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PIPER - Paediatric Infant Perinatal Emergency Retrieval

Paracetamol

  • Description and indication for use

    Paracetamol produces analgesia and antipyrexis by inhibition of prostaglandin synthesis. It is used extensively in the treatment of mild to moderate pain and fever

    Dose

    15 mg/kg dose.

    Oral and PR

     Infants gestational age equivalent at the time of dosing

    Paracetamol dose (mg/kg) 

    Dosing Interval 

    Maximum dosing per day (mg/kg) 

    CA 28-32 weeks 15 12 hourly Max 30 mg/kg/24 hrs 
    CA 32-36 weeks 15 8 hourly Max 60 mg/kg/24 hrs 
    CA ≥ 37 weeks 15 6 - 8 hourly max 60 mg/kg/24 hrs 

    Reconstitution/Dilution

    Paracetamol is supplied as a suspension 48 mg/mL.         

    Route and method of administration

    The oral preparation may be used rectally.

    Side effects/Contraindications

    Caution in hepatic impairment.

    Chronic toxicity is usually associated with a high incidence of anaemia, renal damage and gastrointestinal disturbances including peptic ulcer.

    Acute toxicity can cause nausea, vomiting, abdominal pain, methaemoglobineamia, delirium, stupor, hypothermia, marked prostration, shallow breathing, irregular pulse, low blood pressure and circulatory failure.

    Hepatic necrosis and hepatic coma may result if high blood levels are maintained over several hours, and are potentially fatal.

    Acetylcysteine is the specific antidote for acute paracetamol toxicity.

    References:

    1.    American Hospital Formulary Service Drug Information 1998.
    2.    RCH Paediatric Pharmocopoeia, 13th ed. 2002.
    3.    RWH Neonatal Pharmocopoeia, 2nd ed., 2005.
    4.    Mercy Hospital for Women, Paracetamol Drug Information Sheet.

Disclaimer:  This Drug information was designed for use by PIPER Neonatal. Whilst great care has been taken to check the information is accurate, it is possible that errors may have been missed. Furthermore, dosage schedules are continually being revised and new side effects recognised. For these reasons, the reader is strongly advised to consult the drug companies' printed information before administering any of the drugs recommended in this book.
Most drugs in this document are appropriate only for specialist use in hospitals.  A number of drugs should only be used in consultation with the appropriate Paediatric subspecialist. 

Note: The electronic version of this guideline is the version currently in use.  Any printed version cannot be assumed to be current. Printed copies of this document are valid for