Ibuprofen (Brufen) Dosing for Pediatric Patients
For children aged ≥6 months, administer ibuprofen at 5-10 mg/kg per dose every 6-8 hours, with a maximum of 30-40 mg/kg per day (not exceeding 4 doses in 24 hours). 1
Weight-Based Dosing Algorithm
The recommended dose is 10 mg/kg per dose for optimal efficacy, as clinical trials demonstrate this provides the most effective antipyretic and analgesic response. 1, 2 However, a lower dose of 5 mg/kg may be used for milder symptoms or in situations where conservative dosing is preferred. 1
Practical Dosing Examples by Weight:
- Child weighing 7 kg: 35-70 mg per dose 1
- Child weighing 10 kg: 50-100 mg per dose 1
- Child weighing 15 kg: 75-150 mg per dose 1
- Child weighing 20 kg: 100-200 mg per dose 1
- Child weighing 25 kg: 125-250 mg per dose 1
Dosing Frequency and Maximum Daily Limits
Administer doses every 6-8 hours as needed, with a maximum of 3-4 doses in 24 hours. 1, 3 The total daily dose should not exceed 30-40 mg/kg per day. 1
Peak temperature reduction occurs 3-4 hours after administration, which is important for timing subsequent doses and assessing efficacy. 2
Critical Safety Considerations
Absolute Requirements Before Administration:
- Ensure adequate hydration status - ibuprofen is contraindicated in dehydrated children 4
- Avoid in children with diarrhea and vomiting (with or without fever) due to increased risk of renal damage 4
- Do not use during varicella (chickenpox) infection 4
- Contraindicated in children with persistent asthma or wheezing 4
- Minimum age is 3 months and minimum weight is 5-6 kg 1
Common Pitfalls to Avoid:
Do not use the rectal route in young infants, as absorption is erratic and unreliable in this age group. 1 The oral route is strongly preferred.
Carefully record all dose times to prevent accidentally exceeding the maximum recommended daily dose, which occurred in 11% of children in one study. 3
Route of Administration
Oral administration is the preferred route due to reliable absorption and predictable pharmacokinetics. 1 The dose should be calculated based on actual body weight using 5-10 mg/kg per dose. 1
Clinical Context
Ibuprofen is the drug of first choice for inflammatory pain in children, demonstrating superior or equal efficacy compared to paracetamol (acetaminophen) with longer duration of action. 3, 2
For fever management, ibuprofen should be used selectively rather than routinely as an antipyretic, and is most appropriate when fever is causing significant discomfort or when treating inflammatory conditions. 4
The pharmacokinetic profile shows a mean elimination half-life of 1.6 hours, with maximum serum concentrations occurring at approximately 1.1-1.2 hours post-dose. 5 Pharmacokinetics are linear across the 5-10 mg/kg dose range and do not vary significantly with age in children 3-10 years. 5