What is the recommended dose and preparation of paracetamol (acetaminophen) for an 11kg pediatric patient?

Recommended Paracetamol (Acetaminophen) Dosing for an 11kg Pediatric Patient

The recommended dose of paracetamol (acetaminophen) for an 11kg pediatric patient is 10-15 mg/kg every 4-6 hours, which equals 110-165 mg per dose, with a maximum of 4 doses (60 mg/kg/day) in 24 hours. 1, 2

Dosing Calculation

• For an 11kg child, the appropriate single dose range is:
  • At 10 mg/kg: 11kg × 10 mg/kg = 110 mg per dose 1
  • At 15 mg/kg: 11kg × 15 mg/kg = 165 mg per dose 2
• Maximum daily dose should not exceed 60 mg/kg/day = 660 mg in 24 hours 3
• Administer every 4-6 hours, with a maximum of 4 doses per day 2

Available Preparations

• Oral liquid suspension (most appropriate for this age):
  • Available as 120 mg/5 mL or 160 mg/5 mL concentrations
  • For 110-165 mg dose: administer 4.5-7 mL of 120 mg/5 mL suspension or 3.5-5 mL of 160 mg/5 mL suspension 1
• Chewable tablets (if child can safely chew):
  • Available in 80 mg and 160 mg strengths
  • For this weight, 1-2 tablets of 80 mg strength would be appropriate 2
• Suppositories:
  • Available in various strengths (80 mg, 120 mg, 325 mg)
  • 120 mg suppository would be most appropriate for this weight 2
  • Note: Rectal absorption can be slow and irregular compared to oral administration 3

Important Considerations

• Oral liquid suspension is generally preferred for accurate dosing in young children 3
• Measure liquid medication with a calibrated oral syringe or dosing cup for accuracy 2
• Avoid exceeding the maximum daily dose of 60 mg/kg/day to prevent hepatotoxicity 4
• For fever management, paracetamol is effective at reducing temperature for approximately 4-6 hours 5
• For pain management, the analgesic effect typically lasts 4-6 hours 3
• Some clinicians use a loading dose approach (25 mg/kg initially, followed by 12.5 mg/kg every 6 hours) for more consistent effect 5

Cautions

• Avoid exceeding 90-95 mg/kg/day as this increases risk of hepatotoxicity 4
• Maintain at least 4-hour intervals between doses 1
• If the child has hepatic impairment, paracetamol is contraindicated 3
• For prolonged use (>3 days for fever or >5 days for pain), medical reassessment is recommended 2