What is the recommended dosing for acetaminophen (Tylenol) in a pediatric patient?

Acetaminophen (Tylenol) Dosing for a 12-Year-Old Child with Pain

For a 12-year-old child with pain, the recommended dosage of liquid acetaminophen is 10-15 mg/kg every 4-6 hours, not to exceed 5 doses (60-75 mg/kg/day) in 24 hours.

Weight-Based Dosing (Preferred Method)

• Calculate dose based on the child's weight using 10-15 mg/kg per dose
• For a typical 12-year-old (approximately 40-45 kg):
  • Dose range: 400-675 mg per dose
  • Maximum daily dose: 2000-3000 mg/day (not to exceed 75 mg/kg/day)

Age-Based Dosing (Alternative Method)

For liquid acetaminophen formulations:

• Children 12 years of age: 480-650 mg every 4-6 hours
• Do not exceed 5 doses (2400-3250 mg) in 24 hours

Prescription Writing Guidelines

1. Patient information: Include name, age, weight
2. Medication: Acetaminophen (Tylenol) oral liquid
3. Concentration: Specify concentration (e.g., 160 mg/5 mL)
4. Dosage: Write "Give [X] mg (or [Y] mL) by mouth every 4-6 hours as needed for pain"
5. Maximum frequency: "Not to exceed 5 doses in 24 hours"
6. Quantity: Sufficient for expected duration of pain
7. Refills: Typically zero for acute pain

Example Prescription

Rx: Acetaminophen 160 mg/5 mL oral solution
Sig: Give 480 mg (15 mL) by mouth every 4-6 hours as needed for pain
     Do not exceed 5 doses in 24 hours
Disp: 240 mL
Refills: 0

Important Considerations

• Verify the concentration of the liquid formulation (commonly 160 mg/5 mL)
• Provide clear instructions to parents about measuring the correct dose using an oral syringe or dosing cup
• Advise parents to avoid giving other medications containing acetaminophen concurrently
• For children with liver impairment, consider reducing the dose or increasing the dosing interval

Monitoring

• Monitor for pain relief effectiveness
• Watch for potential adverse effects including:
  • Nausea/vomiting
  • Abdominal pain
  • Signs of allergic reaction (rare)
  • Signs of overdose (extremely rare at therapeutic doses)

Common Pitfalls to Avoid

• Using household spoons for measurement (leads to dosing errors)
• Confusing different concentrations of liquid acetaminophen
• Exceeding maximum daily dose by combining with other acetaminophen-containing products
• Failing to adjust dosing for underweight or overweight children

Remember that acetaminophen remains the first-line choice for treating pain in children when used at appropriate doses 1.