Safe paracetamol dosing for obese children receiving multiple doses
Research type
Research Study
Full title
Paracetamol dosing safety amongst overweight and obese children receiving multiple inpatient doses in a tertiary paediatric centre.
IRAS ID
271784
Contact name
Nicolas Nicolaou
Contact email
Sponsor organisation
Sheffield Children's NHS Foundation Trust
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Paracetamol is a commonly prescribed medicine for children. It is used to treat pain and fever. In our institution, the dose of paracetamol is based upon the child’s total body weight (TBW). In obese children, their weight is higher than other children of their age which can result in relatively large doses of paracetamol being administered. It is unclear what weight should be used to determine the best dose of paracetamol for obese children. Options include total body weight (TBW), adjusted body weight (ABW), lean body mass (LBM) or ideal body weight (IBW). Using TBW could potentially lead to toxic side effects because the dose may be too high, whereas using IBW may result in under-dosing and not controlling pain or fever.
In a hospital setting, paracetamol doses vary widely according to age of the child and administration route, but there is often no clear guidance on dosing obese children. The current practice in our institution is to give overweight and obese children 15 mg/kg based on their total body weight. This study aims to determine whether the way in which we currently prescribe paracetamol in overweight and obese patients is safe from a toxicity point of view.
The study will investigate paracetamol levels in the blood, liver function and kidney function amongst obese children aged between 2 and 12 years of age receiving serial (> 3 days) regular paracetamol doses. The primary outcome is to determine whether paracetamol dosed on total body weight in obese children results in safe paracetamol levels without any evidence of liver or kidney damage.
REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
21/EM/0242
Date of REC Opinion
4 Oct 2021
REC opinion
Further Information Favourable Opinion