Paracetamol max dosage per day
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paracetamol acetaminophen maximum daily dose adults 2024 guidelines
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Paracetamol (Acetaminophen) - Maximum Daily Dose
Adults (>12 years, weight >50 kg)
| Route | Single Dose | Frequency | Max Daily Dose |
|---|---|---|---|
| Oral | 650-1,000 mg | Every 4-6 hours | 4,000 mg/day |
| Rectal (PR) | 325-650 mg | Every 4-6 hours | 4,000 mg/day |
| IV (Ofirmev) | 650-1,000 mg | Every 4-6 hours | 4,000 mg/day |
- No more than 5 doses in 24 hours
- Space doses at least 4 hours apart
Reduced Limits (Special Populations)
| Population | Recommended Max |
|---|---|
| Elderly / frail | 2,000-3,000 mg/day |
| Low body weight (<50 kg) | 75 mg/kg/day (lesser of 75 mg/kg or 4,000 mg) |
| Liver disease / heavy alcohol use | 2,000 mg/day (use with caution or avoid) |
| Hepatic impairment | Avoid or use lowest effective dose |
Children (Oral/PR)
| Age | Dose | Max Daily |
|---|---|---|
| Infant/child | 10-15 mg/kg every 4-6 hours | 75 mg/kg/day or 4,000 mg (whichever is less) |
| 6-11 years | 325 mg every 4-6 hours | 5 doses/day |
| IV (child >50 kg) | 15 mg/kg single dose | 75 mg/kg/day |
Key Safety Points
- Paracetamol is found in many combination products (cold/flu remedies, opioid combinations like co-codamol). Total intake from all sources must not exceed the daily limit.
- Hepatotoxicity is usually dose-dependent - overdose is the leading cause of acute liver failure in many countries.
- McNeil (Tylenol brand) voluntarily lowered their consumer label to 3,000 mg/day for extra-strength products to provide a wider safety margin for the general public.
- The FDA established the 4,000 mg/day limit; some clinicians use 3,000 mg/day as a practical ceiling for routine use.
Sources: Rosen's Emergency Medicine, 10th Ed.; NIH StatPearls; Harvard Health
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