Pediatric Paracetamol (Acetaminophen) Suppository Dosing
The recommended dose of paracetamol (acetaminophen) suppository for pediatric patients is 10-15 mg/kg every 4-6 hours, with a maximum daily dose of 60 mg/kg/day. 1, 2
Dosing Guidelines by Age and Weight
- For infants and children, the optimal single dose is 10-15 mg/kg per dose 3, 4
- Maximum frequency: Every 4-6 hours (no more than 4-5 doses in 24 hours) 4, 2
- Maximum daily dose: 60 mg/kg/day 1
- Loading dose of 25 mg/kg may be considered for initial treatment, followed by maintenance doses of 12.5 mg/kg every 6 hours 5
Clinical Considerations
- Rectal absorption of paracetamol is slower and more irregular compared to oral administration 1
- There is no direct correlation between serum concentrations of paracetamol and its analgesic or antipyretic effect 1
- Paracetamol is effective for both fever and mild to moderate pain in children 4
- When used in recommended doses, paracetamol has few side effects and is well tolerated 4
Safety Considerations
- Single ingestions exceeding 10 times the recommended dose (>100-150 mg/kg) are potentially toxic 4
- Chronic overdosing at doses >140 mg/kg/day for several days carries risk of serious hepatotoxicity 4
- Paracetamol is contraindicated in patients with hepatic insufficiency 1
- For fever associated with discomfort, paracetamol offers effective relief 4
Special Populations
- In neonates and young infants, dosing may need adjustment due to differences in pharmacokinetics 1
- Paracetamol can be used during pregnancy and lactation if clinically indicated 1
- No dosage adjustment is typically needed for elderly patients or those with chronic renal insufficiency 1
Common Pitfalls to Avoid
- Underdosing: Many dosing schedules recommend inadequate amounts of paracetamol, potentially reducing efficacy 3
- Overdosing: Ensure accurate weight-based dosing to prevent potential hepatotoxicity 4
- Irregular absorption: Be aware that rectal administration results in slower and less predictable absorption compared to oral administration 1
- Failure to maintain consistent dosing intervals: Maintain regular dosing intervals for optimal antipyretic and analgesic effects 2