What is the maximum dose of paracetamol (acetaminophen) for a 10-year-old child weighing 53kg?

Maximum Paracetamol Dose for a 10-Year-Old Child Weighing 53kg

For a 10-year-old child weighing 53kg, the maximum daily dose of paracetamol is 4000mg (4g) per day, administered as 650-1000mg every 4-6 hours, not exceeding 6 doses in 24 hours. 1

Weight-Based Dosing Considerations

Since this child weighs 53kg (well above 40kg), they should be dosed according to adult guidelines rather than pediatric weight-based calculations 2:

• Single dose range: 650-1000mg per dose 1
• Dosing interval: Every 4-6 hours 1
• Maximum daily dose: 4000mg (not exceeding 6 doses in 24 hours) 1

Practical Dosing Algorithm

For this specific patient:

• Standard single dose: 650mg (20.3 mL of liquid formulation) every 4-6 hours 1
• Maximum single dose: 1000mg if needed for adequate symptom control 1
• Daily maximum: Must not exceed 4000mg total in any 24-hour period 1

Important Safety Considerations

Critical dosing pitfall: While pediatric dosing typically uses 10-15 mg/kg per dose 3, 4, applying this calculation to a 53kg child (which would yield 530-795mg per dose) is appropriate, but the total daily maximum remains 4000mg regardless of weight-based calculations 1. The FDA-approved adult dosing takes precedence for children over 40kg 2.

Toxicity threshold: Single ingestions exceeding ten times the recommended dose are potentially hepatotoxic 3. Chronic exposures greater than 140 mg/kg/day (approximately 7420mg/day for this 53kg child) for several days carry risk of serious liver toxicity 3. However, the standard maximum of 4000mg/day provides a substantial safety margin.

Duration and Monitoring

• Acute use: For fever or pain, paracetamol can be given every 4 hours up to the maximum daily dose 1
• Dose recording: All dose times should be carefully recorded to avoid accidentally exceeding the maximum recommended dose, particularly if alternating with other medications 5