Pediatric Ibuprofen Dosing
The recommended dose of ibuprofen for pediatric patients is 10 mg/kg every 6-8 hours orally, with a maximum of 40 mg/kg/day. 1
Age-Based Dosing Guidelines
- For infants aged 3-6 months: 5-10 mg/kg per dose, with special attention to hydration status 2
- For children aged 6 months to 9 years: 10 mg/kg every 8 hours, maximum 40 mg/kg/day 1
- For children aged 10 years or older: 10 mg/kg every 8 hours, maximum 600 mg per dose 1
- For children weighing >40 kg: Use adult dosing (maximum 2400 mg/day) 1, 3
Weight-Based Dosing Considerations
- The relationship between dose and response is linear over the range of 5-10 mg/kg 4
- Clinical trials have shown the effective dose range to be 7.5-10 mg/kg 4
- Maximum antipyretic effect occurs 3-4 hours after administration 4
Administration Guidelines
- Oral administration is preferred due to more reliable absorption compared to rectal routes, especially in young infants 2
- Administer with meals or milk if gastrointestinal complaints occur 3
- Use the lowest effective dose for the shortest duration consistent with treatment goals 3
Safety Considerations
- Not recommended for infants under 3 months of age due to limited safety data 1, 2
- Safe for short-term use in infants older than 3 months with body weight above 5-6 kg 2
- When using multiple antipyretic medications (e.g., ibuprofen and acetaminophen), carefully record all dose times to avoid exceeding maximum recommended doses 5
- Ibuprofen appears to be better tolerated by children than adults and is safer in overdose than acetaminophen and aspirin 4
Clinical Efficacy
- Ibuprofen has been shown to be equally or more effective than acetaminophen as both an analgesic and antipyretic 4
- Ibuprofen has a longer duration of action compared to acetaminophen 4
- For fever management, ibuprofen alone may be considered first-line therapy based on efficacy 5
Common Pitfalls to Avoid
- Exceeding the maximum recommended daily dose (reported in 11% of children in studies) 5
- Using rectal administration in young infants, which can lead to erratic absorption 2
- Failing to adjust dosing based on weight for children over 40 kg 1
- Not considering hydration status, especially in febrile infants 2
Remember that ibuprofen should be dosed based on body weight using 5-10 mg/kg per dose, administered 3-4 times daily, with a maximum total daily dose of 30-40 mg/kg 2.