Cut down on the Calpol: New guidelines instruct parents to slash children’s paracetamol doses by up to half

By Jo Macfarlane
Last updated at 1:18 AM on 20th November 2011

Parents are being told to reduce the amount of paracetamol they give to young children.

The packaging of popular children’s medicines including Calpol, Disprol and Medised is being updated with new dosage advice following a review by the UK medicines watchdog.

Previously, the official guidance stated that children under six could be given up to 10ml of liquid paracetamol four times a day to reduce fever and pain.

But the Medicines and Healthcare products Regulatory Agency (MHRA) has now concluded that that advice resulted in some younger children being given more of the drug than necessary.

It is not known whether the previous guidance resulted in children suffering any ill-effects – although the MHRA has told parents not to be concerned and reassured them that they will not have damaged their children’s health.

A spokesman said: ‘The change is to ensure children get the optimal dose of paracetamol suitable for their age. It is not because of safety concerns.’

There are no short-term effects of giving a child slightly too much paracetamol – although giving high doses over a longer period can, in rare cases, lead to liver damage. The most recent MHRA figures suggest it has only ever received 26 reports of paracetamol overdose in children.

The MHRA’s revised instructions divide children aged between three months and six years old into four distinct age brackets, with a specific dose for each.

It means the youngest infants are recommended to receive 2.5ml up to four times a day – equivalent to two teaspoons in 24 hours – while only those over the age of four can be given the full 10ml dose each time. But the new guidelines do recommend that a baby between six months and a year can now have double the dose, up from 2.5ml to 5ml four times a day.

Boxes come with a special measuring spoon to help parents make sure their child receives the correct dose, along with the instructions that they should not use any other spoon or device to measure the product.

The report containing the updated advice was published on the MHRA’s website last week.

It reads: ‘The recommended dosing tables for children’s liquid paracetamol that were used previously had very wide age bands, where a one-year-old child was recommended the same dose as a six-year-old. With these recommendations, younger children may have received a dose of paracetamol that was higher than necessary.

‘The MHRA reviewed whether dosing recommendations for children’s liquid paracetamol needed to be revised. The recommended doses have been changed to ensure they get the most effective dose.’

The updated guidance comes after the MHRA warned two years ago that many cough and cold remedies, including Calpol Night, do not work in children and could cause allergic reactions and hallucinations.

The watchdog updated the packaging of dozens of popular products advising that they should no longer be used in children under the age of six because of the powerful decongestant and antihistamine drugs they contain. Neal Patel, spokesman for the Royal Pharmaceutical Society, said the advice would not be confusing for parents. ‘What’s important is matching doses with age and weight more accurately. It should make it clearer.’

Sweet liquid products such as Calpol are designed to give smaller doses of paracetamol to children in an easy-to-swallow form. Twelve million bottles of Calpol are sold in the UK every year, leading to claims that Britain is rearing a Calpol generation.

Justine Roberts, of online parenting forum Mumsnet, said: ‘Clear guidelines sound a good idea. One-year-olds and six-year-olds are very different creatures so this is common sense.’

A study in 2007 found 84 per cent of infants had been given paracetamol by the age of six months. GPs and hospitals prescribe the drug on the basis of a child’s body weight. But at home, it is dependent on age alone.

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