What is the recommended dose of ibuprofen (nonsteroidal anti-inflammatory drug (NSAID)) for pediatric patients?

Ibuprofen Dosing for Pediatric Patients

The recommended dose of ibuprofen for pediatric patients is 10 mg/kg every 6-8 hours orally, with a maximum daily dose of 40 mg/kg/day. 1

Standard Dosing by Age and Weight

Infants and Young Children (≥6 months to <10 years)

• Dose: 10 mg/kg orally every 6-8 hours 1, 2
• Maximum daily dose: 40 mg/kg/day 1, 2
• Dosing interval: Every 8 hours is most commonly recommended, though every 6 hours is acceptable for more frequent dosing needs 1, 3

Children ≥10 Years or >40 kg

• Dose: 10 mg/kg every 6-8 hours, with a maximum of 600 mg per dose 1
• For children >40 kg: Use adult dosing recommendations 1

Age-Specific Considerations

Infants 3-6 Months Old

• Ibuprofen is considered safe in infants older than 3 months with body weight above 5-6 kg when special attention is given to hydration 2
• Dose range: 5-10 mg/kg per dose 2
• Maximum frequency: 3-4 times daily, resulting in a maximum total daily dose of 30-40 mg/kg 2

Infants <3 Months

• Not recommended due to lack of safety data 1, 2

Clinical Pharmacology Supporting These Doses

The effective dose range has been established at 7.5-10 mg/kg based on clinical trials, with maximum temperature reduction occurring 3-4 hours after administration 4. Pharmacokinetic studies demonstrate that ibuprofen clearance (1.2-1.4 ml/min/kg) and elimination half-life (1.6 hours) remain consistent across the 5-10 mg/kg dose range in children aged 3-10 years 5.

Comparative Efficacy Data

• 10 mg/kg ibuprofen is equally effective as 15 mg/kg acetaminophen for initial fever reduction 3
• Duration of action: Ibuprofen provides longer fever control than acetaminophen, with an additional 2.5 hours without fever over 24 hours when compared to acetaminophen alone 6
• Lower doses (2.5-5 mg/kg) are less effective than 10 mg/kg for initial fever reduction 3

Route of Administration

Oral route is strongly preferred. The rectal route has been shown to be less reliable because of erratic absorption, especially in young infants 2.

Common Pitfalls to Avoid

• Dehydration risk: Special attention must be given to maintaining adequate hydration, particularly in infants 3-6 months old 2
• Exceeding maximum daily dose: The maximum of 40 mg/kg/day should not be exceeded; studies show 8-11% of parents inadvertently exceed recommended maximum doses when using multiple antipyretics 6
• Use in febrile infants <3 months: Avoid due to insufficient safety data 2
• Rectal administration in young infants: Avoid due to unpredictable absorption 2