Paracetamol – 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.

On this page, you can find the following information:

What is paracetamol?

Paracetamol 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. Read more about fever in children or use our paracetamol dose calculator.

Paracetamol is also called Panadol®, Children's Panadol®, Paracare®, Pamol® and Junior Parapaed®.

Does my child need paracetamol?

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 38.5°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. 

Paracetamol should start to work quite quickly. Your child should feel less pain 30 minutes to an hour after taking paracetamol. Use paracetamol only if necessary, and for the shortest amount of time to reduce fever or pain.

Medicines that have paracetamol in them

In 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 more than one paracetamol-containing medicine. Check the ingredients of cold and flu medicines before you give them to your child.

If you do give your child other medicines that have paracetamol, be careful not to give them more than the recommended dose of paracetamol each day.

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®
  • Panadeine®
  • Sudafed PE®

How to give paracetamol to babies and children

Using paracetamol safely
Paracetamol can be safely given to babies and children but there is a limit to the amount of paracetamol that can be safely taken in a 24-hour period. Giving more than the daily limit is very harmful to the liver. 

Dose

  • How much to give your child: The dose of paracetamol is based on your child’s weight and not their age. Paracetamol liquid is available in 2 strengths. Always check that the dose you are giving your child matches the strength of the liquid. Use the dosing chart below to help you check the dose for your child's weight. If you are unsure about how much paracetamol liquid to give your child, ask your doctor or pharmacist. Do not give more than 4 doses in a 24-hour period.
  • As your child grows: 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. The dose for each child is based on their own weight. Do not use the same dose for each child unless they are the same weight.
  • Measuring the dose: When measuring the dose, measure the right amount using a medicine syringe or medicine spoon. You can get these from your pharmacy. Do not use a kitchen spoon as it will not give you the right amount. Read more: Tips on how to give medicines to babies and children

Timing

  • 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.

Strength

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. 

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
6.5 kg 4 mL 2 mL
8 kg 5 mL 2.5 mL
10 kg 6 mL 3 mL
13 kg 8 mL 4 mL
15 kg 9 mL 4.5 mL
18 kg 11 mL 5 mL
20 kg 12 mL 6 mL
25 kg 15 mL 7.5 mL
30 kg 18 mL 9 mL
35 kg 20 mL 10 mL
40 kg 25 mL 12 mL
45 kg 28 mL 14 mL
50 kg 30 mL 15 mL

Also see: Paracetamol dose calculator

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



 

Paracetamol tablets

  • 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.
  • 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 2 tablets
Maximum: For children weighing more than 66 kg, do not give more than 2 tablets per dose.  

My child's dose

Know the right dose to give your child and check the strength. Use the table 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

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), 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. Paracetamol dosing for children in primary care BPAC, NZ, 2018
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 28 Jun 2018