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Nursing & Med-Math · Med-math

Weight-Based Dosage

Daily total and per-dose amounts from a mg/kg order and the patient’s weight.

Weight units
kg
mg/kg/day
The prescribed amount per kilogram per day.
3 for every 8 hours, 4 for every 6 hours.
mg/mL
Add it to get the volume per dose. Leave at 0 to skip.
Total daily dose
1050mg/day

15 mg/kg/day × 70 kg.

Amount per dose
350mg

Divided into 3 doses a day.

Multiply the ordered milligrams per kilogram by the patient’s weight in kilograms, then divide by the number of doses a day. At 15 mg/kg/day for a 70 kg adult that is 1050 mg per day, given in three doses of 350 mg. Convert pounds to kilograms first.

Why doses are written per kilogram

Many drugs — antibiotics, anticoagulants, most paediatric medication — are dosed against body mass rather than as a fixed amount, because the volume the drug distributes into and the rate the body clears it both scale with size. A single fixed dose that suits an 80 kg adult could be a large overdose in a 12 kg child.

Two forms of order look similar but mean different things. mg/kg/day is the total for 24 hours, which you then divide between doses. mg/kg/dose is the amount given each time, which you multiply by the frequency to find the daily total. Reading one as the other is the single most consequential error in weight-based dosing, and it is why this calculator asks for the daily figure explicitly.

Weight in kilograms, always

Orders are written per kilogram, so a weight recorded in pounds must be converted before anything else: divide by 2.2046. A 154 lb patient is 69.9 kg. Using pounds directly inflates the dose by a factor of about 2.2.

Total daily dose = mg/kg/day × weight in kg Dose to give = total daily dose ÷ doses per day

Where an order is written per dose rather than per day, multiply by the frequency to find the daily total instead. 1 kg = 2.2046 lb.

Worked example: 15 mg/kg/day for a 70 kg adult, three times a day

Multiply for the daily amount, then divide by the frequency:

  1. 1
    Record the weight in kilograms. The patient weighs 70 kg. A weight in pounds is divided by 2.2046 first.
  2. 2
    Read the order carefully. The order is 15 mg/kg/day — a daily total, not a per-dose amount.
  3. 3
    Multiply by the weight. 15 mg/kg/day × 70 kg = 1050 mg per day.
  4. 4
    Divide by the number of doses. Three doses a day: 1050 mg ÷ 3 = 350 mg per dose.
  5. 5
    Convert to a volume if it is a liquid. At 100 mg/mL, 350 mg ÷ 100 mg/mL = 3.5 mL per dose.
  6. 6
    Check against the maximum dose. Compare the daily total with the drug reference’s ceiling — weight-based orders can exceed adult maximums in heavy patients.

Daily totals at common mg/kg orders

Total daily dose = mg/kg/day × weight. Divide by the frequency for the amount per dose.

Weight10 mg/kg/day15 mg/kg/day25 mg/kg/day50 mg/kg/day
10 kg100 mg150 mg250 mg500 mg
20 kg200 mg300 mg500 mg1000 mg
40 kg400 mg600 mg1000 mg2000 mg
60 kg600 mg900 mg1500 mg3000 mg
70 kg700 mg1050 mg1750 mg3500 mg
90 kg900 mg1350 mg2250 mg4500 mg

Ceilings and which weight to use

Weight-based dosing does not scale without limit. Many drugs carry a maximum daily dose that applies regardless of body mass, so a large patient can reach the adult ceiling before the mg/kg arithmetic would suggest. Always compare the calculated total against the reference maximum, and take the lower of the two.

Which weight to use is a clinical decision that varies by drug: some are dosed on actual body weight, others on ideal or adjusted body weight, and some paediatric drugs on body surface area instead. The calculation is the same either way — it is the weight you feed into it that changes.

This tool is a study aid for practising calculations. Doses must be calculated and independently verified by a qualified professional against the order, the drug reference, and local protocol.

What is the difference between mg/kg/day and mg/kg/dose?
mg/kg/day is the total for 24 hours, which you divide between the day’s doses. mg/kg/dose is the amount for each individual dose, which you multiply by the frequency to find the daily total. Confusing them can multiply or divide the dose several-fold.
How do I convert pounds to kilograms?
Divide the pounds by 2.2046. A 154 lb patient weighs 69.9 kg. Orders are written per kilogram, so using pounds directly would overstate the dose by roughly 2.2 times.
What if the calculated dose exceeds the adult maximum?
Take the lower of the two. Many drugs carry a ceiling that applies regardless of body weight, and heavy patients can reach it before the mg/kg arithmetic would suggest. Check the reference maximum every time.
Should I use actual, ideal, or adjusted body weight?
That depends on the drug and is specified in the reference or protocol — some agents are dosed on actual weight, others on ideal or adjusted weight. The arithmetic does not change; only the weight you enter does.
How do I turn the dose into a volume?
Divide the milligrams per dose by the concentration in mg/mL. A 350 mg dose from a 100 mg/mL preparation is 3.5 mL. Enter the concentration in the calculator to see this step worked out.
Does the number of doses change the daily total?
No. The daily total is fixed by the mg/kg/day order and the weight; the frequency only decides how that total is split. Four doses a day means smaller individual doses of the same 24-hour amount.
Why do paediatric doses use weight so much more?
Children vary enormously in size across the same age range, so a fixed dose cannot be safe across it. Dosing per kilogram scales with the child, and paediatric orders are usually checked against a safe mg/kg/day range as well.