Dosage calculation

Weight-based dosage calculation (mg/kg)

Many drugs — especially in pediatrics — are dosed by body weight in mg/kg. Convert the weight to kilograms first (1 kg = 2.2 lb), multiply by the ordered mg/kg, and, when the order is a daily dose divided across the day, divide by the number of doses.

The formula

Dose = Weight (kg) × ordered mg/kg (÷ doses per day if divided)

How to solve it

  1. Convert pounds to kilograms if needed: lb × (1 kg ÷ 2.2 lb).
  2. Multiply the weight in kg by the ordered mg/kg.
  3. If the order is mg/kg/day divided into several doses, divide the daily total by the number of doses.
  4. Compare against the drug's safe range for the child's weight before giving.

Common mistakes

  • Skipping the lb-to-kg conversion and dosing on pounds.
  • Confusing mg/kg/dose with mg/kg/day.
  • Not checking the result against the published safe maximum.
Safety check: Always verify a pediatric result against the drug's safe mg/kg range for that child — a plausible-looking number can still be unsafe.

Worked examples

See it solved

A patient weighs 154 lb. The prescriber orders clindamycin 3 mg/kg/dose.

Weight154 lb
Ordered3 mg/kg/dose

How many mg is the dose?

Answer: 210 mg

Step-by-step solution

1. Convert the patient's weight to kilograms
154 lb × ( 1 kg ÷ 2.2 lb )
= 70 kg
2. Multiply weight by the ordered mg/kg
70 kg × ( 3 mg ÷ 1 kg )
= 210 mg

A patient weighs 132 lb. The prescriber orders acetaminophen 20 mg/kg/day divided into 4 equal doses.

Weight132 lb
Ordered20 mg/kg/day
Frequency4 doses/day

How many mg is each dose?

Answer: 300 mg per dose

Step-by-step solution

1. Convert the patient's weight to kilograms
132 lb × ( 1 kg ÷ 2.2 lb )
= 60 kg
2. Multiply weight by the ordered mg/kg/day
60 kg × ( 20 mg ÷ 1 kg )
= 1200 mg/day
3. Divide the daily dose into 4 equal doses
1200 mg/day ÷ 4 doses
= 300 mg per dose

A patient weighs 60 kg. The prescriber orders gentamicin 10 mg/kg/day divided into 2 equal doses.

Weight60 kg
Ordered10 mg/kg/day
Frequency2 doses/day

How many mg is each dose?

Answer: 300 mg per dose

Step-by-step solution

1. Multiply weight by the ordered mg/kg/day
60 kg × ( 10 mg ÷ 1 kg )
= 600 mg/day
2. Divide the daily dose into 2 equal doses
600 mg/day ÷ 2 doses
= 300 mg per dose