Safe Use Of Paracetamol In Children

Safe Use Of Paracetamol In Children

Too much paracetamol can harm your child. Always measure doses exactly and check the strength - there are different strengths. Find out about some temporary changes in the paracetamol brand available - the amount of medicine you give your child may change.

Safe use of paracetamol for children

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

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Important notice about paracetamol changes

September 2022 update: The funded brand of paracetamol oral liquid is changing - temporarily

From 1 September 2022, a new strength of liquid paracetamol (240 mg in 5 mL) may be temporarily available as a result of supply issues. The funded Paracare brand will be replaced by a new brand called Avallon paracetamol.

How is Avallon paracetamol different?

120 mg in 5 mL (lower strength)
The colour and taste are different.
Avallon is off-white in colour and has a strawberry/vanilla flavour.

240 mg in 5 mL (higher strength)
The dose of 240 mg in 5 mL is different from Paracare Double Strength, which has 250 mg in 5 mL. This may mean the amount of medicine you give your child may change. Check the dose table below.
This strength of Avallon is also off-white in colour and has a strawberry/vanilla flavour.

Both strengths of Avallon paracetamol are the same colour and flavour. Do NOT rely on the colour, smell or flavour.

Always read the label and give your child the right dose based on your child's weight and the strength of paracetamol.

Read more about this temporary change from Pharmac - Te Pātaka Whaioranga

In English (PDF, 180KB)

In te reo Māori (PDF, 261KB)

In Samoan (PDF, 234KB)

In Tongan (PDF, 271KB)

In Chinese, simplified (PDF, 559KB)

In Cook Islands Māori (PDF, 828KB)

Key points about the safe use of paracetamol in children

  • paracetamol 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

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

What is paracetamol?

  • paracetamol is a medicine to help reduce pain
  • paracetamol is the name of the medicine but it has many brand names including Pamol, Avallon, Paracare and Panadol
  • it will not cause drowsiness or cause your child to sleep

Does my child need paracetamol?

You can use paracetamol for children and babies over 3 months old - younger babies must see the doctor.

  • you can use it for children and babies over 3 months old
  • younger babies must see the doctor
  • 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

Paracetamol and immunisation

You don't need to give babies and children paracetamol before immunisation. If your child is miserable or distressed with a fever after immunisation, you can give a dose of paracetamol. 

Using paracetamol around the time of immunisation reduces the immune system response to immunisation when measured in a laboratory. But, there is no evidence that the reduced response decreases protection in children aganist the diseases they were immunised against.

How long will it take for liquid paracetamol to work for my child?

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 for my child?

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

  • the dose of paracetamol depends on your child's weight and the strength of the paracetamol you have
  • 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 of the paracetamol you have
  • ask the pharmacist, doctor or nurse to show you

It's important your child does not take more than the daily recommended dose. If you child takes too much - all at once or over a period of days - paracetamol can damage their liver.

Check the table below or use the dose calculator on the Health Navigator website.

Your child's weight 120mg in 5mL 250mg in 5mL 240mg in 5mL
(new strength)
5kg or less Ask your doctor Ask your doctor Ask your doctor
6 to 7 kg 3.5 mL 1.5 mL 1.5 mL
8 to 9 kg 5 mL 2 mL 2.5 mL
10 to 12 kg 6 mL 3 mL 3 mL
13 to 14 kg 8 mL 4 mL 4 mL
15 to 16 kg 9.5 mL 4.5 mL 4.5 mL
17 to 18 kg 10.5 mL 5 mL 5 mL
19 to 20 kg 12 mL 5.5 mL 6 mL
21 to 22 kg 13 mL 6.5 mL 6.5 mL
23 to 25 kg 14.5 mL 7 mL 7 mL
26 to 28 kg 16.5 mL 8 mL 8 mL
29 to 32 kg 18 mL 8.5 mL 9 mL
33 to 36 kg 20.5 mL 10 mL 10 mL
37 to 41 kg 23 mL 11 mL 11.5 mL
42 to 60 kg 26 mL 12.5 mL 13 mL
Greater than 60 kg 30 to 40 mL 15 to 20 mL 15 to 20 mL

 

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

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

What do I need to do before every dose of paracetamol for my child?

  • check your child to see if they need another dose
  • wait 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

How do I remember how many doses of paracetamol my child has had?

Keep a record of the paracetamol doses you've given your child.

Child's name:

Date and time Child's weight

Strength
120 mg in 5mL or
240 mg in 5 mL or
250 mg in 5mL

Dose (mL)
       
       
       
       

Where should I keep paracetamol in the house?

  • 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

Check out some tips on preventing mistakes with your child's medicines

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) and Korean (PDF, 768KB).

Paracetamol leaflet in Chinese (Waitemata District Health Board)

Paracetamol leaflet in Korean (Waitemata District Health Board)

References

Medsafe New Zealand Medicines and Medical Devices Safety Authority. Paracetamol toxicity in children - let's reduce the risk. June 2011.

Minutes of the 145th Medicines Adverse Reactions Committee (MARC) Meeting 10 March 2011. Hepatic failure with paracetamol

Medicines and Healthcare Products Regulatory Agency. UK public assessment report. November 2011. ​Liquid paracetamol for children: revised UK dosing instructions have been introduced

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

Waitemata District Health Board. Giving paracetamol safely to babies and children (PDF, 570KB).

Health Navigator. Paracetamol for children

This page last reviewed 20 September 2022.

Call Healthline on 0800 611 116 any time of the day or night for free health advice when you need it