Acetaminophen Suppository Dosing for a 14-Month-Old
For a 14-month-old child with fever, administer acetaminophen suppositories at a dose of 10-15 mg/kg per dose, given every 4-6 hours as needed, not exceeding 5 doses in 24 hours.
Weight-Based Dosing Algorithm
- Calculate the dose based on the child's weight: 10-15 mg/kg per dose 1
- For example, if the child weighs 10 kg, the appropriate dose range is 100-150 mg per suppository 1
- Administer every 4-6 hours as needed for fever control 1, 2
- Do not exceed 5 doses in a 24-hour period 2
Important Dosing Considerations
- The 10-15 mg/kg range is the evidence-based standard for pediatric acetaminophen dosing, established through clinical and pharmacokinetic studies 1
- Doses below 10 mg/kg are frequently inadequate for fever reduction, while doses above 15 mg/kg per administration increase toxicity risk without additional benefit 2
- Studies show that 27% of children receive underdoses (<10 mg/kg) when parents are not properly educated on weight-based calculations 2
Rectal Administration Specifics
- Suppositories should be reserved for children who cannot tolerate oral medications due to vomiting or inability to swallow 3, 4
- The rectal route has less predictable absorption compared to oral formulations 4
- In a national survey, 83% of children receiving suppositories were not vomiting, suggesting overuse of this route when oral administration would be more appropriate 3
Common Pitfalls to Avoid
- Do not use suppositories as first-line therapy if the child can tolerate oral medication—oral formulations provide more predictable pharmacokinetics 3, 4
- Avoid dosing more frequently than every 4 hours, as this was observed in 13% of cases and increases hepatotoxicity risk 2
- Do not use age-based dosing alone without considering weight, as this leads to significant under- or overdosing in 39% of children 2