What is the appropriate dose of naproxen (nonsteroidal anti-inflammatory drug) for an 11-year-old child?

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Naproxen Dosing for an 11-Year-Old Child

For an 11-year-old child, administer naproxen at approximately 5 mg/kg twice daily, which typically translates to 250 mg twice daily for most children in this age group. 1

Weight-Based Dosing Strategy

  • The FDA-approved dosing for juvenile arthritis is approximately 10 mg/kg per day given in 2 divided doses (5 mg/kg twice daily). 1
  • For an average 11-year-old weighing 35-40 kg, this equates to 175-200 mg per dose, which rounds to 250 mg twice daily using available tablet strengths. 1
  • The total daily dose should not exceed 15 mg/kg/day in pediatric patients. 1

Formulation Considerations

  • Naproxen tablets are not well suited to precise weight-based dosing in children, so naproxen oral suspension is the preferred formulation when available for more accurate dosing. 1
  • If using tablets, round to the nearest available strength (typically 250 mg) rather than attempting to split tablets for precise weight-based dosing. 1

Alternative Dosing for Pain Management

  • For acute pain conditions (rather than chronic inflammatory arthritis), the European Society for Paediatric Anaesthesiology recommends 5 to 7.5 mg/kg every 12 hours for naproxen in children. 2
  • This aligns with the FDA guidance but provides flexibility toward the higher end of the dosing range for acute painful conditions. 2

Important Safety Considerations

  • Use the lowest effective dose for the shortest duration consistent with treatment goals, as naproxen carries risks of gastrointestinal, cardiovascular, and renal adverse effects. 1
  • Onset of pain relief typically begins within 1 hour of administration. 1
  • Naproxen is substantially excreted by the kidney; monitor renal function if there are concerns about renal impairment. 1
  • The drug is well-tolerated in pediatric patients over 2 years of age based on extensive clinical experience. 1, 3

Pharmacokinetic Evidence

  • Studies demonstrate no significant difference in naproxen peak blood levels and half-life between adults and children, supporting a twice-daily dosing regimen. 4
  • The drug is rapidly and completely absorbed when given orally, with substantial concentrations achieved at the site of action. 5

Clinical Efficacy Data

  • Naproxen at 10-20 mg/kg/day has demonstrated effectiveness for treating inflammatory conditions in children, with fever and arthritis typically resolving within 1-2 days of treatment initiation. 3
  • The drug has been well-established as effective and well-tolerated in pediatric rheumatic diseases over decades of clinical use. 6, 7

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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