Paracetamol Dosing for a 3-Year-Old Child Weighing 35kg
For a 3-year-old child weighing 35kg, the recommended dose of paracetamol is 10.15 mL (325 mg) every 4 hours, not to exceed 5 doses in a 24-hour period. 1
Weight-Based Dosing Considerations
- For children 6 to under 12 years of age, the FDA-approved dosage is 10.15 mL (325 mg) every 4 hours, not exceeding 5 doses in 24 hours 1
- Although the child is only 3 years old, their weight of 35kg puts them in the weight range of an average 10-11 year old, making the 6-12 year dosing category most appropriate 1
- The standard pediatric dosing range for paracetamol is 10-15 mg/kg every 4-6 hours 2, 3
- Using the weight-based calculation (10-15 mg/kg), this child would receive 350-525 mg per dose, but it's safer to use the standardized age-appropriate dose of 325 mg 1, 3
Important Safety Considerations
- The maximum daily dose should not exceed 75-90 mg/kg/day to prevent hepatotoxicity 4, 5
- For this 35kg child, this means not exceeding 2,625-3,150 mg per day, which is well within the safety range when giving 325 mg doses 5 times daily (1,625 mg total) 1, 4
- Single ingestions of more than ten times the recommended dose are potentially toxic 6
- Chronic overdosing exceeding 140 mg/kg/day for several days carries risk of serious toxicity 6
Route of Administration
- Oral administration is preferred for children due to reliable absorption 3
- Effervescent or liquid formulations may provide more rapid onset of action than conventional tablets 3
- Rectal administration results in slower and less predictable absorption compared to oral dosing 3
Monitoring and Follow-up
- Monitor for signs of efficacy (reduction in fever, pain relief) 6
- Be alert for rare side effects, though paracetamol is generally well-tolerated when used at recommended doses 6
- If symptoms persist despite appropriate dosing, consider alternative or additional interventions rather than increasing beyond recommended doses 6
Pitfalls to Avoid
- Do not use adult dosing for children, even if they are large for their age 5
- Avoid calculating doses based on actual weight in overweight or obese children; instead, use ideal body weight to prevent overdosing 5
- Never exceed 5 doses in 24 hours for children, regardless of their weight 1
- Do not administer additional doses if the child vomits after taking medication without consulting a healthcare provider 6