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.
