What is the recommended dose of intravenous (IV) paracetamol (acetaminophen) for a 10-month-old patient weighing 7kg?

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IV Paracetamol Dosing for a 10-Month-Old, 7kg Infant

For a 10-month-old infant weighing 7kg, administer 7.5 mg/kg per dose of IV paracetamol every 6 hours, which equals 52.5 mg (5.25 mL of the standard 10 mg/mL solution) per dose, with a maximum daily dose of 30 mg/kg/day (210 mg/day). 1

Weight-Based Dosing Algorithm

  • Infants <10 kg (including your 7kg patient): The dose is 7.5 mg/kg per dose administered every 6 hours 1
  • Maximum daily dose: 30 mg/kg/day (which equals 210 mg/day for a 7kg infant) 1
  • Dosing interval: Every 6 hours (four times daily maximum) 1

Practical Calculation for This Patient

  • Single dose: 7kg × 7.5 mg/kg = 52.5 mg per dose 1
  • Volume to administer: 52.5 mg ÷ 10 mg/mL = 5.25 mL per dose 1
  • Maximum daily dose: 7kg × 30 mg/kg = 210 mg/day (52.5 mg × 4 doses) 1

Administration Guidelines

  • Standard concentration: IV paracetamol comes as 10 mg/mL solution 1
  • Dilution option: Can be diluted in 0.9% normal saline or 5% dextrose if smaller volumes are needed for neonates, though at 5.25 mL this is typically not necessary 1
  • Infusion time: Administer over 15 minutes 1

Critical Safety Considerations

  • Weight documentation is essential: Always verify and document the patient's actual weight on the drug chart before prescribing, as dosing errors commonly occur when weight is not recorded 2
  • Avoid adult dosing: Never use the standard adult 1g dose for children <50kg, as this leads to significant overdosing and potential hepatotoxicity 2
  • Overdose threshold: Single doses exceeding 10 times the recommended dose (>75 mg/kg) are potentially hepatotoxic 3
  • Chronic overdose risk: Exposures greater than 140 mg/kg/day for several days carry risk of serious liver toxicity 3

Comparison to Oral Dosing

  • The IV dose (7.5 mg/kg every 6 hours) is lower than typical oral dosing (10-15 mg/kg every 4-6 hours) due to 100% bioavailability of the IV route 3, 4, 5
  • Oral dosing in children typically ranges from 10-15 mg/kg every 4-6 hours, up to 60 mg/kg/day 3, 4, 5

References

Guideline

Injectable Paracetamol Dosing in Children

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Paracetamol efficacy and safety in children: the first 40 years.

American journal of therapeutics, 2000

Research

Pediatric dosing of acetaminophen.

Pediatric pharmacology (New York, N.Y.), 1983

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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