Initial Dosage Guidelines for Nonopioid Analgesics in Infants and Children

Table: Initial Dosage Guidelines for Nonopioid Analgesics in Infants and Children*
Drug	Dose (mg/kg) (<60 kg)	Dose (mg) (≥ 60 kg)	Interval (hours)	Daily Maximum Dose (mg/kg)(<60 kg)	Daily Maximum Dose ((mg)(≥ 60 k )
Acetaminophen Oral Rectal	10-15 20†	650-1000 1000	4 6	90* 120	4000
Ibuprofen	5-10	400-600‡	6	40	2400‡
Naproxen	5-6	250-375‡	12	24	1000‡
Aspirin§	10-15	650-1000‡	4	80	3600‡
Ketorolac (IV)	0.25-0.5	15-30	6	2	120
*Maximum daily doses for acetaminophen in term neonates and infants, should be reduced to 60 mg/kg,and to 45 mg/kg in preterm neonates. †A loading dose of 35-40 mg/kg is recommended when acetaminophen is administered rectally ‡Higher doses may be used in selected cases for treatment of rheumatologic conditions in children. §Aspirin carries a risk of provoking Reye's syndrome in infants and children. If other analgesics are available,aspirin use should be restricted to indications where anti-platelet or anti-inflammatory effect is required, rather than as a routine analgesic or antipyretic in neonates, infants, or children. Dosing guidelines for aspirin in neonates have not been established. Reproduced with permission from Berde CB,Sethna NP.Analgesics for the treatment of pain in children. N Engl J Med.2002;347:1094-1103.