Dosing with body weight extremes

Paediatric Weight Adjustment Calculations

The Sydney Children’s Hospital Network Dosing for Overweight and Obese Patients has a pithy summary of common medication adjustments based on weight.

Ideal Body Weight (IBW) is reflective of lean body mass in children aged 2-20 Calculation = (50% BMI for age) x Ht[m]2

Total Body Weight (TBW) is reflective of actual body mass in children

Adjusted Body Weight (AjBW) is reflective of lean body mass plus a proportion of excess mass determined by a cofactor Calculation = IBW + [(cofactor) x (TBW-IBW)]

See also: Ross E, Heizer J, Mixon M, Jorgensen J, Valdex C, Czaja A. Development of recommendations for dosing of commonly prescribed medications in critically ill obese children. Am J Health-Syst Pharm 2015 (Jan); 72 (7): 542-56