TempoLife › Features › Fever and childrens medicine dosing by weight › paracetamol
Paracetamol dosing by weight
15 mg per kilogram per dose, every 4–6 hours, four doses a day at most — with the arithmetic worked.
This is a reference, not a prescriber: the package insert of the bottle in your hand outranks every number on this page, aspirin is never for children, and in a baby under three months any measured fever is urgent — call now, do not dose. If the child is on other medicines, or has a known liver, kidney or stomach condition, dosing belongs to a clinician.
The rule
Paracetamol is dosed by weight, not by age: 15 mg per kilogram per dose, given every 4–6 hours, and never more than four doses in 24 hours — a 60 mg per kilogram daily ceiling. The weight to use is the child's actual current weight, and for infants under about 3 months (or under the weight printed on the bottle) paracetamol is not a home treatment at all: that age group belongs to a clinician, not a dosing table.
Why weight and not age
Two children of the same age can differ by half in weight, and the dose tracks the body mass that has to process the drug. An age-based dose that suits one would under-dose the other and over-dose the third. Every paediatric formulation prints a weight ladder on the package for exactly this reason — and the insert of the bottle in your hand outranks this page.
The overdose line
Paracetamol is safe at the recommended dose and dangerous above it, and the margin is smaller than people assume: the toxic dose starts not far above the daily ceiling, and the damage is to the liver, silently and with a delay. The classic error is double-dosing through two products — a syrup and a suppository, or a combination cold remedy that already contains paracetamol — because each is counted separately. Read the ingredient list of everything given, and never stack two paracetamol products.
Worked examples
A 10 kg child: 15 × 10 = 150 mg per dose. A 16 kg child: 240 mg per dose. A 22 kg child: 330 mg per dose. The bottle's strength (for example 24 mg per ml) converts the milligram dose into millilitres, and the package prints the conversion ladder — use it.
The weight ladder
| Weight | Dose (15 mg/kg) | Interval | Daily ceiling (4 doses) |
|---|---|---|---|
| 5 kg | 75 mg | every 4–6 h | 300 mg |
| 10 kg | 150 mg | every 4–6 h | 600 mg |
| 15 kg | 225 mg | every 4–6 h | 900 mg |
| 20 kg | 300 mg | every 4–6 h | 1 200 mg |
| 25 kg | 375 mg | every 4–6 h | 1 500 mg |
| 30 kg | 450 mg | every 4–6 h | 1 800 mg |
Fever thresholds and red flags: the national paediatric guidance in the region. Dosing: the standard weight-based rules — paracetamol 15 mg/kg per dose every 4–6 hours, at most four doses a day (60 mg/kg/day ceiling); ibuprofen 10 mg/kg per dose every 6–8 hours, at most three doses a day (30 mg/kg/day ceiling), from 3 months and about 5 kg. Febrile seizures: the standard paediatric emergency guidance (simple vs complex, the five-minute line). Checked 2026-09-06.
Frequently asked questions
How often can I give paracetamol?
Every 4 to 6 hours, and no more than four doses in 24 hours. The interval is as much a rule as the dose: shortening it is how the daily ceiling gets crossed, and the ceiling is where the liver risk begins.
Can I alternate paracetamol and ibuprofen?
Alternating is common but easy to get wrong, because two clocks are running and two ceilings apply. The safer pattern is to pick the medicine that fits and give it on schedule. If alternating is done, each medicine keeps its own interval and its own daily maximum — write the times down.
What if the child is under the smallest weight on the bottle?
Then the bottle is not the treatment: an infant below the printed minimum weight (and any baby under about 3 months) needs a clinician's dosing, not a table.
The rest of the fever pages
Fever at every age
All seven fever pages, with the thresholds, the ladders and the red flags.
What counts as a fever at each age
The measurement thresholds, why the site matters, and the one age where any fever is urgent.
Measuring temperature: which thermometer at which age
Rectal is the reference, the armpit is the compromise, and the ear is only as good as its aim.
Ibuprofen dosing by weight
10 mg per kilogram per dose, every 6–8 hours, from 3 months and about 5 kg — and the situations where it is the wrong choice.
When to call instead of waiting
The red flags that override the thermometer — by age, and the combinations that are always urgent.
A medicine log that answers the call
TempoLife timestamps every dose so the daily ceilings stay visible and the doctor gets exact numbers instead of a guess.