What is the maximum acetaminophen per day (mg/kg) in pediatric dosing?

• A. 60 mg/kg per day.
• B. 75 mg/kg per day.
• C. 100 mg/kg per day.
• D. 40 mg/kg per day.

Answer: (B)

Acetaminophen dosing in children is weight-based and uses a daily ceiling to protect the liver. The safe maximum is 75 mg per kilogram of body weight per day, with typical dosing of 10–15 mg/kg per dose every 4–6 hours as needed and no more than five doses in 24 hours. This means the total daily amount is capped to prevent hepatotoxicity, especially since acetaminophen is often found in multiple over-the-counter products.

For example, a child weighing 12 kg should not receive more than 900 mg in 24 hours (12 kg × 75 mg/kg). If you give 15 mg/kg per dose, that’s 180 mg per dose, and you should limit to five doses per day to stay at 900 mg total. Always double-check all medications to avoid double-dosing acetaminophen from different products.