# Chills / Rigors

- Category: acute
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: MSF Essential Drugs 2024 - paracetamol (oral) · Dall L, Stanford JF. Fever, Chills, and Night Sweats. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 211. NCBI Bookshelf ID NBK324; PMID 21250166.
- Verified date: 2026-08

## Verified against

- MSF Essential Drugs 2024 - paracetamol (oral)

## Treatment metadata

- Paracetamol — 500 mg — oral.solid

## Complete treatment card

```text
CHILLS / RIGORS
Sources: MSF Essential Drugs 2024 - paracetamol (oral) · Dall L, Stanford JF. Fever, Chills, and
         Night Sweats. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History,
         Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter
         211. NCBI Bookshelf ID NBK324; PMID 21250166.
Review status: REVIEWED against the source listed above  (2026-08)

1. PARACETAMOL                                            [1st line]
   Adult    1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever
   Peds     15 mg/kg/dose  [child max 500 mg]
            (Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily,
            maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3
            or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table
            gives one 500 mg tablet three times daily from 30 kg to under 50
            kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total
            still applies.)
            3kg -> 45 mg/dose                 4kg -> 60 mg/dose
            5kg -> 75 mg/dose                 6kg -> 90 mg/dose
            7kg -> 105 mg/dose                8kg -> 120 mg/dose
            9kg -> 135 mg/dose                10kg -> 150 mg/dose
            11kg -> 165 mg/dose               12kg -> 180 mg/dose
            13kg -> 195 mg/dose               14kg -> 210 mg/dose
            15kg -> 225 mg/dose               16kg -> 240 mg/dose
            17kg -> 255 mg/dose               18kg -> 270 mg/dose
            19kg -> 285 mg/dose               20kg -> 300 mg/dose
            21kg -> 315 mg/dose               22kg -> 330 mg/dose
            23kg -> 345 mg/dose               24kg -> 360 mg/dose
            25kg -> 375 mg/dose               26kg -> 390 mg/dose
            27kg -> 405 mg/dose               28kg -> 420 mg/dose
            29kg -> 435 mg/dose               30kg -> 450 mg/dose
            31kg -> 465 mg/dose               32kg -> 480 mg/dose
            33kg -> 495 mg/dose               34kg -> 500 mg/dose (capped)
            35kg -> 500 mg/dose (capped)      36kg -> 500 mg/dose (capped)
            37kg -> 500 mg/dose (capped)      38kg -> 500 mg/dose (capped)
            39kg -> 500 mg/dose (capped)      40kg -> 500 mg/dose (capped)
            41kg -> 500 mg/dose (capped)      42kg -> 500 mg/dose (capped)
            43kg -> 500 mg/dose (capped)      44kg -> 500 mg/dose (capped)
            45kg -> 500 mg/dose (capped)      46kg -> 500 mg/dose (capped)
            47kg -> 500 mg/dose (capped)      48kg -> 500 mg/dose (capped)
            49kg -> 500 mg/dose (capped)      50kg -> 500 mg/dose (capped)
   Source   MSF Essential Drugs 2024 - paracetamol (oral)
   Why      Symptomatic relief of the pain and fever only. It does not treat the cause, and the dose
            is the same whatever the cause is.
   Caution  Relief only - it does not treat what is causing the pain or fever.
            Check every other product the patient is taking for paracetamol; combination cold and
            flu preparations are the usual route to an accidental overdose.
            Reduce the dose in significant liver disease, chronic alcohol use, or low body weight.
            RED FLAG - Rigors with high fever suggest serious bacterial infection, sepsis or, in a
            returning traveller, imported malaria; chills with hypotension or confusion suggest
            sepsis and are an emergency. Investigate rather than treating chills in isolation.
   Egypt    FEBRIMOL 500 MG 20 TAB.          PHARCO               3.50 EGP (0.17/unit)
            CETAMOL 500 MG 20 TABS.          MEMPHIS              8.00 EGP (0.40/unit)
            PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP                            13.00 EGP (0.65/unit)
            CETAL 500 MG 20 TABS.            EIPICO              24.00 EGP (1.20/unit)
            ARKADOLOW 500 MG 30 F.C. TABS.   UTOPIA              42.00 EGP (1.40/unit)
            PARAMOL 500MG 20 TAB.            MISR                38.00 EGP (1.90/unit)
            ADOL 500MG 24 CAPLETS            JULPHAR             32.00 EGP
            AUGICETAMIDE 500 MG 20 SACHETS   AUG PHARMA          50.00 EGP
            FEBRIMOL ORAL DROPS 20 ML        PHARCO               4.00 EGP
                -> ? strength differs, ? different route - not oral solid
            THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA                               5.00 EGP
                -> ? strength differs, ? different route - not oral solid

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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