Intravenous Paracetamol Dosing for 38 kg Patient
For a 38 kg patient, administer 570 mg (15 mg/kg) of IV paracetamol every 4-6 hours, with a maximum daily dose of 2,280 mg (60 mg/kg/day). 1
Weight-Based Dosing Requirements
- Patients weighing 10-50 kg require weight-adjusted IV paracetamol dosing at 15 mg/kg per dose every 4-6 hours 1
- The standard 1 gram dose used for adults >50 kg is inappropriate and potentially hepatotoxic for patients under 50 kg 1
- Maximum daily dose must not exceed 60 mg/kg/day 1
Specific Calculation for 38 kg Patient
- Single dose: 38 kg × 15 mg/kg = 570 mg per dose 1
- Maximum daily dose: 38 kg × 60 mg/kg = 2,280 mg per day 1
- Dosing interval: Every 4-6 hours 1
- Maximum number of doses: 4 doses per 24 hours if given every 6 hours 1
Critical Safety Considerations
Patient weight must be documented on the drug chart to prevent iatrogenic paracetamol toxicity, which is a potentially life-threatening yet avoidable cause of acute liver failure 1. A quality improvement study demonstrated that failure to adjust IV paracetamol doses for patients <50 kg resulted in 25% of patients receiving inappropriate (excessive) doses 1.
- Verify actual body weight on admission and document it clearly 1
- Do not default to the standard 1 gram adult dose for patients under 50 kg 1
- Monitor for signs of hepatotoxicity, particularly if dosing errors occur 1
Pharmacokinetic Rationale
The 15 mg/kg dosing achieves therapeutic plasma concentrations while maintaining safety margins below toxic thresholds 2. In healthy subjects, a 2-gram starting dose (approximately 26 mg/kg for a 75 kg adult) produced peak concentrations of 67.9 μg/mL without toxicity, demonstrating that weight-based dosing at 15 mg/kg provides adequate analgesia with substantial safety margin 2.