Acetaminophen Dosing for a 52-Pound Child
For a child weighing 52 pounds (23.6 kg), administer 236-354 mg of acetaminophen per dose, given every 4-6 hours as needed, not exceeding 5 doses in 24 hours.
Weight-Based Dosing Calculation
- The standard dose of acetaminophen is 10-15 mg/kg per dose, given every 4-6 hours 1
- For a 52 lb child (23.6 kg):
- Low dose (10 mg/kg): 236 mg per dose
- High dose (15 mg/kg): 354 mg per dose
- The maximum daily dose must not exceed 60 mg/kg per day (1,416 mg/day for this child) or 5 doses in 24 hours 1
Practical Dosing Recommendations
- Use 15 mg/kg dosing (354 mg) for optimal efficacy, as pharmacokinetic modeling demonstrates that 10 mg/kg doses fail to reach therapeutic plasma concentrations (10-20 μg/mL) needed for antipyresis 2
- The oral syrup formulation is absorbed more rapidly and provides more consistent response compared to rectal suppositories 1
- Common formulations include 160 mg/5 mL concentration, which would require approximately 11 mL for a 354 mg dose 2
Critical Safety Considerations
- Never exceed 60 mg/kg per day or 5 doses in 24 hours to prevent hepatotoxicity 1
- Weight-based dosing is superior to age-based dosing, as up to 30% of febrile children receive inadequate doses when parents use age-based recommendations 2
- If alternating with ibuprofen, stagger medications every 3-4 hours (acetaminophen every 4-6 hours, ibuprofen every 6-8 hours) 1
Special Circumstances
- For post-vaccination fever, acetaminophen can be given at the time of vaccination and every 4 hours for 24 hours 1
- For children with history of febrile seizures, prophylactic dosing at 15 mg/kg every 4 hours may reduce fever risk, though it does not prevent seizure recurrence 1
- Avoid rectal formulations when possible due to erratic absorption that may result in inadequate analgesia or risk of accumulation 1