Paracetamol Dosing for a 13 kg Child
For a 13 kg child, administer paracetamol syrup at 15 mg/kg per dose (195 mg), given every 4-6 hours, not exceeding 60 mg/kg per day (780 mg/day) or 5 doses in 24 hours. 1
Weight-Based Calculation
- Single dose: 13 kg × 15 mg/kg = 195 mg per dose 1, 2
- Maximum daily dose: 13 kg × 60 mg/kg = 780 mg per day 1
- Dosing interval: Every 4-6 hours as needed 1
- Maximum frequency: Not to exceed 5 doses in 24 hours 1
Rationale for 15 mg/kg Dosing
The 15 mg/kg dose is strongly supported over lower doses:
- Recent evidence demonstrates that 15 mg/kg is significantly more effective than placebo and at least as effective as NSAIDs for both fever and pain management 2
- Older studies using subtherapeutic doses of ≤10 mg/kg showed paracetamol to be less effective than NSAIDs, but this was due to inadequate dosing 2
- The 15 mg/kg dose has a tolerability profile similar to placebo when used for short-term treatment 2
- This dosing maximizes efficacy and avoids delays in therapeutic effect 2
Practical Administration
For a 13 kg child requiring 195 mg per dose:
- If using standard pediatric paracetamol syrup (160 mg/5 mL): Administer approximately 6 mL per dose 1
- Oral syrup formulations are absorbed more rapidly and provide more consistent response compared to suppositories 1
- The dose can be rounded by up to 5% for ease of home administration while maintaining safety 3
Critical Safety Parameters
Never exceed these limits:
- Maximum single dose: 15 mg/kg (195 mg for this child) 1
- Maximum daily dose: 60 mg/kg/day (780 mg for this child) 1
- Maximum number of doses: 5 doses in 24 hours 1
- Minimum dosing interval: 4 hours between doses 1, 4
Toxicity Prevention
- Single ingestions exceeding 10 times the recommended dose are potentially toxic 5
- Chronic exposures greater than 140 mg/kg/day for several days carry risk of serious hepatotoxicity 5
- For this 13 kg child, the maximum daily dose of 780 mg is well below toxic thresholds when used as directed 1
Special Considerations
- For infants under 3 months, paracetamol is the only recommended analgesic, but this child is beyond that age range 1
- Paracetamol is indicated for use in children of all ages, unlike NSAIDs which have age restrictions 2
- When used at repetitive doses for consecutive days, paracetamol shows lower risk of adverse events compared to NSAIDs 2