Intravenous Paracetamol Dosing for a 29kg Patient
For a 29kg pediatric patient, administer 435 mg (15 mg/kg) of IV paracetamol every 6 hours, with a maximum daily dose of 1740 mg (60 mg/kg/day). 1
Weight-Based Dosing Calculation
- Single dose: 15 mg/kg = 15 × 29 = 435 mg per dose 1
- Frequency: Every 6 hours (4 doses per 24 hours) 1
- Maximum daily dose: 60 mg/kg/day = 60 × 29 = 1740 mg/day 1
- Minimum interval: 4 hours between doses 1
Loading Dose Consideration
For acute pain management requiring more rapid onset, consider a loading dose approach:
- Loading dose: 15-20 mg/kg = 435-580 mg as first dose 1
- Maintenance: 10-15 mg/kg every 6-8 hours thereafter 1
- This still respects the 60 mg/kg/day maximum 1
Critical Safety Parameters
Do not exceed these thresholds:
- Maximum single dose: 15 mg/kg (435 mg for this patient) 1
- Maximum daily dose: 60 mg/kg (1740 mg for this patient) 1
- Maximum number of doses: 4 doses in 24 hours 1
Administration Guidelines
- Infuse over 15 minutes for standard dosing 2
- Monitor for hypotension during IV administration, particularly in hemodynamically unstable patients 3
- Ensure minimum 4-hour intervals between doses 1
High-Risk Situations Requiring Dose Reduction
Reduce dosing or extend intervals if:
- Pre-existing hepatic impairment present 1
- Concurrent chronic alcohol exposure (unlikely in pediatrics but relevant for adolescents) 1
- Malnutrition or chronic illness affecting hepatic function 1
In these cases, consider limiting to 2-3 grams/day maximum and extending dosing intervals 1
Common Pitfall to Avoid
Never combine with other paracetamol-containing products. The 1740 mg/day maximum includes ALL sources of paracetamol (oral, rectal, IV, and combination products). 3 Verify the patient is not receiving paracetamol through any other route or in combination medications before administering IV doses.