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Paracetamol

Safe use of paracetamol for children

Developed by the Health Navigator NZ team with support from Pharmac.

Key points to remember about paracetamol

Always measure doses exactly. Ask your pharmacist or nurse for an oral syringe - to give your child medicine by mouth.

  • paracetamol ('Pamol', 'Panadol') is a medicine to help reduce pain
  • your child doesn't need it for fever alone - if your child is miserable because of the fever, you can give paracetamol to make them more comfortable
  • too much paracetamol can be dangerous
  • keep all medicines out of reach of children, in a locked or latched cupboard
  • before each dose, check if your child still needs it
  • know the right dose to give and check the strength
  • give no more than 4 times in 24 hours
  • if someone else has been caring for your child, ask if they gave your child paracetamol, how much and when
  • check other medicines your child is taking - they may have paracetamol in them

What is paracetamol?

  • paracetamol ('Pamol', 'Panadol') is a medicine to help reduce pain
  • it will not cause drowsiness or cause your child to sleep
  • you can use it for children and babies over 3 months old
  • younger babies must see the doctor

Does my child need paracetamol?

  • only give paracetamol if it's necessary
  • fever is a normal response to infection and is not in itself harmful, so you don't need to give paracetamol for fever alone
  • if your child is miserable because of the fever, you can give paracetamol to make them more comfortable
  • it's not a good idea to give babies and children paracetamol before and repeatedly after immunisation just in case they feel unwell - there is some evidence that paracetamol may reduce the effectiveness of childhood vaccinations

How long does it take liquid paracetamol to work in children?

It varies between individuals but paracetamol seems to have the maximum effect between 1 ½ and 3 hours after you give the dose. Pain levels and temperature may start to come down before this.

What is the correct dose of paracetamol?

  • the dose depends on your child's weight and the strength of paracetamol
  • always measure doses exactly - ask your pharmacist or nurse for an oral syringe
  • weigh your child, then check the dosing table below
  • check the strength - there are 2 strengths
  • ask the pharmacist, doctor or nurse to show you
Your child's weight 120mg per 5mL 250mg per 5mL
5kg or less Ask doctor Ask doctor
6.5kg 4mL 2mL
8kg 5mL 2.5mL
10kg 6mL 3mL
15kg 9mL 4.5mL
20kg 12mL 6mL
30kg 18mL 9mL
40kg 25mL 12mL

If your child won't take liquid paracetamol, and is old enough to safely swallow a tablet, you can give them a paracetamol tablet - make sure to give them the right dose:

Wait at least 4 hours between doses - give no more than 4 times in 24 hours.

  • 1 tablet (500mg) if your child is more than 33kg
  • 2 tablets (500mg each) if your child is more than 66kg

What to do before every paracetamol dose

  • check your child to see if they need another dose
  • it at least 4 hours between doses - give no more than 4 times in 24 hours
  • keep a record of the doses you give your child - check when you gave the last dose, before giving it again

Keeping a record of paracetamol doses

Child's name:

 

 

Date and time Child's weight

Strength
120mg / 5mL or
250mg / 5mL

Dose (mL)
       
       
       
       

Where should I keep paracetamol?

  • keep it in a high place out of reach and out of sight of children
  • store it in a locked or latched cupboard
  • the most common cause of poisoning is by children helping themselves
  • it doesn't need to be chilled so don't keep it in the fridge
  • it should have a child-resistant cap - ask your pharmacist

You might also be interested in the page Medicine safety: Tips for parents [1].

What if my child has too much paracetamol?

  • too much paracetamol can damage your child's liver
  • if your child has had too much, call your doctor, nurse or the Poisons Centre 0800 POISON (0800 764 766) immediately
  • signs of overdose may include feeling sick (nausea), vomiting, diarrhoea, yellow skin or eyes, poor appetite, confusion or extreme sleepiness

Paracetamol information in other languages

See the Waitemata District Health Board website for paracetamol information in Chinese (PDF, 836KB) [2] and Korean (PDF, 768KB) [3].

Paracetamol leaflet in Chinese (Waitemata District Health Board) [2]

Paracetamol leaflet in Korean (Waitemata District Health Board) [3]

References: 

Medsafe New Zealand Medicines and Medical Devices Safety Authority. Information for health professionals. 

  • Paracetamol toxicity in children - let's reduce the risk [4]. June 2011.  [Accessed 24/4/2017]
  • Minutes of the 145th Medicines Adverse Reactions Committee (MARC) Meeting 10 March 2011. Hepatic failure with paracetamol [5]  [Accessed 24/4/2017]

Medicines and Healthcare Products Regulatory Agency. UK public assessment report. November 2011. ​Liquid paracetamol for children: revised UK dosing instructions have been introduced [6].  [Accessed 24/4/2017]

National Health Service (NHS) Choices. UK. March 2011. ​Advice for managing child feve [7]r.  [Accessed 24/4/2017]

SafeRx (Quality initiative by the Quality Use of Medicines (QUM) Team). Waitemata District Health Board. 2009. Review 2011. Paracetamol – safe prescribing – mind that child! [8]  (PDF, 274KB) [Accessed 24/4/2017]

Acknowledgements: 

Our thanks to Waitemata District Health Board for permission to adapt the following leaflet:

Waitemata District Health Board. 2014. Giving paracetamol safely to babies and children (English). (PDF, 1.16MB) [9] [Accessed 24/4/2017]

More detail (see the online version for links to more detailed content)
[10]

Paracetamol - what if my child has too much? [10]

Too much paracetamol is one of the most common causes of poisoning in under 5 year olds. Ring the Poisons Centre if you are worried that your child may have swallowed too much of their own medicine, or has swallowed someone else's medicine. 

Child Cancer Foundation provides strength and comfort to families, parents and children impacted by child cancer. [11]

Free parenting advice
PlunketLine [12]
0800 933 922

HealthLine - Free health advice when you need it 0800 611 116 [13]

Free health advice
www.healthline.govt.nz (link is external) [14]
0800 611 116

Paediatric Society of NZ [15]

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This page last reviewed 26 April 2017.
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A joint initiative between the Paediatric Society of New Zealand and Starship Foundation

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Source URL: https://www.kidshealth.org.nz/paracetamol

Links
[1] https://www.kidshealth.org.nz/medicine-safety-tips-parents
[2] http://saferx.co.nz/paracetamol-for-children-leaflet-chinese.pdf
[3] http://www.saferx.co.nz/paracetamol-for-children-leaflet-korean.pdf
[4] http://www.medsafe.govt.nz/profs/puarticles/paracetamoljune2011.htm
[5] http://www.medsafe.govt.nz/profs/adverse/Minutes145.htm#2.1.2
[6] http://www.mhra.gov.uk/safety-public-assessment-reports/CON221602
[7] http://www.nhs.uk/news/2011/03March/Pages/advice-for-managing-child-fever.aspx
[8] http://www.saferx.co.nz/full/paracetamol-for-children.pdf
[9] http://www.saferx.co.nz/paracetamol-for-children_leaflet.pdf
[10] https://www.kidshealth.org.nz/paracetamol-what-if-my-child-has-too-much
[11] https://www.childcancer.org.nz
[12] http://www.plunket.org.nz/what-we-do/what-we-offer/plunketline/
[13] http://www.health.govt.nz/yourhealth-topics/health-care-services/healthline
[14] http://www.healthline.govt.nz
[15] http://www.paediatrics.org.nz/
[16] https://www.health.govt.nz/
[17] http://www.starship.org.nz/foundation
[18] https://www.kidshealth.org.nz/contact?from=http%3A%2F%2Fwww.kidshealth.org.nz%2Fprint%2F1209