Article Text

other Versions

PDF
Editorial
What is the dose of intravenous paracetamol for pain relief in neonates?
  1. Paola Mian1,
  2. Catherijne AJ Knibbe2,3,
  3. Dick Tibboel1,
  4. Karel Allegaert1,4
  1. 1Intensive Care and Department of Paediatric Surgery, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands
  2. 2Division of Pharmacology, LACDR, Leiden University, Leiden, The Netherlands
  3. 3Department of Clinical Pharmacy, St Antonius Hospital, Nieuwegein, The Netherlands
  4. 4Department of Development and Regeneration KU Leuven, Catholic University of Leuven, Leuven, Belgium
  1. Correspondence to Paola Mian, Erasmus MC-Sophia Children’s Hospital, room NA-1723, Wytemaweg 80, Rotterdam 3015 CN, The Netherlands; p.mian{at}erasmusmc.nl

Statistics from Altmetric.com

Paracetamol (acetaminophen) is an effective analgesic and antipyretic. It is commonly prescribed to treat mild to moderate pain and fever in adults, children and neonates.1 Paracetamol can be administered orally, rectally or by intravenous route. It is reasonable to assume that intravenous administration improves the prediction in concentration profile compared with enteral administration, through elimination of variability in bioavailability and absorption.1 2 Due to its more predictable pharmacokinetic (PK) profile, intravenous paracetamol seems attractive to treat (pre)term neonates with pain. However, the question remains which dosage regimen has to be given. Therefore, we discuss what dose of intravenous paracetamol should be given to treat neonates with pain, taken into account current literature on both PK and pharmacodynamics (safety).

Dosing guidelines in neonates

In Europe, intravenous paracetamol is registered for short-term treatment of pain in term, but not preterm neonates, with a dose of 7.5 mg/kg every 6 hours. In the USA, intravenous paracetamol is unlicensed below 2 years of age because the efficacy/safety balance in infants and neonates is questioned.1 Despite this lack of labelled dosing information, intravenous paracetamol is widely …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.