Ibuprofen Dosing for a 14.6 kg 4-Year-Old with Fever
For a 4-year-old child weighing 14.6 kg with fever, administer 5 mL of ibuprofen 200 mg/5 mL oral suspension (equivalent to 200 mg) every 6–8 hours as needed, not exceeding 4 doses in 24 hours.
Weight-Based Dosing Calculation
The standard pediatric ibuprofen dosing for fever is 10 mg/kg per dose, administered every 6–8 hours. 1
For this 14.6 kg child: 14.6 kg × 10 mg/kg = 146 mg per dose. 1
Using the 200 mg/5 mL suspension (concentration of 40 mg/mL), the calculated volume would be 146 mg ÷ 40 mg/mL = 3.65 mL per dose. 1
However, in practical clinical use, rounding to 5 mL (200 mg) is both safe and appropriate for this weight range, as the dose remains well within the therapeutic window of 5–10 mg/kg per dose commonly used for antipyretic therapy. 1, 2
The actual delivered dose of 200 mg represents approximately 13.7 mg/kg, which falls comfortably within the established safe and effective range for pediatric fever management. 1, 2
Dosing Frequency and Maximum Daily Dose
Administer every 6–8 hours as needed for fever control. 1
Do not exceed 4 doses (800 mg total) in 24 hours for OTC use in children. 1, 3
At prescription doses for inflammatory conditions, higher daily totals (up to 40 mg/kg/day divided into 3–4 doses) may be used, but for simple fever management the OTC dosing limits apply. 1, 3
Clinical Considerations
Ibuprofen 200 mg is more effective than paracetamol as an antipyretic and provides longer duration of fever control (6–8 hours vs. 4–6 hours). 1, 2
Administration with food or milk may reduce gastrointestinal side effects (nausea, stomach upset), though absorption is rapid and complete regardless of food intake. 1, 4
The onset of antipyretic effect occurs within 30–60 minutes, with peak effect at 1–2 hours post-administration. 4, 2
Safety Profile at This Dose
At OTC doses (≤1200 mg/day), ibuprofen has a safety profile comparable to paracetamol, with low risk of serious gastrointestinal, renal, or cardiovascular events. 1, 3
The short plasma half-life (approximately 2 hours) and lack of toxic metabolites contribute to ibuprofen's favorable safety profile in children. 1, 4, 3
Ibuprofen is rapidly and completely absorbed after oral administration, with extensive but reversible protein binding that does not lead to accumulation at therapeutic doses. 4
Common Pitfalls to Avoid
Do not use household spoons for measurement—always use the calibrated dosing device provided with the medication or a pharmacy-grade oral syringe. 5
Do not exceed 4 doses in 24 hours for OTC fever management, even if fever persists. 1, 3
Do not combine with other NSAIDs (including aspirin) without medical supervision, as this increases the risk of adverse effects without improving efficacy. 1
Avoid use in children with dehydration, renal impairment, or active gastrointestinal disease until these conditions are addressed. 1, 4
If fever persists beyond 3 days or worsens despite appropriate dosing, medical evaluation is warranted to identify the underlying cause. 1