What is the recommended dose of acetaminophen (paracetamol) for a 14-year-old?

Acetaminophen Dosing for a 14-Year-Old

For a 14-year-old, the recommended dose of acetaminophen is 10-15 mg/kg every 6 hours, with a maximum daily dose of 60 mg/kg/day not to exceed 4 grams per day. 1

Dosing Guidelines

Weight-Based Dosing (Preferred Method)

• Calculate dose based on 10-15 mg/kg per dose
• Administer every 6 hours as needed
• Maximum of 4 doses in 24 hours
• Do not exceed 60 mg/kg/day or 4 grams total daily dose, whichever is less

Standard Dosing (If Weight Unknown)

• For most 14-year-olds (who typically weigh 40-70 kg):
  • 500-650 mg per dose
  • Every 6 hours as needed
  • Maximum 4 doses in 24 hours
  • Not to exceed 4 grams total daily dose

Important Considerations

Safety Profile

• Acetaminophen is generally well-tolerated when used at recommended doses 2
• It remains the first-line choice for treatment of both fever and pain in pediatric patients
• Unlike NSAIDs, acetaminophen is not associated with significant gastrointestinal bleeding or cardiovascular toxicity 1

Monitoring and Precautions

• Parents should be educated on the maximum safe dose (60 mg/kg/day not exceeding 4 g/24 hours) from all sources 2
• Careful recording of dose times is essential to avoid accidentally exceeding the maximum recommended dose 3
• Hepatotoxicity can occur with overdose; single ingestions of more than ten times the recommended dose are potentially toxic 2

Common Pitfalls to Avoid

1. Dosing confusion: Some parents may be confused by different dosing recommendations on various acetaminophen products. Always clarify the concentration of the product being used 4

2. Concurrent use in combination products: Many over-the-counter cold medicines and prescription pain medications contain acetaminophen. Ensure the total daily dose from all sources doesn't exceed the maximum 2

3. Inadequate dosing: Some dosing schedules recommend inadequate amounts of acetaminophen. Weight-based dosing (10-15 mg/kg) ensures accurate therapeutic levels 5

4. Extended use: For acute pain or fever, acetaminophen should be used for the shortest duration necessary. Prolonged use increases risk of adverse effects 1

By following these guidelines, acetaminophen can be safely and effectively used to manage pain and fever in a 14-year-old patient.