What is the recommended dose of Tylenol (acetaminophen) for an 8.9kg infant?

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Acetaminophen Dosing for an 8.9kg Infant

For an 8.9kg infant, administer acetaminophen 10-15 mg/kg per dose (89-134 mg) every 6 hours, with a maximum daily dose of 60 mg/kg (534 mg/day). 1

Specific Dose Calculation

  • Per dose range: 89-134 mg every 6 hours 1
  • Practical dosing: Start with 10 mg/kg (89 mg) and increase toward 15 mg/kg (134 mg) if needed for adequate fever or pain control 1
  • Maximum daily limit: 534 mg total in 24 hours (60 mg/kg/day) 1
  • Dosing interval: Every 6 hours, allowing up to 4 doses per day 1

Formulation and Administration

  • Oral suspension concentration: Most pediatric acetaminophen suspensions are 160 mg/5 mL 2
  • Volume calculation: For 10 mg/kg (89 mg), administer approximately 2.8 mL; for 15 mg/kg (134 mg), administer approximately 4.2 mL 2
  • Administration: Can be given with or without food, though administration with meals may improve gastrointestinal tolerability 2

Critical Safety Considerations

  • Avoid combination products: Parents must be counseled to avoid all other products containing acetaminophen, including over-the-counter cold remedies, as inadvertent overdosing is a significant risk 1
  • Hepatotoxicity threshold: Toxicity is unlikely unless plasma concentrations exceed 150 micrograms/mL, far above therapeutic levels of 5-20 micrograms/mL 3
  • No long-term hepatic damage: Long-term therapeutic use at recommended doses does not appear to be associated with liver damage 3

Common Pitfalls to Avoid

  • Double-dosing error: The most common error is parents administering acetaminophen while also giving combination cold/flu products that contain acetaminophen 1
  • Exceeding maximum daily dose: Never exceed 60 mg/kg/day (534 mg for this 8.9kg infant), as this increases hepatotoxicity risk 1
  • Incorrect concentration: Verify the concentration of the suspension being used, as infant drops (80 mg/0.8 mL) differ from children's suspension (160 mg/5 mL) 2

Alternative Route (If Oral Not Feasible)

  • Intravenous dosing: If IV administration is required, use 7.5-10 mg/kg per dose (67-89 mg) every 6 hours 4
  • IV preparation: Standard concentration is 10 mg/mL; can be diluted in 0.9% normal saline or 5% dextrose 4

References

Guideline

Dosage Recommendations for Ibuprofen and Paracetamol in Children

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Acetaminophen: a practical pharmacologic overview.

Canadian Medical Association journal, 1984

Guideline

Injectable Paracetamol Dosing in Children

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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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