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BNF revises paracetamol dosing advice for infants

GPs have been advised of updated maximum daily dosages of paracetamol for infants aged up to six months in a revision to BNFC guidance.

The updated advice includes the addition of a maximum daily dose of 60 mg/kg in children one to three months of age, when used for pain or pyrexia with discomfort.

There is also an addition of intravenous dose advice according to weight, with a maximum dose of 30 mg/kg for children under 10 kg.

The updates come alongside changes to maximum post-operative doses, following advice from the UK Medicines and Healthcare Products Regulatory Agency (MHRA) that previous doses exceeded those now considered to be toxic, according to the latest evidence.

A BNF spokesperson said: ‘These are relatively small changes in comparison to changes made to the maximum postoperative pain doses in children up to 12 years but have also been discussed with expert advisers and agreed with the Paediatric Formulary Committee.’

The February BNF newsletter stated: ‘Recommended indications and doses of paracetamol in children have been revised to take account of the MHRA and Toxbase advice that paracetamol toxicity may occur with paracetamol doses between 75-150mg/kg/day (ingestion of over 150mg/kg/day is regarded as a definite risk of toxicity).

‘The doses affected are oral and rectal doses in children under six months, intravenous doses, and maximum doses recommended in postoperative pain; paracetamol is no longer recommended for the treatment of severe postoperative pain.’

Readers' comments (3)

  • Vinci Ho

    60mg/kg/day should be always in our mind.
    So a 5 kg baby can really only have 300mg paracetamol a day , i.e. 60mg(2.5ml) five times a day.

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  • or of course if your are a bear of little brain like me, 60mg/kg/day = 10mg/kg q4hly [ easy rithmetic ] and half as much again q6hly
    bin doin it that way since was anaesthetist in 1986

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  • The way I read the BNF, it suggests 4 times a day maximum

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