Triclofos Weight-Based Dosing in Pediatrics Over 2 Years Old
For pediatric sedation in children over 2 years old, triclofos should be dosed at 75-80 mg/kg orally, with a maximum single dose not exceeding 100 mg/kg, administered 30-45 minutes before the procedure. 1, 2
Standard Dosing Protocol
The recommended dose is 75-80 mg/kg given orally for sedation during non-painful diagnostic procedures such as EEG, audiometry, or ophthalmic examinations 1, 2
Onset of sedation occurs at a median of 25-45 minutes after oral administration, with duration of sedation lasting approximately 35 minutes 1, 2
If inadequate sedation is achieved after 30 minutes, supplemental doses of 5 mg/kg can be given every 5 minutes up to 60 minutes from initial administration 2
Dosing Range and Variations
Lower doses of 50 mg/kg have been used successfully but may result in lower success rates for adequate sedation 1, 3
The upper limit of 80 mg/kg has been validated as safe and effective in multiple studies involving children with neurocognitive disorders and those undergoing ophthalmic procedures 1, 2
Combination regimens using 50 mg/kg triclofos plus 1 mg/kg promethazine have been studied for particularly difficult-to-manage children, though this adds complexity and additional side effect risks 3
Safety Considerations
Triclofos demonstrates excellent safety when administered in monitored settings, with desaturation rates of only 0.2% and emesis rates of 0.35% in large pediatric cohorts 1
No cases of apnea, hemodynamic instability, or poor perfusion were reported in a study of 869 children, including 41.2% with neurocognitive disorders 1
Continuous monitoring of heart rate and oxygen saturation is mandatory throughout the sedation period 1, 2
Common Pitfall to Avoid
Do not use doses below 75 mg/kg expecting adequate sedation—the mean effective dose in successful cases was 83.8 mg/kg, and lower doses (50 mg/kg) resulted in suboptimal sedation depth 1, 2
Rare paradoxical reactions can occur, including non-epileptic pedaling-like movements that may be mistaken for seizures but are benign and self-limited 4
Administration Details
Triclofos is available as a syrup containing 100 mg/mL, making it palatable for oral administration in children 5
The medication should be given 45 minutes before the planned procedure to allow adequate time for onset 1, 3
Success rates of 88.5% for adequate sedation depth have been documented when proper dosing and timing are followed 1