Recommended Paracetamol (PCM) Dosing in Children
The recommended dose of paracetamol (acetaminophen) for children is 10-15 mg/kg per dose every 4-6 hours, not exceeding 5 doses in a 24-hour period for most children. 1, 2
Age-Based Dosing Guidelines
- For children 12 years and older: 650 mg every 4-6 hours, not to exceed 6 doses in 24 hours 3
- For children 6 to under 12 years: 325 mg every 4 hours, not to exceed 5 doses in 24 hours 3
- For children 4 to under 6 years: 240 mg every 4 hours, not to exceed 5 doses in 24 hours 3
- For children 2 to under 4 years: 160 mg every 4 hours, not to exceed 5 doses in 24 hours 3
- For children under 2 years: Consult a doctor for appropriate dosing 3
Weight-Based Dosing
- The standard weight-based dose is 10-15 mg/kg per dose every 4-6 hours 1, 4
- Maximum daily dose should not exceed 60 mg/kg/day to avoid toxicity 4
- For infants 1-3 months, a total daily dose of 60-65 mg/kg/day divided into multiple doses is recommended 5
Important Considerations
- Single doses exceeding 10 times the recommended dose (>100-150 mg/kg) are potentially toxic 1
- Chronic exposure to doses >140 mg/kg/day for several days carries risk of serious hepatotoxicity 1
- Paracetamol is the only recommended analgesic for children under 3 months of age 6
- Effervescent tablet formulations may provide more rapid onset of action compared to conventional tablets 4
Special Populations
- For neonates in the first 2 weeks of life, a lower dose of approximately 30 mg/kg/day divided into multiple doses is suggested 5
- No dose adjustment is typically needed for elderly patients or those with chronic renal insufficiency 4
- Paracetamol is contraindicated in patients with hepatic insufficiency 4
Safety Monitoring
- Monitor for signs of hepatotoxicity with prolonged use or in overdose situations 1
- The therapeutic effect of paracetamol typically lasts for 4-6 hours, which guides the dosing interval 4
- There is no direct correlation between serum concentrations and analgesic or antipyretic effect 4
When administering paracetamol to children, it's crucial to calculate the dose based on accurate weight measurements and to adhere to the recommended dosing intervals to ensure both efficacy and safety 2.