What is the appropriate ibuprofen dose for a 3‑year‑old child weighing 17 kg with fever using a 200 mg/5 mL suspension?

Ibuprofen Dosing for a 3-Year-Old Child Weighing 17 kg with Fever

For a 17 kg child with fever, administer 85 mg (approximately 2 mL) of ibuprofen suspension (200 mg/5 mL) every 6-8 hours, not exceeding 3 doses in 24 hours.

Weight-Based Dosing Calculation

• The recommended dose of ibuprofen for fever in children is 10 mg/kg per dose 1, 2, 3
• For a 17 kg child: 17 kg × 10 mg/kg = 170 mg per dose
• Using your 200 mg/5 mL suspension: (170 mg ÷ 200 mg) × 5 mL = 4.25 mL per dose
• However, the effective dose range is 7.5-10 mg/kg, with clinical trials showing efficacy at 5-10 mg/kg 2, 3
• A dose of 5 mg/kg (85 mg or 2 mL) is appropriate and safer for initial dosing, particularly for home management 3

Dosing Frequency and Maximum Daily Dose

• Administer ibuprofen every 6-8 hours as needed for fever 1, 4
• Maximum of 3 doses in 24 hours (total daily dose should not exceed 30-40 mg/kg/day) 1, 3
• The maximum reduction in temperature occurs 3-4 hours after administration 2
• Duration of action is longer than acetaminophen, supporting the 6-8 hour dosing interval 2

Critical Safety Considerations

• Ensure adequate hydration before and during ibuprofen administration, as dehydration increases risk of renal complications 3
• Ibuprofen should not be used in children with varicella (chickenpox) due to risk of severe adverse events 1
• Avoid in children with compromised fluid status or renal insufficiency 1
• Carefully record all dose times to prevent accidentally exceeding the maximum recommended dose 4

When to Expect Improvement

• Clinical improvement should occur within 48-72 hours 5, 1
• If fever persists beyond 72 hours, worsens, or the child develops respiratory distress, severe dehydration, or altered consciousness, seek immediate medical evaluation 1

Alternative Dosing Strategy

• If using the 10 mg/kg dose (170 mg or 4.25 mL), this provides more robust antipyresis but requires stricter attention to hydration status and dosing intervals 2, 3, 6
• The 10 mg/kg dose is particularly appropriate if the child has higher fever (>39°C) or significant discomfort 2, 6

Important Caveats

• Antipyretics improve comfort but do not prevent febrile seizures 1
• The primary goal is improving the child's overall comfort, not just reducing temperature 1
• Ibuprofen is generally better tolerated in children than adults and safer in overdose than acetaminophen 2