Pediatric Acetaminophen Suppository Dosing
The recommended pediatric dose of acetaminophen suppositories is 10-15 mg/kg every 4-6 hours, not to exceed 5 doses in 24 hours. 1, 2
Dosing Guidelines by Age and Weight
- For infants and children, the appropriate dose should be calculated based on weight using 10-15 mg/kg per dose 1, 2
- Maximum daily dose should not exceed 60 mg/kg/day or 4000 mg per day, whichever is less 2
- Dosing intervals should be maintained at 4-6 hours between doses 2, 3
- For accurate dosing in infants younger than 1 year, an appropriate measuring device should be used if the suppository needs to be divided 4
Efficacy Considerations
- A minimum dose of 10 mg/kg is required to maintain adequate antipyretic effect for approximately 4-6 hours 5
- Doses of 20 mg/kg as a single dose have been shown to be more effective than 10 mg/kg, but standard recommendations remain 10-15 mg/kg to balance efficacy and safety 5
- There is no significant difference in antipyretic effect between suppository and oral suspension forms at equivalent doses of 10-15 mg/kg, though oral suspension may provide more consistent response 5
Safety Considerations
- Single ingestions exceeding ten times the recommended dose (>100-150 mg/kg) are potentially toxic 2
- Chronic overdosing at >140 mg/kg/day for several days carries risk of serious hepatotoxicity 2
- When administering suppositories to young children, parents should be properly educated on correct dosing to avoid under or overdosing 3
- In a community study, 27% of children received underdoses (<10 mg/kg) and 12% received overdoses (>20 mg/kg), highlighting the importance of clear dosing instructions 3
Special Populations
- Acetaminophen is the only recommended analgesic for infants under 3 months of age 6
- For neonates and young infants, dosing should be carefully calculated based on accurate weight measurements 2
Administration Tips
- For suppositories that need to be divided for smaller doses, refrigeration can make them easier to cut precisely 2
- Parents should be instructed on proper insertion technique to ensure retention and absorption 3
- If a child has difficulty retaining the suppository, holding the buttocks together for 1-2 minutes after insertion may help 2