Common prescribed drug dosage for children

ADAPTED FROM ESSENTIAL DRUGS LIST OF SOUTH AFRICA, SOUTH AFRICAN MEDICINES FORMULARY AND WESTERN CAPE ACADEMIC HOSPITALS ANTIMICROBIAL RECOMMENDATIONS 2013.

Before using this prescription list please note that this is just a reference to drug dosage in children only and therefore dosage may be different in neonates. There may be different dosage for different indications. Before prescribing first check reference textbooks for:

• Correct dose for neonates
• Dosage changes for specific indications not mentioned
• Contraindications for prescribing drug
• Adverse effects of drug
• Drug interactions
• Max dosages in children

• Abacavir. 8mg/kg (adult 300mg) 12H. Acetazolamide. Raised ICP: 20mg/kg/dose 8H (Max: 1 g/day).
• Acetic acid 1%. 3 drops/ear 6H.
• Acetylcysteine. Paracetamol poisoning: 150mg/kg in 5ml/kg 5%DW over 60min loading dose, then 50mg/kg in 5ml/kg 5%DW over the next 4H continuous infusion, then 100mg/kg in 10ml/kg 5%DW over 16H, then 100 mg/kg in 10ml/kg 5%DW over next 24H.
• Aciclovir. Herpes encephalitis, Varicella, Zoster: 500mg/m2 or 10-20 mg/kg/dose 8H PO/IV. Cutaneous herpes: 5-10mg/kg/dose. Indications see EDL.
• Activated charcoal. <6 years: 10g in 50-100mL water, >6 years 20–50g in 100–300ml water.
• Adenosine. Arrhythmia: 0.1 mg/kg/dose rapid IV push, incr by 0.1 mg/kg/dose to max 0.5 mg/kg. Max 12mg. Follow with rapid flush 5mL NaCl 0.9%. With Pediatrician consultation only.
• Adenosine. Arrhythmia: 0.1 mg/kg/dose rapid IV push, incr by 0.1 mg/kg/dose to max 0.5 mg/kg. Max 12mg. Follow with rapid flush 5mL NaCl 0.9%. With Pediatrician consultation only.
• Adrenaline. CPR: 0.1 ml/kg IV of 1:10 000 dilution. Anaphylaxis: 0.01 mL/kg IMI of 1:1 000 dilution. Infusion: 0.3mg/kg in 50ml 5%Dex at 0.5-5ml/hr (0.05-0.5mcg/kg/min).
• Albendazole. 1-2y 200mg, >2y 400mg
• Albumin 20%. 2-5 ml/kg IV over 4 hours. With Pediatrician consultation only.
• Alprostadil (PGE1). Cong Cyanotic Heart open PDA: 0.05–0.1 mcg/kg/min IV, initial dose. Maintenance dose 0.01–0.1 mcg/kg/min. Ventilation for apnoea.
• Amikacin. Neonate: 15mg/kg/day. <10y: 25mg stat then 18mg/kg daily. >10y: 20mg stat then 15mg/kg daily.
• Aminophyline. Apnoea of prematurity: 6mg/kg IV loading dose over 30 min. Thereafter 2mg/kg 12 hourly IV or orally. Severe asthma: 6mg/kg IV over 20-30min followed by infusion at 1mg/kg/hr IV. Consultant only.
• Amiodarone. VF, pulseless VT: 5mg/kg/dose IV. Follow algorithm.
• Amlodipine. Severe acute hypertension: 0.2mg/kg/dose 12H twice then 24H.
• Amoxicillin. 15-30mg/kg 8H oral.
• Amoxicillin/clavulanic acid. 15-30mg/kg 8H oral of amoxicillin.
• Ampicillin. 25–50 mg/kg/dose 6H IV.
• Artemeter/lumefantrine. See National Malaria Guidelines.
• Atenolol. 0.5–1 mg/kg/dose once daily. CI: heart failure and asthma.
• Atropine. Organophosphate poisoning: 0.02–0.05 mg/kg every 10–15 min until bronchial secretions are controlled.
• BCG vaccine. 0.05ml Intradermal.
• Beclomethasone. MDI 100-400mcg 12H.
• Benzathine benzylpenicillin. Syphilis exp: 50 000 U/kg IM stat. Prophylaxis: <30kg 600 000 U, >30kg 1.2 million U.
• Benzylpenicillin (Pen G). Meningitis: 100 000 U/kg/dose IV. Other: 50 000 U/kg/dose IV 6H. Neonates 12hourly.
• Biperiden. Acute dystonic reactions: IM/slow IV injection: <1y 1mg, 1-6y 2mg, 6-10y 3mg, >10y 6mg.
• Budesonide. MDI 100-400mcg 12H.
• Calcium carbonate. 30mg/kg oral
• Calcium chloride 10%. (0.7mmol/ml) 0.2ml/kg/dose give slow IV stat.
• Calcium gluconate 10%. (0.22mmol/ml) 0.5-1ml/kg/dose give slow IV stat.
• Captopril. 0.5mg/kg/day 8H for 24–48 hours. Increase by 0.5 mg/kg/day every 24–48 hours until maintenance dose of 3–5mg/kg/day. Cardiologist only.
• Carbamazepine. 2 mg/kg/dose (starting dose). Increase slowly at 2 weekly intervals to 5–10 mg/kg/dose 8–12 hourly. Maintenance: 10– 20 mg/kg/day. Dosage intervals: syrup 8 hourly, tablets 12 hourly. Max dose: <1y 200mg, 1-6y 400mg, 6-12y 800mg.
• Cefotaxime (Claforan). 25-50mg/kg/dose IV 6-8H. Neonate: <1wk 12H, 1-2wks 8H.
• Ceftriaxone (Rocephin). 50mg/kg/dose IV once daily. Meningitis: 100mg/kg daily.
• Cefuroxime (Zinacef IV, Zinnat PO). 10-15mg/kg/dose 12H PO. Max: 250mg. Severe inf: 25-50mg/kg/dose 6-8H IV.
• Cefalexin. 15mg/kg/dose 12H oral
• Cetirizine. 2-6y 2.5mg. 6-12y 5mg nocte.
• Charcoal. See Activated charcoal.
• Chloramphenicol. 1% Eye Ointment.
• Chloroquine. See Malaria Guidelines.
• Chlorpheniramine. 0.1 mg/kg/dose 8H.
• Ciprofloxacin. 15mg/kg/dose 12 hourly. Clarithromycin. 7.5-15mg/kg/dose 12H.
• Clindamycin. 6 mg/kg/dose 6H oral. Malaria: see National guidelines.
• Clotrimazole. 1% topical cream.
• Cloxacillin. 25-50 mg/kg/dose 6H IV. Neonate: <2wk 12H, 2-4wks 8H.
• Co-trimoxazole. IV/PO, 5mg/kg/dose of trimethoprim 6hrly. PJP Rx 21 days. Cyclizine. Nausea: 1 mg/kg/dose 8-12H.
• Cyclophosphamide. Specialist initiated.
• Desferrioxamine. Iron poisoning: 15mg/kg/hour as a continuous infusion.
• Desmopressin (DDAVP). Enuresis: Intra nasal, 10-20mcg (0.1-0.2ml) before sleep. Endocriniologist initiated.
• Dexamethasone. Cerebral oedema, Raised ICP, severe croup: IV 0.5mg/kg stat. Bacterial Meningitis: IV, 0.15 mg/kg/dose 6H.
• Diazepam. Seizure: 0.1-0.2mg/kg/dose IV. Max 5mg. Rectal 0.5mg/kg/dose. Spasticity: 0.05-0.1mg/kg 12H oral.
• Didanosine. See ARV drug dosing chart.
• Digoxin. Paediatric cardiologist only.
• Dinoprostone (Prostin E2). Congenital Cyanotic Heart open PDA: 0,125mg every 30 minutes. 1/4 tablet suspended in 1 mL sterile water.
• Dobutamine. IV inf, 5-15 mcg/kg/min. Mix 15mg/kg in 50ml 5%DW or NS. (1ml/hr = 5mcg/kg/min). Give via a central line if available.
• Dopamine. IV inf, 5-15 mcg/kg/min. Mix 15 mg/kg in 50ml 5%DW or NS. (1ml/hr = 5mcg/kg/min). Give via a central line if available.
• Doxapram. Apnoea of prematurity: 10-20 mg/kg 6H oral. IV infusion, 0.1-1.5 mg/Kg/hour. Mix 24mg/kg in 24ml 5%DW (1ml/hr =1mg/kg/hr)
• Doxycycline. See EDL of South Africa.
• Efavirenz. See ARV drug dosing chart.
• Emulsifying ointment
• Enalapril. 0.1mg/kg daily oral, increase over 2wk if require to max 0.5mg/kg 12H. (Adult 5-20mg). Consultant only.
• Epinephrine. See adrenaline.
• Erythromycin. 10mg/kg/dose 6H oral.
• Ethambutol. 15-25mg/kg daily PO
• Ethionamide. 15-20mg/kg daily PO
• Ferrous gluconate. 2mg/kg/dose. Syrup: elemental iron 8mg/ml.
• Ferrous lactate. 2mg/kg/dose. Drops: elemental iron 16mg/0.6ml.
• Flucloxacillin. 12.5–25mg/kg 6H PO.
• Fluconazole. IV/PO, Load 12mg/kg, then 6mg/kg daily. Neonate: < 1wk 72H, 1-2wks 48H.
• Fluoxetine. 0.5 mg/kg/day PO. Dose range: 5–40 mg daily.
• Folic acid. 5mg daily.
• Furosemide. PO/IV, 0.5-1mg/kg 6-24H.
• Ganciclovir. Initial dose: 5mg/kg/dose 12H for 21 days. Follow with: 5mg/kg daily for 21 days. Specialist initiated.
• Gentamicin. Neonates: IV 5mg/kg daily. 1m-10y 6mg/kg daily. >10y 5mg/kg daily.
• Glucagon. Hypoglycaemia in Diabetics: IM/SC, 0.1–0.2 mg/10 kg. Max dose: <12 years 0.5mg, >12 years 1.0 mg. Neonatal hypoglycemia: See guidelines in text. Start infusion at 0.1mcg/kg/min (Dose: 0.1-1 mcg/kg/min). Mix: 1mg (1ml) up to 15ml in 5%DW.
• Glucose. Hypoglycaemia: Dex 10%, 2mL/kg IV OR Dex 50% 0.5 mL/kg IV diluted in N/S 1:4. Start IV infusion. See hypoglycaemia protocol in text.
• Haloperidol. See EDL of South Africa.
• Heparin sodium. For specific indications and dosage see EDL of South Africa.
• Hepatitis B immunoglobulin. Antenatal exposure: 0.5ml IM within 12hrs of birth.
• Hepatitis B vaccine. IM, 0.5ml stat. Give at 6, 10 and 14wks. Give at birth if antenatal exposure to Hep B.
• Hydrochlorthiazide. 1mg/kg 12-24H PO.
• Hydrocortisone. For specific indications and dosage see EDL of South Africa.
• Ibuprofen. 5–10 mg/kg/dose 6H oral.
• Immunoglobulin. For specific indications and dosage see EDL of South Africa. Specialist initiated.
• Influenza vaccine. See package insert.
• Insulin. See EDL of South Africa.
• Ipratropium bromide (Atrovent). Nebulise 0.25mg (2ml) in 2ml N/S 4H.
• Iron. See Ferrous gluconate (syrup) and Ferrous lactate (drops).
• Isoniazid (INH). PTB: 10mg/kg/day oral. Use Rimactizid 60/60 combination tablet. TBM: 20mg/kg/day. Max 400mg.
• Ketamine. Sedation 2mg/kg/dose IV.
• Labetalol. 0.5-3 mg/kg/hour IV infusion. See severe acute hypertension protocol. Specialist initiated.
• Lactulose. Constipation: PO, <1y 2.5mL, 1-6y 5mL, >6y 10mL. Daily or 12 hourly.
• Lamivudine (3TC). 4mg/kg 12H oral.
• Lamotrigine. Specialist initiated.
• Levothyroxine (Eltroxin). Daily oral. 0-6m 25-50mcg. 6-12m 50-75mcg. 1-5y 75-100mcg. 6-12y 100-150mcg. Adjusted dosage to blood levels.
• Levofloxacin. MDR TB: 20 mg/kg daily
• Lopinavir/ritonavir. See ARV drug chart.
• Lorazepam (Ativan). Slow IV, 0.1 mg/kg.
• Magnesium sulphate 50%. Oral/IV, 0.2mL/kg/dose.
• Mannitol. Cerebral Oedema: 250mg/kg IV infusion over 30-60 minutes.
• Mebendazole. 2-5 years 100 mg 12H for 3 days. >5 years 500mg single oral dose.
• Meropenem. 20mg/kg/dose 8H IV. Meningitis 40mg/kg/dose 8H IV.
• Methotrexate. Specialist initiated.
• Methylphenidate. 0.3-1mg/kg/day. Max 40mg daily. Specialist initiated.
• Methylprednisolone. See EDL.
• Metoclopramide. 0.15-0.3mg/kg oral.
• Metronidazole. 7.5mg/kg/dose 8H oral.
• Midazolam. Seizure: Buccal, 0.5mg/kg. IV, 0.1-0.2mg/kg/dose. Ventilated: 1-4mcg/kg/min. Mix: 3mg/kg in 50ml 5%DW. (1ml/hr = 1mcg/kg/min).
• Morphine. IV, 0.05-0.1mg/kg/dose 4-6H. Oral, 0.2-0.5mg/kg/dose 4-6H. Apnoea!
• Naloxone. Neonatal opiate depression: IV/IM, 0.1mg/kg stat. Max 0.4mg. May need repeat dose. Opioid toxicity: Child: IV, initially 0.01mg/kg. If no response 0.1mg/kg may be given. Max dose 2mg.
• Nevirapine. 150-200 mg/m2/dose bd. Once daily for 14 days, then increase to bd if no rash or severe side effects.
• Ofloxacin. MDR TB: 15-20mg/kg dly.
• Omeprazole. 0.5-1mg/kg/day twice or once daily. Specialist initiated.
• Oxybutinin. Voiding dysfunction, with diurnal enuresis. Oral, 2.5-5mg, 8-12H.
• Paracetamol. 10-15mg/kg/dose 6H oral.
• Phenobarbital. Status Epilepsy: 20mg/kg/dose IV over 10min, can give additional 10mg/kg bolus twice. Maintenance: 3–5mg/kg/day oral.
• Phenoxymethylpenicillin (Pen VK). Eradication of streptococci: 12.5mg/kg/dose 6H. Prophylaxis: <5y 125mg, >5y 250mg 12H oral.
• Phenytoin. Status Epilepsy: 15-20mg/kg IV over 30min, can give additional 10mg/kg bolus twice.
• Phosphate Enema: Oral replacement therapy: 0.1ml/kg/dose 6 hourly.
• Phosphate Sandoz. 500mg Effervescent Tablet. 30-90mg/kg/day 6H oral.
• Piperacillin /tazobactam (Piptaz). IV, 50mg/kg/dose 6 hourly of piperacillin. Neonates: 12H < 2wks; 8H 2-4wks.
• Polyethylene glycol. 30 mL/kg/hour
• Potassium oral solution. 100mg/kg/day in 2-3 doses oral. (Max 1g/dose).
• Potassium chloride 15 %. Severe hypokalaemia only. 1-2ml/200ml ½ DD as constant infusion. (1ml=2mmol K+).
• Praziquantel. Bilharzia: 40mg/kg/24H oral as a single dose.
• Prednisone. 1-2mg/kg/day oral. TBM: 4mg/kg/day
• Prednisolone. See prednisone.
• Promethazine. 0.125 mg/kg/dose 6H.
• Propranolol. Cong. Cyanotic Heart Disease with cyanotic spells: 0.5-1mg/kg/dose 6 hourly. Cardiologist consultation only.
• Pyrazinamide. PTB: 20-30mg/kg dly. TBM:40mg/kg dly. 500mg Tab. Max 2g.
• Pyridostigmine. Myasthenia Gravis: Oral, 1-1.5mg/kg/day 4-6H. Paed initiated.
• Pyridoxine (Vit B6). 6.25-12,5mg dly .
• Quinine. See Malaria Guidelines.
• Rifampicin. PTB: 10mg/kg/day oral. Use Rimactizid 60mg/60mg Tab. TBM:20mg/kg/day.
• Rimactizid. 60mg Rif/60mg INH. Give according to weight. See TB drug chart.
• Risperidone. 0.125-3mg bd. Average dose: 0.25-2mg/day. Specialist initiated.
• Ritonavir. See ARV Dosing Chart.
• Salbutamol. MDI: 1 puff = 100mcg. Nebs: 5mg (1ml) in 2-4ml N/S. Severe asthma: IV 15 mcg/kg over 10 min. If needed cont infusion 0.2mcg/kg/min, increase by 0.1 mcg/kg every 15 minutes (Max: 2mcg/kg/min). Monitor in PICU.
• Sodium bicarbonate (4.2%). HCO-3 (mmol) = BE x 0.3 x kg. (Give this amount in ml over 4-6 hours to half correct). 1ml Sodabic 4.2% = 0.5mmol HCO-3. CPR: Stat dose 1-2ml/kg/dose. Only with specialist knowledge. See contra-indications in textbooks.
• Sodium valproate. 20-30mg/kg/day PO 8-12 hourly. Specialist initiation.
• Sorbitol. <1y 5mL, 1-6y 5-10mL, >6y 10-15mL per dose oral. Daily or twice daily.
• Spironolactone. 1-2mg/kg/dose 12H PO
• Stavudine. See ARV Dosing Chart.
• Suxamethonium chloride. Intubation: 2mg/kg/dose IV stat.
• Tilidine (Valoron). Oral, 1mg/kg 4 hrly. 1 drop = 2.5mg. Drops = weight ÷ 2.5.
• Trimethoprim/sulfamethoxazole. See Co-trimoxazole.
• Vancomycin. IV, 10mg/kg 6hrly or 15mg/kg 8hrly. Neonates: <35wks 12hrly, <28wks 24hrly. Do levels.
• Vitamin A. <6m 50 000 IU, 6-12m 100 000 IU, >12m 200 000 IU.
• Vitamin D. Breastfeeding: Oral, 400 IU dly. Rickets: Oral, 5 000 IU, once dly.
• Zidovudine. See ARV Dosing Chart.
• Zinc sulphate. <10kg 10 mg/day, >10kg 20 mg/day.

Abbreviations

H: Hourly CI: Contraindication
PO: Give orally IV: Give intravenous
ARV: Antiretroviral
EDL: Essential Drug List of South Africa
MDI: Metered Dose Inhaler