Paracetamol (Acetaminophen) Dosage for Children
The recommended paracetamol (acetaminophen) dosage for children is 10-15 mg/kg every 4-6 hours, not to exceed 5 doses in a 24-hour period, with specific age-based dosing guidelines available for children over 2 years of age. 1
Age-Based Dosing Guidelines
| Age | Dose | Maximum Frequency |
|---|---|---|
| Children under 2 years | Consult a doctor | N/A |
| Children 2 to under 4 years | 5 mL (160 mg) | Every 4 hours, max 5 doses/24 hours |
| Children 4 to under 6 years | 7.5 mL (240 mg) | Every 4 hours, max 5 doses/24 hours |
| Children 6 to under 12 years | 10.15 mL (325 mg) | Every 4 hours, max 5 doses/24 hours |
| Children 12 years and over | 20.3 mL (650 mg) | Every 4-6 hours, max 6 doses/24 hours |
Weight-Based Dosing Approach
For more precise dosing, especially for younger children or those with weights outside typical ranges for their age:
- Standard dose: 10-15 mg/kg per dose 2, 3
- Maximum daily dose: Should not exceed 75 mg/kg/day 4
- Dosing interval: Every 4-6 hours as needed
- Maximum doses per day: 4-5 doses depending on interval
Important Safety Considerations
Overdose Prevention
- Never exceed the recommended daily maximum dose of 75 mg/kg/day 4
- Consider potential liver injury when a child has received more than 75 mg/kg/day for at least 2 days 4
- Single ingestions of more than ten times the recommended dose are potentially toxic 2
Special Populations
- For children under 2 years: Always consult a doctor before administration 1
- For children with hepatic insufficiency: Paracetamol is contraindicated 5
- For children with renal insufficiency: Paracetamol is generally safe without dose adjustment 5
Monitoring
- Monitor for signs of liver toxicity if high doses have been administered, including:
- Vomiting
- Right upper quadrant abdominal pain
- Jaundice
- Elevated liver enzymes
Administration Routes
- Oral route (tablets, liquid): Preferred for most situations
- Rectal route (suppositories): May have more erratic absorption compared to oral formulations 5
- Effervescent tablets: Provide more rapid absorption than conventional tablets 5
Clinical Efficacy
- Paracetamol is effective for both fever and mild to moderate pain in children 2
- For fever: A 10-15 mg/kg dose can reduce temperature by approximately 1.5°C for up to 6 hours 6
- For optimal antipyretic effect, plasma concentrations between 4-18 mg/L are recommended 6
Remember that fever alone does not necessarily require treatment, but paracetamol can be used when fever is associated with discomfort or pain 2. Always use the appropriate measuring device provided with the medication to ensure accurate dosing.