Maximum Dose of Paracetamol Suppository for a 3-Year-Old with Fever
The maximum dose of paracetamol (acetaminophen) suppository for a 3-year-old child with fever of 101°F is 15 mg/kg every 6 hours, not exceeding a total daily dose of 60 mg/kg. 1, 2
Dosing Guidelines
- For rectal administration of paracetamol in children, the recommended single dose is 20-40 mg/kg as a loading dose, followed by 15 mg/kg every 6 hours 1
- The maximum daily dose should not exceed 60 mg/kg/day to ensure safety while maintaining efficacy 2
- For a 3-year-old child (typically weighing between 12-16 kg), this translates to approximately:
Administration Considerations
- Rectal paracetamol has slower and more irregular absorption compared to oral formulations 3
- When using suppositories, careful attention to dosing is required due to the relatively erratic bioavailability 3
- The antipyretic effect typically lasts 4-6 hours, so dosing should be spaced accordingly 4
Safety Considerations
- Single ingestions exceeding 10 times the recommended dose (>150 mg/kg) are potentially toxic 4
- Chronic exposure to doses greater than 140 mg/kg/day for several days carries a risk of serious hepatotoxicity 4
- It's important to record all doses given to avoid accidentally exceeding the maximum recommended daily dose 5
Monitoring and Follow-up
- If fever persists beyond 48-72 hours without improvement, medical attention should be sought 6
- The child should demonstrate clinical improvement within 48 hours of initiating appropriate therapy 1
- If the child shows decreased feeding or activity, or signs of respiratory distress, immediate medical assessment is recommended 6
Alternative Options
- Ibuprofen may be considered as an alternative at a dose of 10 mg/kg every 8 hours if paracetamol alone is insufficient for fever control 1, 5
- For mild to moderate fever without significant discomfort, non-pharmacological measures such as adequate hydration and light clothing may be sufficient 6
Remember that the primary goal of antipyretic therapy is to improve the child's comfort rather than to normalize body temperature completely 2.