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Table: Dosing Guidelines for Commonly Used Opioid Analgesics in Infants and Children |
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| Drug | Equianalgesic Doses | Usual Starting IV Doses and Intervals |
Parenteral/ Oral Dose Ratio |
Usual Starting Oral Doses and Intervals | |||
| PARENTERAL | ORAL | Child < 50 kg | Child ≥ 50 kg | Child < 50 kg | Child ≥ 50 kg | ||
| Codeine | 120 mg | 200 mg | N/R | N/R | 1:2 | 0.5-1 mg/kg q 3-4 hrs | 30-60 mg q 3-4 hr |
| Morphine | 10 mg | 30 mg (long-term) |
Bolus: 0.1 mg/kg q 2-4 hr Infusion: 0.02 –0.03 mg/kg/hr |
Bolus: 5-8 mg q 2-4 hr Infusion:1.5 mg/hr |
1:3 | Immediate Release: 0.3 mg/kg q 3-4 hr |
Immediate Release: 15-20 mg q 3-4 hr Sustained Release: 30-45 mg q 8-12 hr |
| Oxycodone | N/A | 15-20 mg | N/A | N/A | N/A | 0.1-0.2 mg/kg q 3-4 hr | 5-10 mg q 3-4 hr |
| Methadone | 10 mg | 10-20 mg | 0.1 mg/kg † | 5-8 mg q 4-8 hr | 1:2 | 0.1 mg/kg q 4-8 hr | 10 mg q 4-8 hr |
| Fentanyl |
100 mcg (0.1 mg) |
N/A |
Bolus: 0.5-1.0 mcg/kg q 1-2 hr Infusion: 0.5- 2.0 mcg/kg/hr |
Bolus: 25-50 mcg q 1-2 hrs Infusion: 25-100 mcg hr | N/A | N/A | N/A |
| Hydromorphone | 1.5-2 mg | 6-8 mg |
Bolus: 0.02 mg q 2-4 hr Infusion: 0.006 mg/kg/hr |
Bolus:1 mg q 2-4 hrs Infusion: 0.3 mg/hr |
1.4 |
0.04-0.08 mg/kg q 3-4 hr |
2-4 mg q 3-4 hr |
| Meperidine+ (pethidine) | 75-100 mg | 300 mg |
Bolus:0.8-1.0 mg/kg q 2-3 hr |
Bolus:50-75 mg q 2-3 hr |
1.4 | 2-3 mg/kg q 3-4 hr |
100-150 mg q 3-4 hr |
*Doses are for patients
over six months of age. All doses are approximate and should be adjusted
according to clinical circumstances. |
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