What is the recommended dose of Tylenol (acetaminophen) for children?

Acetaminophen (Tylenol) Dosing in Children

The recommended dose of acetaminophen (Tylenol) for children is 10-15 mg/kg every 4-6 hours, not to exceed 5 doses (60-75 mg/kg) in 24 hours. 1, 2, 3

Weight-Based Dosing (Preferred Method)

• Dosage range: 10-15 mg/kg per dose
• Frequency: Every 4-6 hours as needed
• Maximum doses per day: 5 doses in 24 hours
• Maximum daily dose: 60-75 mg/kg/day

Age-Based Dosing (Alternative)

When weight is unavailable, age can be used as a rough guide:

• 2-3 years: 160 mg per dose
• 4-5 years: 240 mg per dose
• 6-8 years: 320 mg per dose
• 9-10 years: 400 mg per dose
• 11+ years: 480-650 mg per dose

Important Considerations

Formulations

• Liquid/syrup: 160 mg/5 mL (most common for young children)
• Chewable tablets: 80 mg or 160 mg
• Regular strength tablets: 325 mg
• Extra strength tablets: 500 mg

Administration Tips

• Always use the measuring device provided with the medication
• Never use household spoons for dosing
• For liquid formulations, ensure accurate measurement using a calibrated medication syringe or cup
• Administer with food if stomach upset occurs

Safety Precautions

1. Avoid dosing errors:

   • Weight-based dosing is more accurate than age-based dosing 4
   • Use proper measuring devices, not household spoons
   • Double-check concentration of formulation before administering

2. Prevent overdose:

   • Record all doses given with time and amount
   • Single ingestions of more than 10 times the recommended dose (>150 mg/kg) are potentially toxic 2
   • Chronic exposures greater than 140 mg/kg/day for several days carry risk of serious hepatotoxicity 2

3. Monitor for side effects:

   • Gastrointestinal symptoms (mild nausea, stomach discomfort)
   • Allergic reactions (rare)
   • Signs of overdose: nausea, vomiting, abdominal pain, loss of appetite

Clinical Pearls

• Acetaminophen begins working within 30-60 minutes
• Peak effect occurs at approximately 3 hours post-administration 3
• Maximum temperature reduction is typically achieved around 3 hours after dosing 3
• Consider alternating with ibuprofen for persistent fever, but carefully record all doses to avoid medication errors 5
• Acetaminophen (15 mg/kg) should be given at the time of DTP vaccination and every 4 hours for 24 hours to reduce post-vaccination fever 6

When to Seek Medical Attention

• Fever persists beyond 3 days
• Child appears very ill despite treatment
• Child is less than 3 months old with any fever
• Signs of acetaminophen overdose develop (vomiting, right upper quadrant pain, confusion)

Remember that fever itself is not harmful and is a natural immune response. Treatment should focus on improving comfort rather than normalizing temperature.