Pediatric Drug Dosages

Franklyn P. Cladis

appendix

Generic Name
(Trade Name)

Route

Dose

Indication

Acetaminophen
(Tylenol)

PO
PR

10 to 15 mg/kg q 4 to 6 hr
20 to 40 mg/kg initial dose, then 20 mg/kg q 6 hr

Pain/fever

Adenosine

IV

0.1 mg/kg bolus; if not effective, 0.2 mg/kg

(12 mg maximum single dose)

SVT

Flushing, chest pain,

bronchospasm

Albuterol

Nebulized

0.15 mg/kg in 2 mL normal saline solution

Bronchospasm

Tachycardia

Alfentanil

IV

10 to 150 mcg/kg bolus

0.5 to 3 mcg/kg per min

Anesthesia
Adjunct for anesthesia
maintenance

Apnea, bradycardia

Alprostadil

IV

0.05 to 0.1 mcg/kg per min

Patency of ductus arteriosus

Fever, apnea,
arrhythmias

Aminocaproic acid
(Amicar)

IV

100 mg/kg bolus, infusion 30 mg/kg per hr

Excessive bleeding from

fibrinolysis

Hypotension,
bradycardia,
arrhythmias

Aminophylline

PO, IV

100 mg/kg load: 100 mg/kg dose every 6 hr

5 mg/kg load, infusion 1 mg/kg per hr

Bronchospasm

Arrhythmias

Amiodarone

IV

5 mg/kg bolus slowly, infusion 5 to

10 mcg/kg per min

Ventricular arrhythmias

Hypotension,
arrhythmias (torsades
de pointes)

Ampicillin

IV

50 mg/kg

Endocarditis prophylaxis

Atracurium
(Tracrium)

IV

0.5 mg/kg intubation

5 to 15 mcg/kg per min infusion

Neuromuscular blocker

Atropine

IV

0.01 to 0.02 mg/kg

Bradycardia

Bupivacaine
(Marcaine)

Neuraxial,
peripheral

2.5 mg/kg

Epidural, caudal, peripheral

nerve blockade

Seizures, arrhythmias

Butorphanol

IV

10 mcg/kg

Pain/fever

CNS depression,
respiratory depression

Caffeine

PO, IV

5 to 10 mg/kg as caffeine base (10 to 20 mg/kg

as caffeine citrate)

Apnea of prematurity

Tachyarrhythmias

Caffeine and Sodium

benzate

IV

500 mg (per dose)

Relief of post dural puncture

headache

Tachycardia,
palpitations, nausea

Calcium chloride

IV

10 to 20 mg/kg (via central venous line)

Hypocalcemia, hypotension

Tissue necrosis

Calcium gluconate

IV

30 to 45 mg/kg

Hypocalcemia, hypotension

Tissue necrosis

Cefazolin (Ancef)

IV

25 mg/kg

Wound prophylaxis

Chloral hydrate

PO/PR

50 to 75 mg/kg

Sedation

Arrhythmias

Cimetidine (Tagamet)
Cisatracurium
(Nimbex)

IV/PO
IV

5 to 15 mg/kg q 6 to 12 hr
0.1 to 0.2 mg/kg bolus, infusion
1 to 5 mcg/kg per min

Gastric pH control
Neuromuscular blockade

Confusion, headache

Clindamycin (Cleocin) IV

5 to 10 mg/kg (slowly) q 6 to 8 hr
20 mg/kg (slowly) for SBE prophylaxis

Wound prophylaxis (penicillin

[PCN] allergic)

Thrombophlebitis,
hypotension

Clonidine

Neuraxial

1 to 3 mcg/kg

Enhance neuraxial blockade

Hypotension, sedation

PO

4 mcg/kg

Preoperative sedation

Intraoperative
hypotension

Side Effects

Histamine release

Continued

A1

A2 S e c t i o n viii Appendixes
Generic Name
(Trade Name)

Route

Dose

Indication

Side Effects

Codeine

PO

0.5 to 1 mg/kg

Pain

Sedation, nausea,
vomiting, respiratory
depression

Dantrolene

IV

2.5 mg/kg to maximum 10 mg/kg

Malignant hyperthermia

Slow to solubilize,
drowsiness, muscle
weakness

Desmopressin
(DDAVP)

IV
IV

0.3 mcg/kg (over 15 min)

2 to 4 mcg/day in 2 doses (12 years old)

Platelet dysfunction, von

Willebrand disease
Diabetes insipidus

Hyponatremia,
hypertension, flushing
Hyponatremia,
hypertension, flushing

Dexamethasone
(Decadron)

IV

0.5 to 1 mg/kg (maximum 16 to 20 mg)

Croup, airway edema,

cerebral edema

Hypertension,
headache,
hyperglycemia

Dexmedetomidine

IV

Load 0.5 to 2 mcg/kg over 15 min infuse 0.3 to

2 mcg/kg/hr

Sedation and analgesia

Hypotension,
bradycardia, transient
hypertension with
rapid administration

Diazepam (Valium)

PO
IV

0.2 to 0.3 mg/kg 45 to 60 minutes preprocedure

0.05 to 0.3 mg/kg

Preoperative sedation

Hypotension,
bradycardia

Digoxin

IV
IV maintenance

0.03 mg/kg <2 years old

0.01 to 0.04 mg/kg >2 years old (digitalizing
dose; 1/2 dose initially, then 1/4 q 6 hr 2)
2 to 10 mcg/kg per day (IV dose = 75% oral dose)

SVT, CHF

Arrhythmias,
atrioventricular block

Diphenylhydantoin
(Dilantin)

IV

12 to 20 mg/kg (over 30 min to avoid

hypotension; limit infusion rate to 50 mg/min)

Seizure, digoxin toxicity

Hypotension, skin
necrosis at IV site,
ataxia, gingival
hyperplasia

Diphenhydramine
(Benadryl)

IV

0.5 to 2 mg/kg (maximum single dose 50 mg)

(maximum 150 mg/day if <12 years old,
300 mg if >12 years old)

Sedation, pruritus, acute

dystonic reactions

Paradoxical excitement

Dobutamine

IV

2 to 15 mcg/kg per min (maximum dose

40 mcg/kg/min)

Heart failure

Increased heart rate,

ectopy, hypotension

Dopamine

IV dose

2.5 to 20 mcg/kg per min

Heart failure, increased renal

blood flowlow

Increased heart rate,

ectopy

Doxacurium

IV

0.05 to 0.1 mg/kg intubation

Neuromuscular blocker

Droperidol

IV

10 to 75 mcg/kg (maximum dose 1.25 mg)

Antiemetic

Hypotension,
arrhythmias (FDA
warning)

Edrophonium
(Enlon, Tensilon)

IV

0.5 to 1.0 mg/kg

Neuromuscular blocking
reversal agent

Bradycardia

EMLA cream

Topical

0 to 3 mo maximum 1 g (10 cm2), 3 to 12 mo

maximum 2 g (20 cm2),
1 to 6 years old maximum 10 g (100 cm2),
7 to 12 years old maximum 20 g (200 cm2)

Dermal anesthesia for

venipuncture

Methemoglobinemia,
blanching of skin

Ephedrine

IV

0.02 to 0.2 mg/kg

Hypotension

Bradycardia,
hypotension,
confusion

Epinephrine
(Adrenalin)

IV
Endotracheal

10 mcg/kg q 3 to 5 min, infusion 0.01 to

1 mcg/kg per min
100 mcg/kg

Cardiac arrest, hypotension,

heart failure

Tachycardia

Epinephrine, racemic

Nebulized

<2 years old 0.25 mL, >2 years old

0.5 mL of 2.25% solution in 3 mL normal
saline solution

Upper airway edema

Tachycardia

Esmolol

IV

Hypertension, tachycardia

Bradycardia

Etomidate

IV

500 mcg/kg loading dose

50 to 300 mcg/kg per min infusion
0.3 mg/kg (0.2 to 0.6 mg/kg)

Anesthetic induction

Myoclonus, pain on
injection, adrenal
suppression

a p p e n d i x A Pediatric Drug Dosages A3

Generic Name
(Trade Name)

Route

Dose

Indication

Side Effects

Fentanyl

IV

0.5 to 3 mcg/kg (may repeat q 30 min)

2 to 10 mcg/kg bolus, infusion 1 to
4 mcg/kg per hr

Analgesia and sedation

Adjunct for induction and
maintenance of anesthesia

Apnea, cough,
laryngospasm,
chest wall rigidity,
bradycardia

Fentanyl (Oralet,
Actiq)

PO

5 to 15 mcg/kg (200 mcg is smallest dose)

Sedation preoperatively

Sedation, pruritis,
oxygen desaturation

Flumazenil

IV

0.01 mg/kg (maximum dose 0.2 mg) q 1 min

up to 1 mg (maximum cumulative dose)

Benzodiazepine antagonist

Altered blood pressure,

arrhythmias

Furosemide (Lasix)

IV

1 to 2 mg/kg q 6 hr (6 mg/kg per day

maximum dose)

Diuretic

Hypokalemia,
hyponatremia,
potential ototoxicity

Gentamicin

IV

1.5 to 2.5 mg/kg

Antibiotic

Nephrotoxicity,
ototoxicity, potentiate
neuromuscular
blockade

Glucagon

IM, IV

<20 kg 0.5 mg, >20 kg 1 mg

Antihypoglycemic, relaxant
for gastrointestinal tract

Tachycardia

Glucose

IV

200 mg/kg, 4 mg/kg per min

Hypoglycemia

Glycopyrrolate
(Robinul)

IV

0.005 to 0.01 mg/kg

Antisialagogue, bradycardia

Tachycardia, flushing

Hydralazine

IV

0.05 to 0.3 mg/kg (15 min onset)

Hypertension

Tachycardia, flushing

Hydrocortisone
(Solu-Cortef)

IV

1 to 2 mg/kg q 6 hr

Adrenal suppression, asthma

Hypertension,
hyperglycemia

Hydromorphone
(Dilaudid)

IV

0.01 to 0.015 mg/kg

Analgesia

Sedation, nausea,
vomiting, respiratory
depression

Hydroxyzine
(Atarax, Vistaril)

IM
PO

0.5 to 1 mg/kg q 4 to 6 hr
2 to 4 mg/kg q 6 to 8 hr

Sedation

Drowsiness

Ibuprofen

PO

10 mg/kg q 6 hr

Analgesic/antiinflammatory

Inhibition of platelet
aggregation, renal
failure

Inamrinone

IV

Load 3 to 4.5 mg/kg over 30 min, then

3 to 10 mcg/kg per min infusion

Heart failure

Arrhythmias,
thrombocytopenia

Insulin, regular

IV

Load 0.01 to 0.1 unit/kg, infuse

0.1 unit/kg per hr

Hyperglycemia, DKA

Hypoglycemia

Intralipid 20%

IV

1.5 ml/kg bolus, then infuse 0.25 ml/kg/min over Cardiac arrest secondary to
30 to 60 min
local anesthetic toxicity

Isoproterenol
(Isuprel)

IV

0.05 to 1 mcg/kg per min

Bradycardia

Tachycardia, ventricular
arrhythmias,
hypotension

Ketamine

IV
IV
IV
IM
IM
PO

0.5 to 1 mg/kg
1 to 2 mg/kg
2-5
3 to 5 mg/kg
5 to 10 mg/kg
5 to 10 mg/kg

Sedation
Anesthesia
Anti-hyperalgesia dose
Sedation
Anesthesia
Sedation

Hallucinations,
tachycardia, may
increase intracranial
and intraocular
hypersalivation,
pressure, apnea,
vomiting

Ketorolac (Toradol)

IV

0.5 mg/kg

Analgesia

Inhibition of platelet
aggregation, renal
failure

Labetalol

IV

0.2 to 0.5 mg/kg (q 5 min)

Tachycardia, hypertension

Hypotension,
bradycardia

Lidocaine

IV
IV

1 mg/kg
20 to 50 mcg/kg per min infusion

Ventricular arrhythmias

Seizures

Lidocaine

Intratracheal

3 to 4 mg/kg

Topical anesthesia

Arrhythmias, seizures
Continued

A4 S e c t i o n viii Appendixes
Generic Name
(Trade Name)

Route

Dose

Indication

Side Effects

Lorazepam

IV

0.05 to 0.1 mg/kg (maximum 4 mg)

Sedation, anxiolysis

Neurotoxicity
in neonates
(preservative)

Mannitol

IV

0.25 to 1 g/kg (over 20 min)

Increased intracranial
pressure, diuresis

Meperidine
(Demerol)
Methadone

IV
IV
IM
IV

1 to 2 mg/kg
0.5 mg/kg max dose (12.5 mg)
1 to 2 mg/kg
0.1 mg/kg

Analgesia, preoperative
sedation
Postoperative shivering
Analgesia

Accumulation of
normeperidine in
renal dysfunction
Sedation, nausea,
vomiting, respiratory
depression

Methohexital
(Brevital)

IV
PR

1 to 2 mg/kg
25 to 35 mg/kg (10% solution)

Anesthesia
Sedation/anesthesia

Apnea

Methylene blue

IV

1 to 2 mg/kg may repeat in 1 hr

Antidote for drug-induced

methemoglobinemia

Stains skin

Methylprednisolone
(Solu-Medrol)

IV
IV

2 mg/kg load, 0.5 to 1 mg/kg q 6 hr 30 mg/kg

over 15 min, infusion
5.4 mg/kg per hr for 23 hr

Asthma exacerbation
Acute spinal cord injury

Hypertension,
psychosis, glucose
intolerance

Metoclopramide
(Reglan)

IV

0.1 to 0.5 mg/kg

Antiemetic

Extrapyramidal
reactions

Midazolam (Versed)

IV
IN
PO

0.05 to 0.1 mg/kg

0.2 to 0.3 mg/kg (5 to 10 min onset)
0.5 to 1 mg/kg (20 to 30 min onset)

Sedation
Sedation
Sedation

Hypotension in
neonates, hiccups
Nasal irritation
Bad taste

Milrinone

IV

50 mcg/kg load, infusion 0.25 to 0.75 mcg/kg

per min

Heart failure

Hypotension

Morphine

IV/IM

0.05 to 0.1 mg/kg

Analgesia

Histamine release,
apnea, sedation,
nausea, vomiting

Nalbuphine

IV

0.01 to 0.02 mg/kg q 4 hr

Opiod-induced pruritis

Naloxone (Narcan)

IV/IM

1 to 10 mcg/kg titrated

Apnea/sedation after opioids

Hypertension

Naproxen
(Naprosyn)

PO

5 to 10 mg/kg q 12 hr

Analgesia, antiinflammatory

Inhibition of platelet
aggregation, renal
failure

Neostigmine

IV

0.05 to 0.07 mg/kg

Neuromuscular blockade
reversal

Bradycardia, secretions

Nicardipine

IV

0.5 to 5 mcg/kg per min

Induced hypotension,
hypertension

Hypotension

Nitroglycerin

IV

0.5 to 3 mcg/kg per min

Venodilation, myocardial
ischemia

Hypotension

Nitroprusside

IV

0.5 to 10 mcg/kg per min

Induced hypotension,
hypertension

Cyanide toxicity

Norepinephrine
(Levophed)

IV

0.1 to 1 mcg/kg per min

Hypotension

Arrhythmias

Ondansetron
(Zofran)

IV

0.05 to 0.1 mg/kg (maximum 4 mg)

Antiemetic

Headache

Oxycodone

PO

0.05 to 0.15 mg/kg q 4 to 6 hr

Analgesia

Sedation, nausea,
vomiting, respiratory
depression

Pancuronium
(Pavulon)

IV

0.08 to 0.15 mg/kg

Neuromuscular blocker

Tachycardia

Pentobarbital
(Nembutal)

IV

1 to 3 mg/kg (maximum 100 mg)

Sedation

Respiratory depression,
apnea

Phenylephrine
(Neo-Synephrine)

IV
IV

1 to 10 mcg/kg
0.1 to 0.5 mcg/kg/min infusion

Hypotension

Hypertension

a p p e n d i x A Pediatric Drug Dosages A5

Generic Name
(Trade Name)

Route

Dose

Indication

Side Effects

Potassium chloride

IV

0.5 mEq/kg (via CVP over 30 to 45 min)

Hypokalemia

Arrhythmias with rapid

infusion

Procainamide

IV

3 to 6 mg/kg per dose over 5 min q 5 to

10 min (maximum 15 mg/kg), infusion
20 mcg/kg per min

Ventricular and atrial

arrhythmias

Hypotension, QT
prolongation

Prochlorperazine
(Compazine)

IV/IM
PO/PR

0.1 to 0.15 mg/kg q 6 hr (IV not recommended)

0.4 mg/kg per day divided q 6 to 8 hr

Antiemetic

High incidence of
extrapyramidal
reactions, sedation,
hypotension

Promethazine
(Phenergan)

IV/IM

0.25 to 0.5 mg/kg q 4 to 6 hr

Antiemetic

Sedation,
contraindicated in
children <2 years old

Propofol

IV

2 to 3 mg/kg; 100 to 200 mcg/kg per min

infusion

Anesthesia

Apnea, hypotension

Propranolol (Inderal)

IV

0.01 to 0.1 mg/kg (over 10 min)

Tachycardia, hypertension

Hypotension,
bradycardia

Prostaglandin E1

IV

0.05 to 0.1 mcg/kg per min

Maintain patent ductus

arteriosus

Fever, apnea

Protamine

IV

1 mg for every 100 units of heparin to

be neutralized

Heparin neutralization

Hypotension,
bradycardia,
pulmonary
hypertension

Ranitidine (Zantac)

IV
PO

1 to 1.5 mg/kg per day divided q 8 hr

2 to 3 mg/kg per day divided q 12 hr

Gastric pH control

Remifentanil

IV

1 to 4 mcg/kg bolus, infusion 0.1 to 0.5 mcg/kg

per min

Analgesia, adjunct to
anesthesia

Rocuronium
(Zemuron)

IV

0.6 to 1.2 mg/kg

Neuromuscular blocker

Scopolamine

IV/IM

6 to 10 mcg/kg (maximum 0.3 mg/dose)

Antisialagogue, amnestic

Sodium bicarbonate

IV

0.5 to 1 mEq/kg

Metabolic acidosis

Succinylcholine

IV
IM

1.5 to 2 mg/kg (fast onset)

5 mg/kg

Neuromuscular blocker
(depolarizing)
Neuromuscular blocker

Hyperkalemia,
malignant
hyperthermia trigger

Sufentanil

IV
IV

0.25 to 1 mcg/kg bolus

0.1 to 1 mcg/kg per hr infusion

Anesthesia
Adjunct for maintenance of
anesthesia

Apnea, chest wall

rigidity

Thiopental

IV

3 to 7 mg/kg

Anesthesia

Apnea

Tramadol

PO

1 to 2 mg/kg

Analgesia; structurally related Nausea, vomiting, and

to codeine; also inhibits
dizziness
reuptake of serotonin and
norepinephrine

Vancomycin

IV

10 mg/kg (over 30 min)

Wound prophylaxis

Hypotension, histamine
release, red man
syndrome

Vasopressin

IV

0.0005 to 0.005 unit/kg per min

Vasopressor, diabetes
insipidus

Hypertension

Vecuronium
(Norcuron)

IV

0.07 to 0.2 mg/kg

0.8 to 1 mcg/kg per min infusion

Neuromuscular blocker

Verapamil

IV

0.1 to 0.3 mg/kg (1 to 15 years old)

SVT, CHF

Apnea, bradycardia

Tachycardia, confusion

Bradycardia, hypotension

M, Intramuscular; IN, intranasal; IV, intravenous; CHF, congestive heart failure; PR, per rectum; SVT, supraventricular tachycardia; DKA, diabetic ketoacidosis; PO, orally;
ACT, activated clotting time.