Ibuprofen Dosing for a 74-Pound Pediatric Patient
For a patient weighing 74 pounds (33.6 kg), administer ibuprofen 335 mg (10 mg/kg) every 8 hours, with a maximum of 3 doses per 24 hours. 1
Weight-Based Dosing Calculation
- 74 pounds converts to approximately 33.6 kg (using standard conversion of 1 kg = 2.2 lbs) 1
- The recommended dose is 10 mg/kg per dose, which equals 336 mg for this patient 1, 2
- Since this patient weighs less than 40 kg, pediatric weight-based dosing applies rather than standard adult dosing 1, 2
Dosing Schedule and Maximum Limits
- Administer every 8 hours (3 times daily) with a maximum of 3 doses in 24 hours 1, 2
- Maximum daily dose should not exceed 40 mg/kg/day (approximately 1,344 mg/day for this patient) 2, 3
- The effective dose range is 7.5-10 mg/kg, with maximum temperature reduction occurring 3-4 hours after administration 4
Practical Administration
- Round the calculated 336 mg dose to a practical 300-400 mg per dose depending on available tablet strengths (typically 200 mg tablets, so 1.5-2 tablets)
- For patients weighing more than 23 kg but less than 40 kg, some guidelines suggest 60 mg per dose for certain indications, but weight-based calculation of 10 mg/kg is more accurate and appropriate 5, 1
Critical Safety Considerations
- Use with extreme caution or avoid in patients with dehydration, diarrhea, or vomiting, as dehydration significantly increases risk of renal damage 6
- Contraindicated in patients with wheezing, persistent asthma, or active varicella infection 6
- Monitor for gastrointestinal upset, though serious GI events are rare in pediatric patients 6
- Do not combine with other NSAID medications without dose adjustment 1
Common Pitfalls to Avoid
- Do not use ibuprofen primarily as an antipyretic except in rare cases; it should be reserved for inflammatory pain 6
- Avoid the rectal route in young patients due to erratic absorption 3
- Ensure adequate hydration status before administration, particularly in febrile illness 3, 6
- Be aware of "hidden sources" of NSAIDs in combination over-the-counter medications 1