>1600 mg in this case) are potentially toxic 2
• Chronic overdosing exceeding 140 mg/kg/day (>1400 mg/day for this child) for several days carries risk of serious toxicity 2

Common Pitfalls to Avoid

1. Dosing errors: Using incorrect concentration or measuring device
2. Frequency errors: Administering doses more frequently than every 4 hours
3. Double-dosing: Administering multiple paracetamol-containing products simultaneously (e.g., combination cold medicines)
4. Extended use: Using for more than 5 days without medical supervision

When to Seek Medical Attention

• If fever persists beyond 3 days
• If pain persists beyond 5 days
• If symptoms worsen
• If new symptoms develop

Evidence Quality

The dosing recommendation is based on FDA-approved guidelines 1, which represent the highest level of evidence for medication dosing. This is supported by research showing that 10-15 mg/kg every 4 hours is the appropriate dosing range for children 3, 4. The recommended maximum of 60 mg/kg/day aligns with international standards to prevent toxicity while maintaining efficacy 2.