title: Drug type - Neonatal Intensive Care Drug Manual
text: |
  Neonatal Intensive Care Drug Manual
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  bet | 436/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Drug type
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  Non-narcotic analgesic and antipyretic.
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  Trade name
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  Intravenous: Paracetamol Actavis; Paracetamol ACT; Paracetamol BNM; Paracetamol IV Pfizer; Paracetamol Kabi; Paracetamol-AFT; Paramat
  Oral: Dymadon, Febridol, Panadol (Children)
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  Presentation
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  IV: 500 mg/50 mL, 1000 mg/100 mL (10 mg/mL) vial or infusion bag
  Oral: 100 mg/mL drops
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  Dose
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  Analgesia/Antipyretic/Adjunct to post-operative analgesia
  Oral/Intravenous/Rectal1-3:
  Weight*
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  Loading
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  Maintenance
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  <2.0 kg
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  15 mg/kg
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  7.5 mg/kg every 6 hours
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  2.0 – 3.0 kg
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  15 mg/kg
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  10 mg/kg every 6 hours
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  >3.0 kg
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  20 mg/kg
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  10 mg/kg every 6 hours
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  *Current/best weight
  Patent Ductus Arteriosus (treatment course 3-7 days with 48-hourly monitoring of liver function)
  Oral/Intravenous4,5:
  Criteria
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  Loading
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  Maintenance
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  ≥28 weeks CGA/PMA and ≥1000 g*
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  15 mg/kg
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  15 mg/kg every 6 hours
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  <28 weeks and/or <1000 g**
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  15 mg/kg
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  7.5 mg/kg every 6 hours**
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  *Current/best weight
  **Higher maintenance doses (15 mg/kg) in extreme preterm infants have been used but there are limited safety data. At Canberra Hospital, a dose of 15mg/kg 6 hourly is used for treatment in all patients
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  Dose adjustment
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  Therapeutic hypothermia –Caution to be applied with associated hepatic and renal impairment.
  Renal impairment – Refer to precautions section.
  Hepatic impairment – Refer to monitoring and precautions sections.
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  Maximum dose
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  60 mg/kg/day
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  Total cumulative dose
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  Route
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  IV, oral, rectal
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  Preparation
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  Intravenous: Use undiluted. Can be diluted to 2 mg/ml for use in ELBW infants using sodium chloride 0.9% or glucose 5%. If diluted, the solution should be used immediately.
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  Administration
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  Intravenous:
  Administer over 15 minutes via syringe driver.
  Oral:
  Can be given with or without feeds. Shake bottle well before measuring dose.
  Rectal:
  Dilute oral mixture 1:1 with water for rectal doses. Low dose suppositories are not commercially available but can be prepared by selected pharmacy departments. Do not cut suppositories to make part rectal dose.
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  Monitoring
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  Monitor hepatic and renal function.
  If signs of acute liver injury (example, raised ALT >50 IU/L) – refer to acetylcysteine formulary and contact Poisons Information Centre (13 11 26 for New South Wales) or local toxicology service.
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  1000>28> |
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