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

Maximum Dose of Ibuprofen for Children

The maximum recommended dose of ibuprofen for children is 40 mg/kg/day, typically divided into doses of 10 mg/kg every 6-8 hours, with a maximum single dose of 600 mg for children weighing over 40 kg. 1

Dosing by Age and Weight

• For children 6 months to 9 years: 10 mg/kg every 8 hours, not exceeding 40 mg/kg/day 1
• For children 10 years or older: 10 mg/kg every 8 hours, with a maximum of 600 mg per dose 1
• For children weighing over 40 kg: adult dosing should be used, not exceeding 3200 mg total daily dose 2
• For infants 3-6 months: 5-10 mg/kg per dose, 3-4 times daily, with a maximum total daily dose of 30-40 mg/kg 3

Important Considerations

• Ibuprofen is not recommended for infants younger than 3 months due to limited safety data 1, 3
• The lowest effective dose should be used for the shortest duration consistent with treatment goals 2
• Hydration status must be carefully monitored, as dehydration increases the risk of renal adverse effects 4
• Ibuprofen should not be given to children with:
  • Dehydration or ongoing diarrhea/vomiting 4
  • Known sensitivity to NSAIDs 4
  • Persistent asthma or wheezing 4
  • During varicella (chicken pox) infection 4

Administration Recommendations

• Oral administration is preferred over rectal routes, especially in young infants, as rectal absorption can be erratic 3
• Administering with food or milk may help reduce gastrointestinal complaints 2
• When using for fever, ibuprofen has been shown to provide longer duration of action compared to paracetamol (acetaminophen) 5, 6

Safety Considerations

• While generally well-tolerated in children, careful attention to dosing is essential to avoid adverse effects 5
• Parents should be provided with clear dosing instructions and advised to record administration times, especially if alternating with other medications like acetaminophen 6
• Accidental overdosing can occur; parents should be educated about maximum daily doses and proper measurement of liquid formulations 6
• The risk of gastrointestinal events is rare in children but increases with higher doses or prolonged use 4

Clinical Pearls

• Ibuprofen is particularly effective for inflammatory pain conditions in children 4
• For fever management, ibuprofen at 10 mg/kg provides effective antipyresis for 6-8 hours 5, 6
• When treating pain, the onset of action is typically within 30-60 minutes after oral administration 5
• Short-term use (less than 7 days) at recommended doses has a favorable safety profile in otherwise healthy children 3, 4