What is the recommended oseltamivir (Tamiflu) dosage for a child weighing 9 kg?

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Tamiflu Dosage for a 9 kg Child

For a child weighing 9 kg who is ≥12 months old, administer 30 mg (5 mL of oral suspension) twice daily for 5 days for treatment, or 30 mg once daily for 10 days for prophylaxis. 1, 2, 3

Age-Specific Dosing Considerations

The correct dose depends critically on whether this child is younger or older than 12 months:

For Children ≥12 Months (Weight-Based Categorical Dosing)

  • Treatment regimen: 30 mg orally twice daily for 5 days 1, 2, 3
  • Prophylaxis regimen: 30 mg orally once daily for 10 days 1, 2, 3
  • This applies to all children weighing ≤15 kg who are at least 12 months old 1, 2
  • The 30 mg dose equals 5 mL of the 6 mg/mL oral suspension 1, 3

For Infants <12 Months (mg/kg-Based Dosing)

If this 9 kg child is younger than 12 months, do not use the 30 mg categorical dose—instead, calculate based on actual body weight:

  • Infants 9-11 months: 3.5 mg/kg per dose twice daily = 31.5 mg (approximately 5.25 mL) twice daily for treatment 1, 2, 4
  • Infants 0-8 months: 3.0 mg/kg per dose twice daily = 27 mg (4.5 mL) twice daily for treatment 1, 2, 4
  • Prophylaxis for infants 3-11 months: 3.0 mg/kg once daily for 10 days 1, 2
  • Prophylaxis is not recommended for infants <3 months unless the situation is critical 1, 2, 3

For Preterm Infants (Postmenstrual Age-Based Dosing)

If this child was born prematurely, dosing must be based on postmenstrual age (gestational age + chronological age), not weight alone:

  • <38 weeks postmenstrual age: 1.0 mg/kg twice daily = 9 mg (1.5 mL) 1, 2
  • 38-40 weeks postmenstrual age: 1.5 mg/kg twice daily = 13.5 mg (2.25 mL) 1, 2
  • >40 weeks postmenstrual age: 3.0 mg/kg twice daily = 27 mg (4.5 mL) 1, 2

Critical Pitfalls to Avoid

  • Never apply the ≤15 kg categorical dose (30 mg) to infants <12 months old—this dosing scheme is exclusively for children ≥12 months 2, 5
  • Never use term-infant dosing for preterm infants—immature renal function requires lower, postmenstrual age-adjusted doses to prevent toxic drug accumulation 1, 2, 5
  • Never round up to the next weight category—a 9 kg child remains in the ≤15 kg bracket and should not receive 45 mg 2
  • Never use household spoons for measurement—always use a calibrated oral syringe, particularly for infants requiring precise mg/kg dosing 2, 5

Formulation and Administration

  • Use the oral suspension formulation (6 mg/mL concentration) for young children 1, 3
  • If commercial suspension is unavailable, pharmacies can compound it according to package insert instructions 1, 6, 3
  • Administer with food to reduce gastrointestinal side effects (nausea, vomiting), which occur in approximately 10-15% of patients 6, 7
  • For infants <12 months requiring small volumes, use a 3-mL or 5-mL calibrated oral syringe for accurate measurement 2, 5

Timing and Clinical Context

  • Initiate treatment within 48 hours of symptom onset for maximum benefit; starting within 12-24 hours provides substantially greater effectiveness 2, 5, 7
  • Early treatment reduces illness duration by approximately 1-1.5 days (26-36% reduction) and decreases secondary complications like otitis media by 44% 5, 8
  • Complete the full 5-day treatment course even if symptoms improve earlier 2, 5
  • For prophylaxis, initiate within 48 hours following close contact with an infected individual 1, 3

Special Populations

  • Renal impairment: For creatinine clearance 10-30 mL/min, reduce treatment dose to 30 mg once daily (instead of twice daily) for 5 days 1, 6, 3
  • Immunocompromised patients: Prophylaxis may be extended up to 12 weeks during community outbreaks 3
  • Consultation recommended: For infants <1 year, especially neonates or those with low body weight, consider consulting a pediatric infectious disease specialist 1, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Tamiflu Dosing Guidelines for Pediatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Pediatric Oseltamivir Dosing and Clinical Guidance

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Oseltamivir Dosage and Administration Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Oral oseltamivir treatment of influenza in children.

The Pediatric infectious disease journal, 2001

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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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