What is the minimum and maximum dose of children's ibuprofen (ibuprofen) for pediatric patients?

Pediatric Ibuprofen Dosing

For children, ibuprofen should be dosed at 10 mg/kg per dose every 6-8 hours, with a maximum total daily dose of 30-40 mg/kg per day. 1, 2

Minimum Effective Dose

• The minimum effective dose is 5 mg/kg per dose, though clinical trials demonstrate that 7.5-10 mg/kg provides optimal efficacy for fever and pain relief. 2, 3
• Doses below 5 mg/kg are generally subtherapeutic and should be avoided. 2

Standard Dosing Range

• The recommended dose range is 5-10 mg/kg per dose, administered every 6-8 hours as needed. 2
• The dose-response relationship is linear across this range, meaning higher doses within this range provide incrementally better antipyretic and analgesic effects. 3
• Maximum fever reduction occurs 3-4 hours after administration. 3

Maximum Dosing Limits

• The maximum single dose should not exceed 10 mg/kg. 2, 4
• The maximum frequency is 3-4 times per 24 hours, resulting in a maximum total daily dose of 30-40 mg/kg per day. 2
• Exceeding these limits increases risk without additional therapeutic benefit. 2

Age and Weight Restrictions

• Ibuprofen is generally not recommended for infants under 6 months of age. 1
• For infants aged 3-6 months, short-term use is considered safe only if body weight exceeds 5-6 kg and special attention is given to hydration status. 2
• Children weighing more than 40 kg should receive adult dosing. 5

Route of Administration

• Oral administration is strongly preferred over rectal routes. 2
• The rectal route has erratic absorption, especially in young infants, making it unreliable for consistent therapeutic effect. 2

Comparative Efficacy

• Ibuprofen 5-10 mg/kg is more effective as an antipyretic than acetaminophen 10-15 mg/kg at 2,4, and 6 hours post-treatment, with effect sizes of 0.31,0.33, and 0.33 respectively. 4
• For pain relief, ibuprofen 4-10 mg/kg and acetaminophen 7-15 mg/kg show comparable efficacy. 4
• Ibuprofen provides approximately 2.5 additional hours without fever over 24 hours compared to ibuprofen alone when combined with acetaminophen. 6

Safety Considerations

• Ibuprofen is better tolerated by children than adults and is safer in overdose than acetaminophen or aspirin. 3
• No difference in adverse effects has been observed between ibuprofen and acetaminophen in pediatric populations. 6, 4
• Ensure adequate hydration, particularly in infants under 6 months. 2

Common Pitfalls to Avoid

• Do not use rectal formulations as a first-line route due to unpredictable absorption. 2
• Do not exceed 4 doses in 24 hours to prevent inadvertent overdosing, particularly when alternating with acetaminophen. 6
• Do not use in dehydrated patients without first addressing fluid status, especially in young infants. 2
• If alternating with acetaminophen, carefully record all dose times to avoid exceeding maximum recommended doses for either medication. 6