What is the recommended dose of paracetamol (acetaminophen) 100mg/ml for a 1-year-old patient weighing 13.8 kg?

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Paracetamol Dosing for a 1-Year-Old Weighing 13.8 kg

For a 1-year-old child weighing 13.8 kg, administer 0.7 mL of paracetamol 100mg/mL solution (equivalent to 70 mg) every 4-6 hours as needed, not exceeding 4 doses in 24 hours (maximum 280 mg/day).

Weight-Based Dosing Calculation

  • The recommended pediatric dose is 10-15 mg/kg per dose, with a maximum daily dose of 60 mg/kg/day divided into 4-6 doses 1
  • For this 13.8 kg child:
    • Minimum single dose: 10 mg/kg × 13.8 kg = 138 mg (1.4 mL of 100mg/mL solution)
    • Maximum single dose: 15 mg/kg × 13.8 kg = 207 mg (2.1 mL of 100mg/mL solution)
    • Maximum daily dose: 60 mg/kg × 13.8 kg = 828 mg total per day 1

Practical Dosing Recommendation

  • Start with 10 mg/kg (138 mg or 1.4 mL) every 4-6 hours as this provides adequate analgesia and antipyresis while minimizing toxicity risk 1
  • The dose can be increased toward 15 mg/kg if pain or fever control is inadequate, but this should be done cautiously 1
  • Never exceed 4 doses in 24 hours to stay well below the maximum daily threshold 1

Administration Considerations

  • Use an oral syringe for accurate measurement - this is critical in young children where small volume errors can lead to significant dosing errors 2
  • Oral absorption is rapid, with onset of action within 30-60 minutes and peak effect at 1-2 hours 3
  • The dosing interval of every 4-6 hours aligns with the drug's elimination half-life of approximately 2-2.5 hours and duration of analgesic effect 3

Critical Safety Points

  • Hepatotoxicity risk: While paracetamol has an excellent safety profile at therapeutic doses, exceeding 60 mg/kg/day significantly increases the risk of hepatic injury 4, 5
  • Avoid combining with other paracetamol-containing products (many over-the-counter cold and flu medications contain paracetamol) 4
  • In cases of suspected overdose, early administration of N-acetylcysteine is protective against liver damage 3, 5

Common Pitfalls to Avoid

  • Do not use adult dosing formulas - children under 40 kg require strict weight-based pediatric calculations 6
  • Avoid rectal administration if possible - suppositories have erratic and unpredictable absorption in young children, making oral dosing preferable 1, 3
  • Do not dose more frequently than every 4 hours - this increases the risk of accumulation and toxicity 1
  • Verify the concentration - paracetamol comes in multiple concentrations (100mg/mL, 160mg/5mL, etc.), and dosing errors are common when caregivers confuse formulations 2

References

Guideline

Acetaminophen Dosing Guidelines for Children Over 40kg

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Clinical pharmacokinetics of paracetamol.

Clinical pharmacokinetics, 1982

Research

Paracetamol: past, present, and future.

American journal of therapeutics, 2000

Guideline

Body Surface Area Calculation and Medication Dosing for Pediatric Patients

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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