Acetaminophen Dosing for a 7-Year-Old Weighing 19 kg
For this 19 kg child, administer 190-285 mg of acetaminophen per dose (using the standard 10-15 mg/kg dosing), given every 4-6 hours, not exceeding 5 doses in 24 hours (maximum 1140 mg/day). 1
Weight-Based Dosing Calculation
- Standard dose range: 10-15 mg/kg per dose 1, 2, 3
- For a 19 kg child:
- Minimum dose: 190 mg (10 mg/kg × 19 kg)
- Maximum dose: 285 mg (15 mg/kg × 19 kg)
- Dosing interval: Every 4-6 hours 1, 2
- Maximum daily dose: 60 mg/kg/day = 1140 mg/day for this child 1
- Maximum frequency: 5 doses in 24 hours 1
Practical Administration
- Oral syrup is preferred over rectal suppositories because it provides more rapid and consistent absorption 1
- Common liquid formulations are 160 mg/5 mL, so this child would receive approximately 6-9 mL per dose 3
- Document all dose times carefully to avoid accidentally exceeding the maximum recommended daily dose 4
Clinical Context and Safety
- The 10 mg/kg dose provides adequate antipyresis for most children, while 15 mg/kg may be more effective for higher fever or pain 5
- A loading dose approach (15 mg/kg initially, then 10-12.5 mg/kg maintenance) can be considered for more rapid symptom control 5
- Single ingestions exceeding 150 mg/kg (2850 mg for this child) are potentially hepatotoxic, though chronic exposures above 140 mg/kg/day for several days also carry toxicity risk 2
Common Pitfalls to Avoid
- Underdosing is common: studies show 27% of parents give less than 10 mg/kg, resulting in inadequate symptom relief 6
- Overdosing also occurs: 12% of parents exceed 20 mg/kg per dose, and 8-11% exceed the maximum number of daily doses 6, 4
- Parents must understand that "every 4 hours" means no more than 5 doses in 24 hours, not continuous around-the-clock dosing 1
When to Consider Ibuprofen Instead
- If fever persists or acetaminophen alone is insufficient, ibuprofen 10 mg/kg every 6-8 hours (maximum 190 mg per dose for this child) may be more effective 1
- Ibuprofen is generally not recommended for infants under 6 months but is appropriate for this 7-year-old 1
- Alternating acetaminophen and ibuprofen provides an additional 2.5-4.4 hours without fever compared to either alone, but increases the risk of dosing errors 4