Can You Give Paracetamol 300mg IV?
No, 300mg is not a standard intravenous dose of paracetamol and should not be administered. Standard IV paracetamol dosing for adults is typically 1000mg (1g) per dose, with a maximum of 4000mg per day in divided doses 1, 2.
Standard IV Paracetamol Dosing
Adult dosing: The typical IV dose is 1000mg administered over 15 minutes, repeated every 6 hours as needed, not exceeding 4000mg in 24 hours 1, 2
Weight-based dosing: For patients under 50kg, the dose should be 15mg/kg per dose (maximum 60mg/kg per day) 1
Pediatric dosing: Children require weight-based calculations, typically 10-15mg/kg per dose every 4-6 hours 1
Why 300mg is Problematic
Subtherapeutic dose: 300mg IV is far below the therapeutic range needed for effective analgesia or antipyresis in adults 1, 2
No established safety data: There is no clinical evidence supporting 300mg as a safe or effective IV dose 2
Risk of dosing errors: Using non-standard doses increases the likelihood of medication errors and confusion among healthcare providers 3
Appropriate Alternatives
If pain control is inadequate: Consider using the standard 1000mg IV dose of paracetamol if the patient has not exceeded daily limits 2
If concerned about cumulative dosing: Verify total paracetamol intake in the past 24 hours before administering additional doses to avoid exceeding 4000mg daily maximum 2
Alternative analgesics: If paracetamol limits are reached, consider NSAIDs (if not contraindicated) or opioid analgesics depending on pain severity 1, 4
Critical Safety Considerations
Maximum daily dose: Never exceed 4000mg of paracetamol from all sources (oral + IV) in 24 hours to prevent hepatotoxicity 2, 5
Hepatotoxicity risk: Doses exceeding 10g can cause acute liver failure, but toxicity can occur at lower doses in high-risk patients (chronic alcohol use, fasting, hepatic impairment) 5, 6
Monitoring: Watch for signs of toxicity including right upper quadrant pain, nausea, vomiting, and elevated liver enzymes, which may be delayed 24-72 hours 2, 5
Common Pitfalls to Avoid
Do not use arbitrary doses: Always use established dosing regimens (1000mg for adults >50kg, 15mg/kg for those <50kg) 1, 2
Account for all paracetamol sources: Include oral, rectal, and IV formulations when calculating 24-hour totals 2, 3
Avoid in hepatic failure: Paracetamol is contraindicated in patients with severe liver disease 5, 6