Paracetamol Dosing for a 21kg, 5-Year-Old Male
For a 21kg child aged 5 years, administer 6.3 mL of paracetamol 250mg/5mL syrup every 4 hours, not exceeding 5 doses in 24 hours. 1
Dosing Calculation
- The standard pediatric dose is 10-15 mg/kg per dose, given every 4-6 hours 1
- For this 21kg child, the recommended single dose range is 210-315 mg per dose
- Using the 15 mg/kg dosing (which provides optimal analgesia): 21kg × 15 mg/kg = 315 mg per dose 1, 2
- With a 250mg/5mL concentration: (315 mg ÷ 250 mg) × 5 mL = 6.3 mL per dose 3
Dosing Interval and Maximum Daily Dose
- Administer every 4 hours as needed for fever or pain 1, 3
- Maximum of 5 doses in 24 hours for children aged 4 to under 6 years 3
- The total daily dose must not exceed 60 mg/kg/day (1,260 mg/day for this child) 1, 4
- At 315 mg per dose × 5 doses = 1,575 mg/day, which slightly exceeds the weight-based maximum, so strict adherence to the 5-dose limit is essential 1
Critical Safety Considerations
- Never exceed 5 doses in 24 hours to prevent hepatotoxicity 1, 3
- Oral syrup formulation is preferred over rectal suppositories due to more rapid and consistent absorption 1, 5
- Parents should carefully record all dose times to avoid accidentally exceeding the maximum recommended dose 6
- Chronic exposures greater than 140 mg/kg/day for several days carry risk of serious hepatotoxicity 7
Alternative Dosing Based on Age Guidelines
- The FDA-approved dosing for children 4 to under 6 years is 7.5 mL (240 mg) every 4 hours 3
- However, weight-based dosing at 15 mg/kg is more accurate and provides better efficacy for this specific child 2, 5
- The 6.3 mL calculated dose falls between the age-based recommendation (7.5 mL) and provides appropriate dosing without exceeding safety limits 1