Acetaminophen Dosing for a 35.5 kg Child Using 10 mg/mL Solution
For a 35.5 kg child using a 10 mg/mL acetaminophen solution, administer 35.5–53 mL per dose (355–530 mg) every 6 hours, with a maximum daily volume of 213 mL (2,130 mg/day). 1
Dose Calculation at 10–15 mg/kg
At the lower end (10 mg/kg): 35.5 kg × 10 mg/kg = 355 mg per dose 1
- Volume needed: 355 mg ÷ 10 mg/mL = 35.5 mL per dose
At the upper end (15 mg/kg): 35.5 kg × 15 mg/kg = 532.5 mg per dose 1
- Volume needed: 532.5 mg ÷ 10 mg/mL = 53.25 mL per dose
Practical dosing range: 35.5–53 mL per dose every 6 hours 1
Maximum Daily Dosing
- The maximum daily dose is 60 mg/kg/day for children 1
- For this 35.5 kg child: 35.5 kg × 60 mg/kg = 2,130 mg maximum per day 1
- Maximum daily volume: 2,130 mg ÷ 10 mg/mL = 213 mL per day 1
- This allows for 4 doses of 53 mL (532.5 mg each) in 24 hours without exceeding the maximum 1
Critical Safety Considerations
Counsel caregivers to avoid all other acetaminophen-containing products, including over-the-counter cold and flu remedies, as inadvertent co-administration is a common cause of overdose 1
The 10 mg/mL concentration requires relatively large volumes (35.5–53 mL per dose), which increases the risk of measurement errors 1
- Use an oral syringe with clear mL markings rather than household spoons
- Double-check volume measurements before each dose
Acetaminophen can be administered without regard to meals, though giving it with food may improve gastrointestinal tolerability 1
Hepatotoxicity risk begins when plasma concentrations exceed 150 micrograms/mL—far above therapeutic levels of 5–20 micrograms/mL—but cumulative dosing errors over multiple administrations can lead to toxic accumulation 2
Common Pitfall to Avoid
The most frequent error with dilute solutions (10 mg/mL) is volume miscalculation. A 35.5 kg child requires 35.5–53 mL per dose—volumes that may seem unexpectedly large to caregivers accustomed to more concentrated formulations (typically 160 mg/5 mL or 32 mg/mL). Explicitly verify that caregivers understand they are measuring milliliters of solution, not milligrams of drug, and demonstrate proper syringe technique before discharge. 1