What is the recommended dosage and duration of paracetamol (acetaminophen) for a 3-year-old child weighing 15kg?

Paracetamol Dosing for a 3-Year-Old Child Weighing 15kg

For a 3-year-old child weighing 15kg, administer paracetamol 10-15 mg/kg per dose (150-225 mg) every 4-6 hours, not exceeding 5 doses in 24 hours or a maximum daily dose of 60-75 mg/kg (900-1125 mg/day). 1, 2, 3

Specific Dosing Recommendations

Single Dose Calculation

• Weight-based dosing: 10-15 mg/kg per dose 2, 3
• For a 15kg child: 150-225 mg per dose 2
• The optimal single dose is 15 mg/kg (225 mg) for effective antipyretic and analgesic effect 3

Dosing Interval and Maximum Daily Dose

• Administer every 4-6 hours as needed 1, 2
• Do not exceed 5 doses in 24 hours 1
• Maximum daily dose: 60-75 mg/kg/day (900-1125 mg for a 15kg child) 2, 3
• Some guidelines support up to 65 mg/kg/day with a loading dose approach 4

Practical Formulation Guidance

According to FDA labeling for oral liquid paracetamol, a 3-year-old child (2 to under 4 years) should receive 5 mL (160 mg) every 4 hours, not exceeding 5 doses in 24 hours 1. However, this may be suboptimal for a 15kg child, as it provides only 10.7 mg/kg per dose.

For optimal efficacy in a 15kg child, consider 7.5 mL (240 mg) every 4-6 hours, which provides 16 mg/kg per dose and aligns with evidence-based recommendations 2, 3.

Duration of Treatment

• Use for the shortest duration necessary to control symptoms 5
• For acute pain or fever: typically 2-3 days is sufficient 5
• Do not exceed 5 consecutive days without medical reassessment 5
• Chronic use beyond several days at high doses (>140 mg/kg/day) carries risk of hepatotoxicity 5

Critical Safety Considerations

Hepatotoxicity Risk

• Single ingestions >150 mg/kg are potentially toxic 5
• Chronic exposures >140 mg/kg/day for several days carry serious toxicity risk 5
• For a 15kg child, this translates to >2100 mg/day as a dangerous threshold 5

Common Pitfalls to Avoid

• Underdosing: Many dosing schedules recommend inadequate amounts; 10 mg/kg may provide insufficient analgesia/antipyresis 2, 4
• Overdosing: Ensure caregivers understand total daily limits and check for paracetamol in other medications (combination products) 5
• Incorrect formulation: Verify concentration of liquid formulation before calculating volume 1

Route-Specific Considerations

• Oral route is preferred for predictable absorption 3
• Rectal administration has slow and irregular absorption; not recommended as first-line 3
• Effervescent or rapidly dissolving formulations provide faster onset of action than conventional tablets 3