The FAMHP would like to remind caregivers of the main recommendations to prevent dosing errors when administering paracetamol to children, particularly with oral solutions.
Paracetamol is commonly used to treat pain and fever in children and requires particular care when administered. Dosing errors are common, particularly with oral solutions. The FAMHP wishes to remind you of several good practices to help reduce these risks.
Carefully read the package leaflet and strictly follow the dosage instructions when administering oral solutions
As with any medicine administered to a child, the person administering paracetamol must:
• read the package leaflet carefully before using the medicine;
• check the concentration and the prescribed dose;
• strictly follow the volume to be administered (based on the child's weight);
• follow the specified intervals between doses;
• consult a doctor if the child still has pain or fever despite taking the treatment.
Increased vigilance when several adults are caring for the child
It often happens that a sick child is cared for by several people: parents, grandparents, childminders, nursery staff, baby-sitters, etc.
When a medicinal product is administered to a child without informing the other caregivers, the risk of medication errors increases. The child could, for example, be given a double dose or doses too close together.
To reduce this risk, we recommend:
• you immediately note down each dose (name of the medicinal product, dose, time, person who administered it);
• you make sure that care information is shared with all caregivers;
• you clearly communicate the medication schedule taken when a carer or other relative takes over;
• you take into account all formulations (liquids, suppositories, tablets, granules, etc.) as well as pain and fever combinations that may contain paracetamol when calculating the maximum daily dose and the time required between two doses;
• if you are not sure (about the dose, timing or whether to take the medicine), you should not give the medicine again and seek advice from a healthcare professional or the poison control centre.
Risk of confusion due to differences in paracetamol concentrations in oral solution compared with those available abroad
In some countries (such as Spain), paediatric oral solutions of paracetamol have significantly different concentrations. This variability can lead, when changing countries or medicines, to the administration of an incorrect dose leading to an overdose.
The FAMHP reminds that when purchasing paracetamol abroad, the dose must always be adjusted to the concentration of the medicine and the child’s weight. It is important to adhere strictly to the recommended dose as stated in the package leaflet and to use only the measuring device supplied with the medicinal product.
Recommendations for healthcare professionals
Prescribers and dispensers play a key role in preventing errors:
• prescribe the exact quantity, based on the child's weight in kilograms (kg), the product’s concentration and the pipette's graduation scale;
• check that parents or carers understand the dosage and the administration device;
• be careful with families who may be using medicines from abroad, as concentrations may differ;
• consider paracetamol overdose in the event of any suggestive clinical symptoms (nausea, vomiting, anorexia, etc.).
Additional recommendations
• Remember to keep medicines out of the sight and reach of children and adolescents.
• Only use the measuring device supplied with the medicine, as this is adapted to its specific concentration and ensures the correct dose is administered.
Any doubts? Any questions?
Please consult a healthcare professional.
What to do in case of accidental overdose?
If more than the recommended dose is administered, please contact a doctor, a pharmacist or the Poison Control Centre (070 245 245) immediately, even if there are no symptoms.