What is the recommended dose of Tylenol (acetaminophen) for a 9-month-old infant weighing 18 pounds?

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Tylenol Dosing for a 9-Month-Old Weighing 18 Pounds

For a 9-month-old infant weighing 18 pounds (8.2 kg), give 82-123 mg of acetaminophen (Tylenol) every 4-6 hours as needed, not exceeding 5 doses in 24 hours. 1

Weight-Based Calculation

  • The standard acetaminophen dose is 10-15 mg/kg per dose 1, 2
  • For an 18-pound infant (8.2 kg):
    • Minimum dose: 10 mg/kg × 8.2 kg = 82 mg
    • Maximum dose: 15 mg/kg × 8.2 kg = 123 mg
  • Administer every 4-6 hours as needed 1
  • Maximum daily dose: 60 mg/kg/day (492 mg/day for this infant) or 5 doses in 24 hours, whichever is less 1

Practical Dosing with Available Formulations

  • Oral suspension (160 mg/5 mL concentration): Give 2.5-4 mL per dose 1
  • The oral syrup formulation is absorbed more rapidly and provides more consistent response compared to suppositories 1
  • Dosing can be rounded by up to 15% for ease of home administration 3

Critical Safety Considerations

  • Never exceed 60 mg/kg per day or 5 doses in 24 hours to prevent hepatotoxicity 1
  • For infants under 3 months, acetaminophen is the only recommended analgesic, but this 9-month-old is beyond that restriction 1
  • Studies show that 27-62% of parents inadvertently underdose or overdose acetaminophen, with infants under 1 year at highest risk for dosing errors 4, 5
  • Parents who base dosing on weight (rather than age alone) are significantly less likely to misdose medication 5

Clinical Context

  • Acetaminophen will improve comfort but does not prevent febrile seizures 1
  • For post-vaccination fever, acetaminophen can be given at the time of vaccination and every 4 hours for 24 hours 1
  • If alternating with ibuprofen becomes necessary (though ibuprofen is generally not recommended under 6 months), stagger medications every 3-4 hours 1

References

Guideline

Pediatric Acetaminophen and Ibuprofen Dosing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Pediatric dosing of acetaminophen.

Pediatric pharmacology (New York, N.Y.), 1983

Guideline

Guaifenesin Dosing Guidelines for Pediatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Acetaminophen and ibuprofen dosing by parents.

Pediatric emergency care, 2000

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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