What is the recommended dose of ibuprofen (nonsteroidal anti-inflammatory drug) for children?

Recommended Dosage of Ibuprofen for Children

The recommended dose of ibuprofen for children is 10 mg/kg every 6-8 hours orally, with a maximum of 40 mg/kg/day. 1

Dosing by Age Group

• Infants 3-6 months: 5-10 mg/kg per dose, can be administered 3-4 times daily with a maximum total daily dose of 30-40 mg/kg. Only recommended for infants weighing above 5-6 kg and with special attention to hydration. 2

• Children 6 months to 9 years: 10 mg/kg every 8 hours orally, with a maximum of 40 mg/kg/day. 1

• Children 10 years or older: 10 mg/kg every 8 hours orally, with a maximum of 600 mg per dose. For children weighing more than 40 kg, adult dosing should be used. 1

Administration Considerations

• Oral administration is preferred over rectal administration, as rectal absorption can be erratic, especially in young infants. 2

• The relationship between dose and response is linear over the range of 5-10 mg/kg, with clinical trials showing the effective dose range to be 7.5-10 mg/kg. 3

• Maximum temperature reduction occurs 3-4 hours after administration. 3

Safety Considerations

• Ibuprofen is not recommended for infants younger than 3 months due to limited safety data. 1, 2

• Ibuprofen appears to be better tolerated by children than adults and is safer in overdose than paracetamol and aspirin. 3

• No relationship has been found between age (3-10 years) and ibuprofen pharmacokinetics, suggesting consistent dosing can be used across this age range. 4

• Ensure proper hydration in children receiving ibuprofen, particularly in infants. 2

Combination Therapy

• When treating fever, using ibuprofen and acetaminophen together provides greater antipyretic effect than ibuprofen alone, particularly at 4-6 hours after administration. 5

• If using both medications, careful recording of dose times is essential to avoid accidentally exceeding the maximum recommended dose. 6

• For fever management, ibuprofen may be considered as first-line treatment, with the option to add acetaminophen if needed, considering the benefit of an additional 2.5 hours without fever over 24 hours. 6

Pharmacokinetics

• The maximum serum concentration of ibuprofen in children ranges from 17-42 μg/ml at 5 mg/kg doses and 25-53 μg/ml at 10 mg/kg doses. 4

• Mean time to maximum concentration is approximately 1.1-1.2 hours, with an elimination half-life of about 1.6 hours in pediatric patients. 4