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Neonatal Intensive Care Drug Manual
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| bet | 436/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Drug type
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Non-narcotic analgesic and antipyretic.
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Trade name
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Intravenous: Paracetamol Actavis; Paracetamol ACT; Paracetamol BNM; Paracetamol IV Pfizer; Paracetamol Kabi; Paracetamol-AFT; Paramat
Oral: Dymadon, Febridol, Panadol (Children)
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Presentation
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IV: 500 mg/50 mL, 1000 mg/100 mL (10 mg/mL) vial or infusion bag
Oral: 100 mg/mL drops
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Dose
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Analgesia/Antipyretic/Adjunct to post-operative analgesia
Oral/Intravenous/Rectal1-3:
Weight*
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Loading
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Maintenance
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<2.0 kg
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15 mg/kg
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7.5 mg/kg every 6 hours
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2.0 – 3.0 kg
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15 mg/kg
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10 mg/kg every 6 hours
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>3.0 kg
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20 mg/kg
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10 mg/kg every 6 hours
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*Current/best weight
Patent Ductus Arteriosus (treatment course 3-7 days with 48-hourly monitoring of liver function)
Oral/Intravenous4,5:
Criteria
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Loading
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Maintenance
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≥28 weeks CGA/PMA and ≥1000 g*
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15 mg/kg
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15 mg/kg every 6 hours
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<28 weeks and/or <1000 g**
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15 mg/kg
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7.5 mg/kg every 6 hours**
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*Current/best weight
**Higher maintenance doses (15 mg/kg) in extreme preterm infants have been used but there are limited safety data. At Canberra Hospital, a dose of 15mg/kg 6 hourly is used for treatment in all patients
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Dose adjustment
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Therapeutic hypothermia –Caution to be applied with associated hepatic and renal impairment.
Renal impairment – Refer to precautions section.
Hepatic impairment – Refer to monitoring and precautions sections.
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Maximum dose
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60 mg/kg/day
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Total cumulative dose
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Route
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IV, oral, rectal
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Preparation
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Intravenous: Use undiluted. Can be diluted to 2 mg/ml for use in ELBW infants using sodium chloride 0.9% or glucose 5%. If diluted, the solution should be used immediately.
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Administration
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Intravenous:
Administer over 15 minutes via syringe driver.
Oral:
Can be given with or without feeds. Shake bottle well before measuring dose.
Rectal:
Dilute oral mixture 1:1 with water for rectal doses. Low dose suppositories are not commercially available but can be prepared by selected pharmacy departments. Do not cut suppositories to make part rectal dose.
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Monitoring
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Monitor hepatic and renal function.
If signs of acute liver injury (example, raised ALT >50 IU/L) – refer to acetylcysteine formulary and contact Poisons Information Centre (13 11 26 for New South Wales) or local toxicology service.
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