Pocket Guide - Analgesics, Oral

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Analgesics, Oral
Acetaminophen - Tylenol, Tempra, Panadol, Ibuprofen - Advil, Motrin, Acetaminophen with Codeine

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Pocket Guide to Pediatric Drugs - Analgesics, Oral

3.1 - ANALGESICS, ORAL (Rx/OTC)
(Acetaminophen - Tylenol, Tempra, Panadol, Ibuprofen - Advil, Motrin, Acetaminophen with Codeine) INDICATIONS:

ACETAMINOPHEN:
- Mild Pain including headache and arthritic pain.
- Fever.
IBUPROFEN:
- Mild to moderate pain including headache and arthritic pain.
- Inflammation.
- Fever.
ACETAMINOPHEN AND CODEINE:
- Moderate to severe pain.

DOSE:

ACETAMINOPHEN (OTC):
- 10 - 15 mg/kg/dose given every 4 - 6 hours.
- See Acetaminophen chart for dosage guidelines.

ACETAMINOPHEN DOSAGE CHART

AGE Weight	DROPS 40 mg/ 0.4 ml	ELIXIR 160 mg/ 5 ml	CHEW TAB 80 mg	SUPPOS- ITORY 120 mg	JUNIOR STRENGTH 160 mg	ADULT STRENGTH 325 mg	SUPPOS- ITORY 650 mg	TOTAL DOSE (mg)
0 - 3 mos 6 - 11 lbs (3 - 5 kg)	0.4 ml	1/4 tsp	1/2 tab	1/3 Supp	----	----	----	40
4 - 11 mos 12 - 17 lbs (6 - 8 kg)	0.8 ml	1/2 tsp	1 tab	2/3 Supp	----	----	----	80
12 - 23 mos 18 - 23 lbs (9 - 10 kg)	1.2 ml	3/4 tsp	1 & 1/2 tab	1 Supp	----	----	----	120
2 - 3 yrs 24 - 35 lbs (11 - 16 kg)	----	1 tsp	2 tab	----	1 tab	1/2 tab	1/4 Supp	160
4 - 5 yrs 36 - 47 lbs (17 - 21 kg)	----	1 & 1/2 tsp	3 tab	2 Supp	----	----	----	240
6 - 8 yrs 48 - 59 lbs (22 - 27 kg)	----	2 tsp	4 tab	----	2 tab	1 tab	1/2 Supp	325
9 - 11 yrs 60 - 95 lbs (28 - 43 kg)	----	2 & 1/2 -3 tsp	5 - 6 tab	----	2 & 1/2 -3 tab	1 & 1/2 -2 tab	3/4 Supp	485
12 - 14 yrs 96 lbs + (44+ kg)	----	----	----	----	4 tab	2 tab	1 Supp	650

IBUPROFEN (Rx/OTC):
- For pain or fever: 5 - 10 mg/kg/dose given every 6 - 8 hours up to a maximum of 40 mg/kg/day.
- The lower dosage (5 mg/kg) is used for fever less than 102.5ƒF, the higher dosage (10 mg/kg) is for fever greater than 102.5ƒF.
- For inflammation due to arthritis: 20 - 40 mg/kg/day.
- See Ibuprofen chart for dosage guidelines.

IBUPROFEN DOSAGE CHART

	5 mg/kg/dose				10 mg/kg/dose
AGE Weight	LIQUID 100 mg/ 5 ml	CHEW TAB 100 mg	TABLET 200 mg	TOTAL DOSE (mg)	LIQUID 100 mg/ 5 ml	CHEW TAB 100 mg	TABLET 200 mg	TOTAL DOSE (mg)
6 - 11 mos 13 - 17 lbs (6 - 8 kg)	1/4 tsp	ó	ó	25	1/2 tsp	1/2 tab	ó	50
12 - 23 mos 18 - 23 lbs (9 - 10 kg)	1/2 tsp	1/2 tab	ó	50	1 tsp	1 tab	ó	100
2 - 3 yrs 24 - 35 lbs (11 - 16 kg)	3/4 tsp	3/4 tab	ó	75	1 & 1/2 tsp	1 & 1/2 tab	ó	150
4 - 5 yrs 36 - 47 lbs (17 - 21 kg)	1 tsp	1 tab	ó	100	2 tsp	2 tabs	1 tab	200
6 - 8 yrs 48 - 59 lbs (22 - 27 kg)	1 & 1/4 tsp	1 & 1/4 tab	ó	125	2 & 1/2 tsp	2 & 1/2 tabs	ó	250
9 - 10 yrs 60 - 71 lbs (28 - 32kg)	1 & 1/2 tsp	1 & 1/2 tab	ó	150	3 tsp	3 tabs	ó	300
11 - 12 yrs 72 - 95 lbs (33 - 43 kg)	2 tsp	2 tabs	1 tab	200	4 tsp	4 tabs	2 tabs	400

5mg/kg is used for fever less than 102.5ƒF, 10mg/kg is for fever greater than 102.5ƒF.

ACETAMINOPHEN WITH CODEINE (Rx):
- 0.5 - 1 mg/kg/dose (Codeine) every 4 - 6 hours as needed.

ACETAMINOPHEN WITH CODEINE DOSAGE SCHEDULE

Age	Elixir (12 mg/tsp)	#2 Tablet (15 mg)	#3 Tablet (30 mg)
3 - 7	1 tsp	1	---
7 - 12	2 tsp	2	1
Over 12	---	---	1 - 2

The dosage should be adjusted up or down based on the severity of the pain trying not to exceed the recommended doses for acetaminophen based on the child's age and weight. SUPPLIED:

Other strengths and dosage forms are available.

Acetaminophen (Tylenol - OTC):
- DROPS: 100 mg/ml, 15 ml bottle, fruit flavor
- ELIXIR: 160 mg/5 ml, 120 ml bottle, fruit flavor
- CHEWABLE TABLETS: 80 mg - 30's, fruit flavor
- TABLETS: 160 mg - 30's; 325 mg - 100's; 500 mg/tab - 50's
- SUPPOSITORIES: 120 mg, 325 mg, 650 mg - 12's
Ibuprofen (Advil, Motrin - OTC/Rx):
- DROPS: 40 mg/ml, 15 ml - berry flavor (OTC)
- SUSPENSION: 100 mg/5 ml, 120 ml bottle, fruit flavor (OTC)
- CHEWABLE TABLETS: 50 mg, 100 mg - 30's, fruit flavor (OTC)
- TABLETS: (OTC) 200 mg, (RX) 300 mg, 400 mg, 600 mg, 800 mg - 50's, 100's
Acetaminophen with Codeine (Rx):
- ELIXIR: Acetaminophen 120 mg, Codeine 12 mg/5 ml
- TABLETS: Acetaminophen 325 mg and
  - Codeine 15 mg (Tylenol with Codeine #2)
  - Codeine 30 mg (Tylenol with Codeine #3)
  - Codeine 60 mg (Tylenol with Codeine #4)

COST:

All relatively inexpensive medications.
Acetaminophen = Acetaminophen with Codeine < Ibuprofen
Tablets < Liquids < Suppositories
Generically available.

CAUTIONS:

Acetaminophen can cause liver toxicity from overdose.
Ibuprofen can cause dizziness, nausea, vomiting, and stomach pain.
Ibuprofen prolongs bleeding time, avoid prior to any surgical procedure.
Codeine can cause dizziness, nausea, vomiting and constipation.

COMMENTS:

Codeine can be habit forming.
Only the OTC dosage forms of ibuprofen are recommended for fever.

Monograph last updated: December 1st, 1999

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Copyright & Disclaimer: Every effort has been made to ensure that the information provided here and in our printed materials is accurate. The reader, however, is advised to verify drug dosage schedules with the latest manufacturer's product information insert prior to administration of the drug. Some dosage schedules have not been approved for inclusion in product package inserts and it is the prescribers responsibility to ascertain the suitability of these doses. The information presented here may not be complete and is not intended to take the place of professional advise. Contact your Doctor, Nurse, Pharmacist or other health professional for additional information.