Paracetamol IV Dosing for a 9.2kg Toddler
For a 9.2kg toddler, administer 15 mg/kg per dose of intravenous paracetamol every 6 hours, which equals approximately 138 mg per dose, with a maximum daily dose not exceeding 60 mg/kg/day (552 mg/day for this child).
Weight-Based Dosing Calculation
- Per dose calculation: 15 mg/kg × 9.2 kg = 138 mg per dose 1
- Frequency: Administer every 6 hours (four times daily) 1
- Maximum daily dose: 60 mg/kg/day = 552 mg/day for this 9.2kg child 1
Administration Guidelines
- Route: Intravenous infusion over 15 minutes 1
- Dosing interval: Every 6 hours (q6h) to maintain therapeutic levels 1
- Do not exceed: Four doses in 24 hours to avoid hepatotoxicity 2, 3
Important Safety Considerations
- Hepatotoxicity risk: Paracetamol overdose is the leading cause of acute liver failure in Western countries, making precise weight-based dosing critical 2, 3
- Therapeutic window: Therapeutic plasma concentrations range from 5-20 micrograms/mL, while hepatotoxicity typically occurs above 150 micrograms/mL 4
- Minimum effective dose principle: Use the lowest effective dosage for the shortest duration necessary, as paracetamol carries risks even at therapeutic doses when used long-term 5, 3
Clinical Monitoring
- Assess efficacy: Clinical improvement should be evident within the first few doses for pain or fever control 1
- Watch for adverse effects: Monitor for signs of hepatotoxicity if prolonged use is required, though acute toxicity is rare at therapeutic doses 4, 2
- Transition to oral: Switch to oral or rectal administration as soon as the clinical situation permits, as IV formulation should be reserved for situations where enteral routes are not feasible 1
Common Pitfalls to Avoid
- Calculation errors: Always double-check weight-based calculations, as dosing errors can lead to serious hepatotoxicity 2, 3
- Cumulative dosing: Ensure total daily dose does not exceed 60 mg/kg/day when combining IV with other paracetamol formulations 1
- Infusion rate: Do not administer as IV bolus; always infuse over 15 minutes to minimize adverse reactions 1