What is the maximum safe dose of paracetamol (acetaminophen) for a 60 kg, 16-year-old boy?

Maximum Safe Dose of Paracetamol for a 60 kg, 16-Year-Old Boy

The maximum safe dose of paracetamol (acetaminophen) for a 60 kg, 16-year-old boy is 4000 mg (4 g) per day, not to exceed 650 mg per dose every 4-6 hours. 1

Dosing Guidelines

For a 16-year-old who weighs 60 kg, the appropriate dosing follows adult guidelines since he is over 12 years of age:

• Single dose: 650 mg (20.3 mL of liquid formulation)
• Frequency: Every 4-6 hours as needed
• Maximum daily dose: 4000 mg (4 g) per day
• Maximum number of doses: No more than 6 doses in a 24-hour period 1

Weight-Based Considerations

While the FDA label provides age-based dosing, it's worth noting that weight-based dosing is also commonly used in clinical practice:

• Standard weight-based dosing ranges from 10-15 mg/kg per dose 2, 3
• For a 60 kg adolescent, this would calculate to 600-900 mg per dose
• The 650 mg standard adult dose falls within this range and is appropriate

Safety Warnings and Precautions

Liver Warning

The FDA label specifically warns about liver damage if:

• An adult takes more than 6 doses in 24 hours
• Total daily intake exceeds 4000 mg
• Paracetamol is taken with other medications containing acetaminophen
• Paracetamol is taken with 3 or more alcoholic drinks daily 1

Overdose Risk

• Single ingestions of more than ten times the recommended dose (>6500 mg at once) are potentially toxic 2
• Chronic overdosing at >140 mg/kg/day (>8400 mg/day for a 60 kg individual) for several days carries risk of serious toxicity 2
• In case of overdose, immediate medical attention is critical 1

Important Clinical Considerations

• Paracetamol should not be used with any other drug containing acetaminophen (prescription or non-prescription) 1
• If the patient is taking warfarin, a healthcare provider should be consulted before use 1
• Treatment should not continue for more than 10 days for pain or 3 days for fever unless directed by a doctor 1

Common Pitfalls to Avoid

1. Combination products: Many over-the-counter and prescription medications contain acetaminophen. Always check all medication labels to avoid unintentional overdose.

2. Dosing confusion: Different formulations (tablets, liquid) may have different strengths. Ensure the correct measurement for the specific formulation.

3. Extended use: While the maximum daily dose is 4000 mg, this should not be taken continuously for extended periods without medical supervision.

4. Alcohol use: Even though the patient is 16, it's important to emphasize that alcohol consumption while taking paracetamol significantly increases the risk of liver damage.

By following these guidelines, paracetamol can be used safely and effectively for pain and fever management in this 16-year-old patient.