Paracetamol IV Dosing for a 2-Year-Old
For a 2-year-old child, administer paracetamol IV at 15 mg/kg per dose every 6 hours, with a maximum of 60 mg/kg/day (not exceeding 4 doses in 24 hours).
Weight-Based Dosing Algorithm
- Calculate the exact dose: Multiply the child's weight in kilograms by 15 mg to determine the single dose 1, 2
- Dosing interval: Administer every 6 hours (or every 4-6 hours if needed for breakthrough fever/pain) 1
- Maximum daily dose: Do not exceed 60 mg/kg/day or 4 doses in 24 hours, whichever is lower 1, 2
Practical Example
For a typical 2-year-old weighing 12 kg:
- Single dose: 12 kg × 15 mg/kg = 180 mg IV
- Maximum daily dose: 12 kg × 60 mg/kg = 720 mg/day
- Dosing schedule: 180 mg IV every 6 hours (4 doses maximum)
Critical Safety Considerations
- Avoid cumulative toxicity: Doses exceeding 90-95 mg/kg/day carry risk of hepatic and renal damage 3
- Document all doses carefully: Studies show that 8-17% of prescriptions inadvertently exceed maximum recommended doses when timing is not carefully tracked 3, 4
- Single toxic dose threshold: Single ingestions exceeding 140-150 mg/kg are potentially hepatotoxic 1
- Chronic overdosing risk: Exposures greater than 140 mg/kg/day for several consecutive days carry serious toxicity risk 1
Common Pitfalls to Avoid
- Do not use age-based dosing for IV administration - always calculate based on actual weight 1, 2
- Avoid rounding up doses - children above 3 years are at increased risk of receiving incorrect (excessive) doses 5
- Do not combine with oral paracetamol without accounting for total daily dose from all routes 4
- Maintain accurate dosing records - caregivers and medical staff frequently lose track of cumulative doses 3, 5