What is the recommended dose of ibuprofen (nonsteroidal anti-inflammatory drug (NSAID)) for a child?

Ibuprofen Dosing for Children

The recommended dose of ibuprofen for children is 10 mg/kg per dose every 6-8 hours (maximum 3-4 doses per day), with a maximum daily dose of 40 mg/kg/day. 1, 2

Weight-Based Dosing Algorithm

The dosing should be calculated based on the child's weight, not age:

• Standard dose: 10 mg/kg per dose 1, 2, 3
• Dosing interval: Every 6-8 hours 3, 4
• Maximum daily dose: 40 mg/kg/day (not to exceed 30-40 mg/kg total in 24 hours) 1, 3
• Maximum single dose: 600 mg for children ≥10 years or >40 kg (use adult dosing) 1

Age and Weight Restrictions

Minimum age: Ibuprofen should only be used in children ≥3 months of age with body weight >5-6 kg, with special attention to hydration status. 3

• Do not use in infants <3 months due to lack of safety data 1
• For infants 3-6 months, ensure adequate hydration before and during treatment 3

Practical Dosing by Weight Categories

For children ≥6 months: 2, 4

• <15 kg: 110 mg per dose
• >15-23 kg: 150-230 mg per dose
• >23-40 kg: 230-400 mg per dose
• >40 kg: Use adult dosing (400-600 mg per dose)

Clinical Efficacy Considerations

Onset and duration of action: 5, 6

• Maximum temperature reduction occurs 3-4 hours after administration 5
• Ibuprofen provides superior antipyretic effect compared to acetaminophen at 2,4, and 6 hours post-dose 6
• Duration of action is longer than acetaminophen 5

Important Safety Caveats

Route of administration: 3

• Oral route is preferred
• Avoid rectal administration in young infants due to erratic absorption 3

Hydration status: Ensure the child is adequately hydrated before administering ibuprofen, especially in infants 3-6 months old. 3

Dosing frequency pitfalls: 4

• Parents frequently exceed the maximum recommended number of doses (8-11% in clinical trials) 4
• Strongly recommend providing parents with a written dosing schedule to track administration times and prevent accidental overdosing 4

Combination therapy: If considering alternating or combining with acetaminophen for persistent fever, this provides additional antipyresis at 4-6 hours but increases risk of dosing errors. 4, 7 Document all medication times carefully to avoid exceeding maximum doses of either drug. 4