Paracetamol for children

Sounds like 'paa-ra-SEE-ta-mol'

Paracetamol is used for pain relief in children. Find out how to give it safely to babies and children and possible side effects.

Giving paracetamol to babies and children/tamariki – important safety tips

It is important to give your child the correct dose of paracetamol. Giving them too much or too often can damage their liver.

  • The dose depends on your child’s weight and the strength of the paracetamol. Here is our paracetamol dose calculator.
  • Paracetamol liquid is available in 2 strengths.
  • After a dose, wait at least 4 hours before giving the next dose.

On this page, you can find the following information:

What is paracetamol?

Paracetamol is a medicine that can be safely given to babies and children to treat different types of pain, including headache, toothache and sore throat. Paracetamol is also used to treat fever but mild fever does not need to be treated unless it is causing discomfort. See below, does my child need paracetamol for fever? 

Paracetamol is also called Panadol®, Children's Panadol®, Paracare®, Pamol® and Junior Parapaed®.
Paracetamol should start to work quite quickly – within 30 minutes to an hour of taking it. Use paracetamol only if necessary, and for the shortest amount of time to reduce fever or pain.

Does my child need paracetamol for fever?

Babies younger than 3 months old must see the doctor.

You can use paracetamol for children and babies over 3 months old. Only give paracetamol if it's necessary.

  • Paracetamol may be used if your child needs pain relief or if your child has a fever (temperature over 38°C) AND is miserable. 
  • 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.
  • You don't need to give babies and children paracetamol before or after vaccination. There is some evidence that paracetamol may reduce the effectiveness of childhood vaccinations. 
  • Read more about fever in children.

The dose of paracetamol is based on your child’s weight and not their age

  • Always give the dose that is written on the bottle or package according to your child's weight. If you are unsure about how much to give your child, ask your pharmacist. See the paracetamol dosing chart below as a guide.
  • As your child grows, the dose of paracetamol will need to be increased, based on their weight, to ensure that they are getting the correct dose. Do not use the same dose for a different child unless they are the same weight.

Paracetamol liquid is available in 2 strengths

  • 120mg in 5mL (lower strength)
  • 250mg in 5mL (higher strength)

Always check that the dose you are giving your child matches the strength of the liquid. If you are unsure, check with your doctor or pharmacist. 

Wait at least 4 hours before giving the next dose

  • Paracetamol is given no more than 4 times a day, eg, in the morning, at about midday, late in the afternoon and at bedtime. Do not give more than 4 times in 24 hours.
  • Wait at least 4 hours before giving the next dose, eg, 8 am, midday, 4 pm and 8 pm. Keep track of the timing of the doses and check when it was last given before giving it again. Before each dose, check if your child still needs it. See below, record of my child's dose.

Measure the dose correctly

Measure the right dose of paracetamol using a medicine syringe or medicine spoon. You can get these from your pharmacy. Do not use a kitchen spoon as it won't give you the right amount. Read more: Tips on how to give medicines to babies and children.

Paracetamol dosing chart

If you are unsure about how much paracetamol liquid to give your child, ask your doctor or pharmacist, or use the following as a guide:  

Paracetamol dosing chart

Wait at least 4 hours between doses. Do not give more than 4 doses in 24 hours.
Child's weight 120mg/5mL 250mg/5mL
Less than 5 kg Ask your doctor Ask your doctor
5 kg 2 mL 1 mL
6 to 7 kg 3.5 mL 1.5 mL
8 to 9 kg 5 mL 2 mL
10 to 12 kg 6 mL 3 mL
13 to 14 kg 8 mL 4 mL
15 to 16 kg 9.5 mL 4.5 mL
17 to 18 kg 10.5 mL 5 mL
19 to 20 kg 12 mL 5.5 mL
21 to 22 kg  13 mL 6.5 mL
23 to 25 kg 14. 5 mL 7 mL
26 to 28 kg  16.5 mL 8 mL
29 to 32 kg 18 mL 8.5 mL
33 to 36 kg 20.5 mL 10 mL
37 to 41 kg 23 mL 11 mL
42 to 60 kg 26 mL 12.5 mL
Greater than 60 kg  20 to 40 mL 10 to 20 mL

Also see: Paracetamol dose calculator.

Weigh your child and use the calculator to calculate their correct dose.



 

Paracetamol tablets for older tamariki/children

  • Paracetamol tablets come as 500 mg tablets.
  • Check other medicines your child is taking. Some combination medicines for colds and flu may also have paracetamol in them. See below, medicines that have paracetamol in them.
  • Tablets are suitable for older children who can swallow them.
  • Tablets should be swallowed with a glass of water. Your child should not chew the tablet as it has a very bitter taste.
  • When giving tablets, you must work out the dose that is right for your child, based on their weight. If you are unsure about how much to give your child, ask your pharmacist. The following is a guide.
Child's weight Tablet (500 mg)
More than 33 kilograms 1 tablet
More than 66 kilograms 1 to 2 tablets 
Maximum: Nobody, child or adult, should take more than 2 tablets in one dose.

Medicines that have paracetamol in them

In Aotearoa New Zealand, paracetamol is available as a liquid, tablet and suppository. It is also found in many other medicines you can buy from the pharmacy for colds and flu or pain. Overdose can happen if you give your child takes more than 1 paracetamol-containing medicine. Check the ingredients of cold and flu medicines before you give them to your child. Note: The following products are not suitable for children younger than 12 years.   

Examples of medicines that have paracetamol in them

  • Codral®
  • Coldrex®
  • Lemsip®
  • Maxigesic®
  • Sudafed PE®

Record of my child's dose

Know the right dose to give your child and check the strength. Use the paracetamol dosing chart above to calculate your child's dose.

  • Strength of paracetamol: 120 mg/5 mL OR 250 mg/5 mL OR 500 mg tablets

  • My child's weight (kg):  ______________

  • Dose (mL):  _________________  

 Date

Dosing times 

  • Before each dose, check whether your child still needs paracetamol.
  • Wait at least 4 hours between doses.
  • Do not give more than 4 doses in 24 hours.
Date: Time of dose 1: _____________________________
Time of dose 2: _____________________________
Time of dose 3: _____________________________
Time of dose 4: _____________________________
Date: Time of dose 1: _____________________________
Time of dose 2: _____________________________
Time of dose 3: _____________________________
Time of dose 4: _____________________________
Date: Time of dose 1: _____________________________
Time of dose 2: _____________________________
Time of dose 3: _____________________________
Time of dose 4: _____________________________
Notes:

  
Keep paracetamol out of the reach and sight of children in a locked or latched cupboard.
  • Paracetamol does not need to be chilled – do not keep it in the fridge.
  • Make sure the bottle has a child-resistant cap – ask your pharmacist about this.

Paracetamol overdose is an emergency

Paracetamol is a very popular medicine and when taken correctly works well. However, too much paracetamol is very harmful to your liver.

  • If you realise you have given your child too much paracetamol (including from other products with paracetamol in them), call your doctor, nurse or the Poisons Centre 0800 POISON (0800 764 766) immediately. Children are most at risk, so take extra care to not give them too much paracetamol.
  • Keep all paracetamol in childproof containers, out of reach and out of sight of children.

Do NOT wait for signs of an overdose as these appear late when damage to the liver is already done.

Late signs may include nausea (feeling sick), vomiting (being sick), diarrhoea (runny poos/hamuti), yellow skin or eyes, poor appetite and confusion or extreme sleepiness.

Learn more

Children's panadol Medsafe Consumer Information Sheets, NZ

References

  1. Paracetamol NZ Formulary for Children
  2. Outcome of the consultation on the proposed changes to paracetamol warning and advisory statements Medsafe, 2020
  3. Paracetamol dosing for children in primary care BPAC, NZ, 2018

Additional resources for healthcare professionals

Paracetamol NZ Formulary
Panadol Medsafe, NZ
Reconsider paracetamol use post vaccination BPAC, NZ, 2009
Paracetamol – dangerous when not used correctly Medsafe, NZ, 2019
Paracetamol for babies and children Health Navigator and Pharmac, NZ, 2018

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 28 Jun 2018