Recommended Paracetamol (Acetaminophen) Dosing for Children
The recommended dose of paracetamol (acetaminophen) for children is weight-based, with 10-15 mg/kg per dose given every 4-6 hours, not exceeding 5 doses in 24 hours. 1, 2, 3
Age-Based Dosing Guidelines
- For children 12 years and older: 650 mg every 4-6 hours, not to exceed 6 doses (3900 mg) in 24 hours 4
- For children 6 to under 12 years: 325 mg every 4 hours, not to exceed 5 doses (1625 mg) in 24 hours 4
- For children 4 to under 6 years: 240 mg every 4 hours, not to exceed 5 doses (1200 mg) in 24 hours 4
- For children 2 to under 4 years: 160 mg every 4 hours, not to exceed 5 doses (800 mg) in 24 hours 4
- For children under 2 years: Consult a doctor for appropriate dosing 4
Weight-Based Dosing
- The optimal single dose range is 10-15 mg/kg given at 4-hour intervals 1, 2
- Maximum daily dose should not exceed 60 mg/kg/day 2, 3
- For fever management, doses of at least 10 mg/kg are required to maintain temperature reduction for approximately 6 hours 5
Administration Considerations
- Oral administration provides more consistent response compared to rectal administration, though both routes can be effective at equivalent doses 5
- For infants and young children, use an appropriate measuring device such as a 3-mL or 5-mL oral syringe for accurate measurement 6
- Effervescent tablet formulations may provide more rapid absorption and onset of action compared to conventional tablets 3
Clinical Applications
- Paracetamol is effective for both fever and pain management in children 2
- When treating fever associated with discomfort, paracetamol offers symptomatic relief 2
- For mild to moderate pain, paracetamol alone or in combination with other analgesics is effective 2
- Even for severe pain, paracetamol can provide significant additive analgesic effect when combined with opiates 2
Safety Considerations
- Single ingestions exceeding 10 times the recommended dose (>150 mg/kg) are potentially toxic and can cause hepatotoxicity 2
- Chronic overdosing at doses greater than 140 mg/kg/day for several days carries risk of serious liver toxicity 2
- Paracetamol is generally well-tolerated when used at recommended doses 2
- In cases of fever management, ibuprofen may be considered as a second-line treatment if paracetamol is ineffective 2, 7
Special Populations
- Paracetamol is the analgesic of choice for elderly persons and patients with chronic renal insufficiency 3
- It can be used during pregnancy and lactation 3
- Paracetamol is contraindicated in patients with hepatic insufficiency 3
Remember that paracetamol remains one of the safest and most widely used analgesic-antipyretics in children when used at appropriate doses 1, 2.