Analgesics Commonly Prescribed for Children

It has been reported that more than 20% of pediatric patients undergoing restorative treatment and extractions require post-operative pain medication. For the vast majority, recommended doses of acetaminophen or NSAIDs will control the pain. In the few cases that narcotics are prescribed the duration should be short and the dosage of codeine determined by weight to avoid respiratory depression.

Table 6. Analgesics Commonly Prescribed for Children.5

AnalgesicRecommended Dosage – Oral RouteAdvantagesDisadvantagesHow Supplied
AcetaminophenChildren ≤ 44 kg:
10-15 mg/kg every 4-6 hours
max = 2.6 gms/day

Children > 44 kg and adults:
325 mg-650 mg/dose every 4-6 hours
max = 4 g/day
Antipyretic: rare side effectsNo anti-inflammatory action; mild pain relief. Use with caution in patients with liver disordersDrops: 80 mg/0.8 ml calibrated dropper

Suspension: 160 mg/5 ml

Chewable tabs: 80 mg/tabs

Tablets: 325 mg, 500 mg
AspirinChildren: Oral, rectal: 10-15 mg/kg/ dose every 4-6 hours up to a total of 80-100 mg/kg/day

Adult: Oral, rectal: 325-650 mg every 4-6 hours up to 4g/day
Analgesic, antipyretic and anti-inflammatory propertiesAllergic type reactions in patients with pre-existing asthma, atopy and nasal polyps Possible association of aspirin with certain viral illnesses and the development of Reye syndrome. Is the analgesic of last choice in children.Chewable tabs: 81 mg

Caplets, tablets: 325 mg, 500 mg

Suppository, rectal: 300 mg, 600 mg
IbuprofenChildren: Oral: 4-10 mg/kg/dose every 6-8 hours up to 40 mg/kg/day

Adult: Oral: 200-400 mg/dose every 4-6 hours up to 1200 mg/day
Anti-inflammatory, good relief for moderate to severe pain, antipyreticGastric irritant, may impair clottingSuspension: 40 mg/1ml (oral drops)
100 mg/5 ml (oral)

Chewable: 50 mg and 100 mg tabs

Tablets: 200 mg, 400 mg, 600 mg, 800 mg
NaproxenChildren: Oral: 5-10/kg/dose every 8 to 12 hours

Adult: Oral: 220 mg every 8-12 hours up to 660 mg/day
Anti-inflammatory, good relief for severe painGastric irritant, may impair clotting, delayed onset.Suspension: 125 mg/ml

Tablets: 250 mg, 375 mg, 500 mg
Acetaminophen with codeineChildren ≤ 44kg: Oral:
Codeine: 0.5-1 mg codeine/kg/dose every 4-6 hours

Acetaminophen:10-15mg/kg/dose every 4-6 hours up to 2.6 gm/day

Children > 44 kg and adults: Oral:Codeine: 30-60 mg/dose every 4-6 hours.

Acetaminophen: 325-650 mg/dose every 4-6 hours, maximum up to 4 g/day
Codeine acts at central site of pain, acetaminophen at peripheral site for enhanced analgesia.Recommended only for acute dosing (3 days or less). Codeine can cause nausea, sedation, constipation and dependency. Use acetaminophen with caution in patients with liver disordersSuspension:Acetaminophen 120 mg and codeine phosphate 12 mg per 5 ml.

Tablets:
#3: Acetaminophen 300 mg and codeine phosphate 30 mg
#4: Acetaminophen 300 mg and codeine phosphate 60 mg