What is the appropriate dosage of Zerodol P (paracetamol + aceclofenac) for a child weighing 50 kg?

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Zerodol P Dosage for a 50 kg Child

For a child weighing 50 kg, administer Zerodol P (paracetamol 325 mg + aceclofenac 100 mg) one tablet twice daily, which provides paracetamol 650 mg/day and aceclofenac 200 mg/day.

Paracetamol Component Dosing

  • The standard paracetamol dose is 10-15 mg/kg per dose every 4-6 hours, with a maximum daily dose of 60 mg/kg/day 1, 2, 3.

  • For a 50 kg child, this translates to 500-750 mg per dose, with a maximum of 3000 mg/day 1.

  • Children weighing more than 40 kg should receive adult dosing 1, which is 650 mg every 4-6 hours, not exceeding 4000 mg in 24 hours 2.

  • The paracetamol component in one Zerodol P tablet (325 mg) given twice daily provides 650 mg/day, which is well within safe limits and appropriate for mild-to-moderate pain 1.

Aceclofenac Component Considerations

  • The FDA label states that dosage and indication for aceclofenac is not established for children less than 6 years old 4.

  • For children over 6 years and weighing 50 kg, the typical adult dose of aceclofenac is 100 mg twice daily (200 mg/day total) 4.

  • One Zerodol P tablet twice daily provides aceclofenac 200 mg/day, which matches standard adult dosing appropriate for this weight 4.

Important Safety Considerations

  • Never exceed the maximum paracetamol dose of 60 mg/kg/day or 5 doses in 24 hours to prevent hepatotoxicity 1.

  • In children with chronic malnutrition, fasting >8 hours, or those on cytochrome P450-inducing medications (e.g., isoniazid), reduce paracetamol to 10 mg/kg per dose 1.

  • For children with pre-existing liver disease, use a reduced paracetamol dose of 10 mg/kg, though paracetamol remains safer than NSAIDs in this population 1.

  • Oral formulations are preferred over rectal due to more consistent absorption 1, 5.

Practical Dosing Algorithm

Step 1: Confirm the child's weight is ≥50 kg and age is >6 years 4.

Step 2: Assess for contraindications (hepatic insufficiency, known hypersensitivity, active peptic ulcer disease) 1, 5.

Step 3: Screen for risk factors requiring dose reduction (malnutrition, fasting, enzyme-inducing medications, liver disease) 1.

Step 4: If no contraindications or risk factors exist, prescribe one Zerodol P tablet twice daily (morning and evening) 2, 4.

Step 5: Monitor for adverse effects including gastrointestinal upset, hepatotoxicity, and renal impairment 1, 5.

Common Pitfalls to Avoid

  • Do not use aceclofenac in children under 6 years as safety and efficacy are not established 4.

  • Avoid combining Zerodol P with other paracetamol-containing products to prevent inadvertent overdose and hepatotoxicity 1, 2.

  • Do not exceed 3000 mg/day of paracetamol in this weight range when using combination products 1, 2.

  • Ensure adequate hydration when using NSAIDs like aceclofenac to minimize renal risk 5.

References

Guideline

Pediatric Acetaminophen and Ibuprofen Dosing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Pediatric dosing of acetaminophen.

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

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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