IV Acetaminophen Dosing for a 7-Year-Old Child
The recommended dose of IV acetaminophen for a 7-year-old child is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of 15 mg/kg and a maximum daily dose of 75 mg/kg per day. 1
Dosing Guidelines
- For children 2-12 years of age, IV acetaminophen should be dosed at 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours 1
- The maximum single dose should not exceed 15 mg/kg 1
- The minimum dosing interval is 4 hours 1
- The maximum daily dose of acetaminophen from all sources (IV, oral, rectal) should not exceed 75 mg/kg per day 1
Administration Instructions
- For pediatric doses, withdraw the appropriate weight-based dose from the container and place into a separate sterile container prior to administration 1
- For small volume pediatric doses up to 60 mL, place in a syringe and administer over 15 minutes using a syringe pump 1
- Monitor the end of the infusion to prevent air embolism, especially when the IV acetaminophen is the primary infusion 1
- Once the container seal has been penetrated or contents transferred, administer the dose within 6 hours 1
Important Considerations
- Calculate the maximum daily dose of acetaminophen based on all routes of administration (IV, oral, rectal) and all products containing acetaminophen to avoid exceeding the recommended maximum 1
- Exceeding the maximum mg/kg daily dose may result in hepatic injury, including the risk of liver failure and death 1
- Do not add other medications to the acetaminophen injection solution 1
- Diazepam and chlorpromazine are physically incompatible with acetaminophen injection and should not be administered simultaneously 1
Clinical Efficacy and Safety
- IV acetaminophen provides an alternative route for fever reduction and analgesia when oral or rectal routes are contraindicated 2
- Studies have shown that IV acetaminophen is well tolerated in pediatric patients across all age groups 2
- The primary pathways of elimination are acetaminophen glucuronidation, sulfation, and glutathione conjugate metabolites 2
Common Pitfalls to Avoid
- Using age-based rather than weight-based dosing can lead to inadequate or excessive dosing 3
- Manufacturer's suggested doses may not always achieve therapeutic plasma concentrations across the entire weight range for a given age group 3
- Failing to account for all sources of acetaminophen when calculating the total daily dose can lead to overdosing 1
- Single ingestions of more than ten times the recommended dose are potentially toxic 4
- Exposures greater than 140 mg/kg/day for several days carry a risk of serious toxicity 4