In children, which dosing schedule for acetaminophen is correct?

• A. Acetaminophen: 10-15 mg/kg per dose every 4-6 h with a maximum of 75 mg/kg per day.
• B. Acetaminophen: 5-10 mg/kg per dose every 8-12 h with a maximum of 50 mg/kg per day.
• C. Acetaminophen: 20-25 mg/kg per dose every 4-6 h with a maximum of 100 mg/kg per day.
• D. Acetaminophen: 15-20 mg/kg per dose every 6-8 h with a maximum of 60 mg/kg per day.

Answer: (A)

Pediatric dosing is weight-based and uses a per-dose range plus a daily maximum to prevent liver toxicity. The safest, effective schedule is 10-15 mg per kilogram per dose, given every 4-6 hours as needed, with a daily maximum of 75 mg/kg (typically no more than five doses in 24 hours). This pairing provides reliable fever and pain relief while keeping total exposure within safe limits.

The other schedules either push the per-dose amount higher than recommended or set a daily maximum that is below the standard safety limit, increasing risk of toxicity or under-treatment. For example, a plan with 5-10 mg/kg per dose every 8-12 hours uses too long an interval and a daily max of 50 mg/kg; a plan with 20-25 mg/kg per dose every 4-6 hours and 100 mg/kg per day exceeds safe daily exposure; and a plan with 15-20 mg/kg per dose every 6-8 hours with 60 mg/kg per day doesn’t align with the common maximum and could underdose if multiple doses are given.