What is the recommended dosage of ibuprofen (nonsteroidal anti-inflammatory drug) and paracetamol (acetaminophen) for a 2.5-year-old child weighing 11kg?

Dosage Recommendations for Ibuprofen and Paracetamol in a 2.5-Year-Old Child (11kg)

For an 11kg child, administer ibuprofen 10 mg/kg (110 mg) every 8 hours and paracetamol 10-15 mg/kg (110-165 mg) every 6 hours, with both medications given separately rather than simultaneously unless breakthrough fever or pain requires combination therapy. 1

Ibuprofen Dosing

• Oral ibuprofen: 10 mg/kg per dose every 8 hours 1
• For an 11kg child, this equals 110 mg per dose
• Maximum of 3 doses in 24 hours 1
• This weight falls into the <15 kg category used in pediatric dosing guidelines 1

Paracetamol (Acetaminophen) Dosing

• Oral paracetamol: 10-15 mg/kg per dose every 6 hours 1
• For an 11kg child, this equals 110-165 mg per dose
• Maximum daily dose: 60 mg/kg (660 mg for this child) 1
• Maximum of 4 doses in 24 hours 2

Combination Therapy Considerations

Use ibuprofen as the first-line agent; reserve combination therapy for inadequate response to single-agent treatment. 2, 3

• Ibuprofen alone provides superior fever reduction compared to paracetamol in children under 2 years 3
• Combination therapy provides an additional 2.5-4.4 hours without fever over 24 hours compared to single agents 2
• Critical safety concern: When using both medications, carefully record all dose times to prevent accidentally exceeding maximum recommended doses, which occurred in 8% of children given paracetamol and 11% given ibuprofen in combination studies 2

Practical Administration Guidelines

• Ibuprofen demonstrates faster onset and longer duration of antipyretic effect in young children 3
• If combining medications, stagger administration (e.g., give ibuprofen at 0,8,16 hours and paracetamol at 3,9,15,21 hours) to maintain coverage while avoiding confusion 2
• Administer with food if gastrointestinal upset occurs with ibuprofen 1

Safety Profile

• Both medications have equivalent serious adverse event profiles in children under 2 years 3
• No increased risk of adverse events when combining ibuprofen and paracetamol compared to either agent alone 4, 5
• Serious adverse events are rare in this age group with appropriate dosing 2, 3

Common Pitfalls to Avoid

• Do not exceed 30 mg/kg/day of ibuprofen (330 mg total daily for this child) 1
• Do not exceed 60 mg/kg/day of paracetamol (660 mg total daily for this child) 1
• Avoid using combination therapy routinely from the start; reserve for inadequate response to monotherapy 2
• Parents must be counseled to avoid all other products containing paracetamol, including over-the-counter cold remedies 1