Paracetamol Suppository Dosing for Babies
The recommended dose of paracetamol (acetaminophen) suppository for a baby is 10-15 mg/kg every 4-6 hours, not exceeding 60 mg/kg/day.
Dosing by Age Group
Neonates and Infants Under 3 Months
- Dosage: 10-15 mg/kg per dose
- Frequency: Every 6 hours as needed
- Maximum daily dose: 40 mg/kg/day
- Caution: Use with particular care in this age group due to immature hepatic metabolism
Infants 3-12 Months
- Dosage: 15 mg/kg per dose
- Frequency: Every 4-6 hours as needed
- Maximum daily dose: 60 mg/kg/day
- Do not exceed: 4 doses in 24 hours
Administration Guidelines
- Ensure the suppository is at room temperature before insertion
- Insert the suppository into the rectum with the pointed end first
- Hold the buttocks together briefly to prevent expulsion
- If the suppository is too soft, refrigerate for a few minutes before removing from the wrapper
Important Considerations
- Indication: Use for fever above 38.5°C or for pain relief
- Duration: Limit use to 48-72 hours without medical supervision
- Absorption: Rectal absorption may be slower and more variable than oral administration 1
- Hepatotoxicity risk: Single doses exceeding 10 times the recommended dose (>150 mg/kg) can cause liver damage 2
- Chronic toxicity: Exposures greater than 90-140 mg/kg/day for several days increase risk of hepatotoxicity 2, 3
Weight-Based Dosing Chart
| Weight (kg) | Dose (mg) at 15 mg/kg | Appropriate Suppository Strength |
|---|---|---|
| 3-5 kg | 45-75 mg | 60 mg or 80 mg |
| 6-8 kg | 90-120 mg | 120 mg |
| 9-12 kg | 135-180 mg | 125 mg or 150 mg |
Common Pitfalls to Avoid
- Overdosing: Never exceed the recommended dose based on weight
- Frequent administration: Maintain minimum 4-hour intervals between doses
- Prolonged use: Do not use for more than 3 consecutive days without medical advice
- Improper calculation: Always calculate dose based on actual weight, not age
- Concurrent medications: Be cautious with other medications that may contain paracetamol to avoid cumulative toxicity
If fever persists beyond 48 hours or pain continues despite appropriate dosing, seek medical attention as this may indicate a condition requiring further evaluation.