What is the recommended dose of ibuprofen (nonsteroidal anti-inflammatory drug (NSAID)) for a 49-pound child with no underlying medical conditions?

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Ibuprofen Dosing for a 49-Pound Child

For a 49-pound (22.2 kg) child, administer ibuprofen 220 mg per dose, given every 6-8 hours as needed, with a maximum of 3 doses in 24 hours. 1

Weight-Based Calculation

  • The standard pediatric dose is 10 mg/kg per dose 1, 2
  • For a 49-pound child (22.2 kg): 22.2 kg × 10 mg/kg = 222 mg per dose 1, 2
  • Round to a practical 200-220 mg per dose depending on available formulation strengths 2
  • This child weighs less than 40 kg, so weight-based pediatric dosing applies rather than adult dosing 1, 2

Dosing Schedule and Maximum Limits

  • Administer every 6-8 hours (not more frequently than every 6 hours) 1
  • Maximum of 3 doses in 24 hours 2
  • Maximum daily dose should not exceed 40 mg/kg/day (approximately 888 mg/day for this child) 2
  • The dosing interval for ibuprofen is longer than acetaminophen (every 6-8 hours versus every 4-6 hours) 1

Practical Administration Considerations

  • Liquid formulations are preferred for children under 40 kg to ensure accurate weight-based dosing 2
  • Ibuprofen is generally not recommended for infants under 6 months 1
  • For children 3-6 months, short-term use is considered safe only if body weight is above 5-6 kg with special attention to hydration 3

Critical Safety Warnings

  • Do not combine ibuprofen with other NSAID medications without dose adjustment 2
  • Be aware of "hidden sources" of NSAIDs in combination over-the-counter medications 2
  • If the child is taking low-dose aspirin (such as in Kawasaki disease), ibuprofen must be avoided as it antagonizes aspirin's antiplatelet effects 2
  • Ensure adequate hydration, especially in young children 3

Duration of Action and Efficacy

  • Peak analgesic effect occurs 3-4 hours after administration 4
  • Duration of action is at least 6 hours for ibuprofen 400 mg doses 5
  • Ibuprofen has been shown to be equally effective or more effective than acetaminophen as an antipyretic with longer duration of action 4, 6

References

Guideline

Pediatric Acetaminophen and Ibuprofen Dosing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Ibuprofen Dosing Guidelines for Pediatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

A general overview of the use of ibuprofen in paediatrics.

International journal of clinical practice. Supplement, 2003

Research

Review of the analgesic efficacy of ibuprofen.

International journal of clinical practice. Supplement, 2003

Research

Ibuprofen: pharmacology, efficacy and safety.

Inflammopharmacology, 2009

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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