Paracetamol Dosing for a 28.6kg Child Using 250mg Suspension
For a 28.6kg child, administer 11.5 mL of paracetamol 250mg suspension (approximately 286mg) every 6 hours, not exceeding 4 doses in 24 hours (total daily dose: 1144mg or 40mg/kg/day). 1
Weight-Based Calculation
- The recommended oral paracetamol dose for children is 10 to 15 mg/kg every 6 hours, with a maximum daily dose of 60 mg/kg/day 1
- For this 28.6kg child:
- Dose per administration: 10-15 mg/kg = 286-429 mg per dose
- Using 250mg/5mL suspension: This equals 5.7-8.6 mL per dose
- Practical dosing: 11.5 mL (287.5mg) provides approximately 10 mg/kg, which is within the safe therapeutic range 2
- Maximum daily dose: 60 mg/kg/day = 1716 mg/day (not to exceed 4000 mg/day in older children) 1
Dosing Schedule
- Administer every 6 hours (four times daily) for optimal pain or fever control 1
- The analgesic effect typically lasts 4-6 hours 3
- Ensure at least 6 hours between doses to prevent cumulative toxicity 1
Critical Safety Considerations
- Never exceed 60 mg/kg/day in divided doses 4, 3
- Single ingestions exceeding 140 mg/kg/day for several days carry risk of serious hepatotoxicity 4
- Chronic overdosing (>90-95 mg/kg/day) can result in hepatic and renal damage 5
- At therapeutic concentrations, paracetamol pharmacokinetics are linear and safe with repeated administration 3
Common Prescribing Pitfalls
- Avoid age-based dosing: Always calculate based on actual body weight rather than age ranges 6
- Prescription clarity: Document the child's weight, total daily dose, number of divided doses, and duration of therapy to prevent pharmacy confusion 6
- Suspension concentration errors: Verify the suspension concentration (250mg/5mL in this case) before calculating volume 5
- Studies show 17% of paracetamol prescriptions exceed safe dosing limits due to unclear instructions 5