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inj pcm 75mg dose for 15kg child

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Searching the Web

intravenous paracetamol dose children 10 kg to 50 kg 15 mg/kg every 4-6 hours maximum 60 mg/kg/day

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"acetaminophen"[MeSH Terms] AND "intravenous" AND "child"

75 mg is too low for a 15 kg child. It works out to 5 mg/kg.
Standard IV paracetamol dose for a child over 10 kg and up to 33 kg
  • The dose is 15 mg/kg per administration, which is 225 mg for 15 kg. This is 22.5 mL of the 10 mg/mL infusion. The EMC product leaflet gives this as 1.5 mL/kg.
  • Some Indian and WHO-type protocols use 10 to 15 mg/kg per dose, which is 150 to 225 mg for 15 kg. The WHO pain poster lists 10 to 15 mg/kg every 4 to 6 hours.
  • The minimum interval is 4 hours, with no more than 4 doses in 24 hours. In severe renal impairment the interval should be at least 6 hours.
  • The maximum daily dose is 60 mg/kg, which is 900 mg per day for 15 kg. It must not exceed 2 g.
Where 75 mg might come from
  • 7.5 mg/kg is the dose for infants under 10 kg. A 15 kg child is in the higher weight band.
  • 75 mg would be 0.5 mL of the 150 mg/mL ampoule (Indian preparation). Check that this isn't a mix-up between mg and mL, which the leaflet warns about.
  • 75 mg is a sensible dose for a child of about 5 kg at 15 mg/kg, or about 10 kg at 7.5 mg/kg. Please check the child's weight.
Safety points
  • Give it as a slow IV infusion over about 15 minutes, diluted if needed. Do not give it as a rapid push.
  • Add up all paracetamol the child has had in the last 24 hours, including oral and rectal doses.
  • Use the lower end of the range, or a longer interval, if the child is malnourished, dehydrated, has liver disease, or has been fasting for a long time.
The one library hit I found was for oral paracetamol at 15 mg/kg every 4 hours (Fuster and Hurst's The Heart, 15th Edition). It supports the 15 mg/kg figure but isn't a pediatric IV reference. A quick PubMed check of recent systematic reviews turned up nothing that contradicts these doses.
Confirm the dose against your local formulary or prescriber before giving it.

inj pcm 75mg/2ml how much the dose for 15kg child

Dose for a 15 kg child, using the 75 mg/2 mL strength (37.5 mg/mL)
DosemgVolumeAmpoules
10 mg/kg (lower range)150 mg4 mL2
15 mg/kg (standard IV dose)225 mg6 mL3
  • The usual dose is 15 mg/kg, which is 225 mg or 6 mL per dose. Some protocols use 10 mg/kg, which is 150 mg or 4 mL.
  • Repeat no sooner than every 4 to 6 hours, with no more than 4 doses in 24 hours.
  • The maximum daily dose is 60 mg/kg, which is 900 mg or 24 mL per day for 15 kg. This includes any oral or rectal paracetamol already given.
How to give it
  • Do not give it undiluted or as a rapid push. Dilute the 6 mL in 50 to 100 mL of normal saline or 5% dextrose, and infuse over about 15 minutes. Do not use more than 7.5 mL of diluent per mL of drug in a small child. Follow your unit's pediatric dilution protocol.
  • Check the label for the concentration, because strengths differ between brands. If your ampoule says 75 mg/2 mL, use the volumes above. If it says 150 mg/mL or 10 mg/mL, the volumes are very different and the same 225 mg dose would be 1.5 mL or 22.5 mL.
  • Confirm the dose with the prescriber or your local formulary before giving it.
The 15 mg/kg dose, the 4-hour minimum interval, the 4-dose limit and the 60 mg/kg/day cap come from the EMC leaflet cited earlier. I did not run a new search for this answer.

im dose

Intramuscular (IM) paracetamol is not a standard route, and I'd avoid it here.
  • The UK/EMC paracetamol injection is licensed for IV infusion only. Some Indian brands are labelled "IV/IM", but I haven't verified your product's label, so check it.
  • If your product is labelled for IM use, the mg/kg dose is the same as IV: 10 to 15 mg/kg, which is 150 to 225 mg for 15 kg.
  • With your 75 mg/2 mL ampoule (37.5 mg/mL), that is 4 to 6 mL, or 2 to 3 ampoules.
Why IM is a poor fit at this strength
  • A 15 kg child (about 3 to 4 years old) should get no more than about 1 to 2 mL per IM site. A 4 to 6 mL dose would need 3 or more injection sites.
  • IM absorption is slow and erratic, and the injection is painful. It risks muscle and sciatic nerve injury.
  • IM gives no real advantage over IV, oral or rectal paracetamol.
Better options for this child
  • IV infusion: 15 mg/kg is 225 mg or 6 mL, diluted and given over 15 minutes, as described earlier.
  • Oral syrup: 15 mg/kg is 225 mg every 4 to 6 hours if the child can swallow.
  • Rectal suppository: 15 to 20 mg/kg if the child can't take oral and there is no IV access.
The 24-hour limit is unchanged: 900 mg (24 mL) at most, with no more than 4 doses a day. Please confirm the route with the prescriber and the product label.

what about adult im dose

Searching the Web

paracetamol injection 150 mg/ml intramuscular adult dose India prescribing information IM IV

Finding Sources
Adult IM dose: 300 to 600 mg (2 to 4 mL of the 150 mg/mL injection) every 4 to 6 hours, given as a deep IM injection.
These Indian products are labelled for IM use, unlike the UK IV infusion products I described earlier.
  • A J.B. Chemicals leaflet for paracetamol 150 mg/mL (2 mL ampoule, so 300 mg) gives an adult IV/IM dose of 2 to 4 mL (300 to 600 mg) every 4 to 6 hours. The pediatric dose in that leaflet is based on 10 mg/kg.
  • A NAFDAC product summary for the same strength gives 2 to 3 mL (300 to 450 mg) IM every 4 to 6 hours for adults. For children aged 2 to 12 years (over 33 kg) it gives up to 2 mL.
Practical points
  • Give it deep IM, ideally in the upper outer quadrant of the gluteal muscle. Take care to avoid the sciatic nerve. Keep to 3 mL or less per site, so a 4 mL dose should be split across two sites.
  • Do not exceed 4 g per 24 hours from all sources and routes. The UK NHS SPS guidance sets a limit of 4 doses in 24 hours, and the J.B. leaflet allows up to 5 doses a day for no more than 5 days. Use a lower daily limit, such as 2 to 3 g, if the patient weighs under 50 kg, is malnourished, drinks heavily, or has liver disease. Extend the interval in kidney impairment.
  • IM paracetamol is generally reserved for situations where oral or IV routes aren't available. Absorption is slower and less predictable, and the injection is painful. Switch to oral as soon as the patient can swallow.
Correction to my earlier child answers
  • I used 75 mg/2 mL, which would be 37.5 mg/mL. That strength is unusual, and the common Indian ampoule is 150 mg/mL. Please check your label.
  • With the 150 mg/mL product, a 15 kg child's dose at 10 mg/kg is 150 mg, which is 1 mL. That is an IM volume a child can tolerate. The leaflet's 1 to 1.25 mL for ages 3 to 6 years agrees with this.
  • With a 150 mg/mL ampoule, giving the 6 mL I calculated for the 37.5 mg/mL strength would be a 6-fold overdose.
I didn't find a textbook in the library covering IM paracetamol dosing. These figures come from manufacturer leaflets, so confirm them against the leaflet for your own brand and your local protocol.
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