Tylenol Dosage

Dear Lisa,

My son was just released from the hospital yesterday. He has RSV. The pediatrician told me he would run a fever and also told me that the infant can only have Tylenol infant drops (only Motrin after the baby is 6 months old). He has started to run a fever and I was wanting to know how much Tylenol infant drops I can give him and how often. He is now on Bromhist (cough medicine), Albuterol (breathing treatment), and Pulmicort (breathing treatment).

“4mtholdmommy”

Dear “4mtholdmommy”,

I’m sorry to hear that your child is sick. Your question is the most common pediatric question parents ask. The Tylenol (also known as Acetaminophen) dosage for each child needs to be calculated according to the child’s weight. The recommended Tylenol dosage is a range; between 10 to 15 mg of Tylenol per Kg of weight per dosage. (1) When calculating and figuring out how much medication to give you must be aware that the concentration of Tylenol differs between products. There is a different amount of Tylenol in each product that you buy.

The amount of Tylenol or Acetaminophen in each product is listed on the package and can be read right underneath the product name (if you have good eyesight!).

Infant’s Tylenol contains 80 mg of Tylenol per 0.8 ml (1/4 fl. Ounce)
Children’s Tylenol contains 160 mg per 5 ml(one teaspoon)
Children’s Tylenol Chewable Tablet contains 80 mg per tablet
Children’s Tylenol with Flavor Creator contains 160mg per 5 ml(one teaspoon)
Children’s Tylenol Meltaways contain 80mg per tablet
Jr. Tylenol Meltaways contain 160mg per tablet

When figuring out the dosage you first need to convert the child’s weight in pounds to kilograms. To do this, take the weight in pounds and divide it by 2.2. For example, for a 13 pound child, you would take 13 and divide by 2.2 which equals 5.9. Rounding this number off, a 13 pound child weighs 6 kilograms. Take 6 and multiply it by 10 which equals 60; then take 6 and multiply by 15, which equals 90. Therefore a 13 pound child should receive between 60 and 90 mg of Tylenol per dosage. Using the Infant’s Tylenol drops you should give 0.8ml or one dropperful which equals 80 mg.

An easier method to follow is the schedule recommended by Johns Hopkins Hospital, The Harriet Lane Handbook and the company that makes Tylenol. (1,2)

Infant’s Tylenol:

0 to 3 months old or 6 to 11 pounds = 0.4 ml or ½ dropperful
4 to 11 months old or 12 to 17 pounds = 0.8 ml or one dropperful
12 months to 23 months or 18 to 23 pounds = 1.2 ml which is equal to 1 ½ dropperfuls

It is recommended that you use the measuring device (dropper or measuring cup) provided by the company.(2) All dosages of Tylenol may be repeated every 4 hours, but should not be given more than 5 times per day.(2) You should always consult your Physician before giving Tylenol to a child under 2 years old.

When treating a child with Tylenol for a fever your Doctor should be consulted if the fever gets worse. Tylenol should not be given for more than three days for fever unless directed by your Doctor. (2) The reason for this recommendation is, a fever in a child that lasts for more than three days can be very serious. A fever for three days duration needs to be re-evaluated by a Physician so the cause can be determined and treated.

When treating pain with Tylenol, if the pain worsens or lasts for more than 5 days, your Doctor should be consulted. It is not recommended to give Tylenol for more than 5 days when treating pain, unless instructed to do so by your Doctor. The reason for this recommendation is a child with pain for 5 or more days needs to be re-evaluated by a Physician in order to determine and treat the cause. Continued or increased pain may be a sign of worsening of a child’s condition.

The recommended Tylenol dosage for children over 2 years old is written on the package. For older children, it is important not to exceed the recommended adult dosage of 325mg to 650mg per dosage, regardless of the weight of the child. An over dosage of Tylenol can be quite serious and can lead to Liver damage or in some cases even death. (1,2) Early symptoms following potentially hepatotoxic overdose may include nausea, vomiting, sweating and general malaise.(2)

If your child accidentally receives the incorrect amount of Tylenol, contact the Poison Control Center at 1-800-222-1222 right away. When an over dosage is suspected, it is recommended to seek medical attention even if the child is not exhibiting any symptoms.

Tylenol should not be used if you are giving your child other products containing Acetaminophen. (2) Children with G6PD deficiency should not receive Tylenol or any products containing Acetaminophen. (1)

I hope you son is feeling better soon.

References:
(1)Greene M. The Harriet Lane Handbook. St. Louis, Missouri: The Mosby-Yearbook, Inc. 1991:150.
(2) Physician’s Desk Reference for Nonprescription Drugs, Dietary Supplements, and Herbs. 2007. Montvale, NJ. Thomson PDR at Montvale:679-681,757.

Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Advice For Parents with Infants