Drug Dosage & IV Rates Calculations

Drug Dosage Calculations

Drug dosage calculations are required when the amount of medication ordered (or
desired) is different from what is available on hand for the nurse to administer.

Formula:
Amount DESIRED (D)
X QUANTITY (Q) = Y (Tablets Required)
Amount on HAND (H)

Note: When medication is given in tablets, the QUANTITY = 1 since the amount of
medication available is specified per (one) tablet.

Example 1: Toprol XL, 50 mg PO, is ordered. Toprol XL is available as 100 mg per

tablets. How many tablets would the nurse administer?

Step 1: Determine your givens. Amount desired (D) = 50 mg

Amount on hand (H) = 100 mg tablets
Quantity = 1
Step 2: Plug in what you know into the
formula and simplify. x 1 = 0.5 tablets

Therefore, the nurse would administer 0.5 of a tablet.

Example 2: 1200 mg of Klor-Con is ordered. This medication is only available as 600

mg per tablet. How many tablets should the nurse give?

Step 1: Determine your givens. Amount desired (D) = 1200 mg

Amount on hand (H) = 600 mg
Quantity = 1
Step 2: Plug in what you know into the
formula and simplify. x 1 = 2 tablets

Therefore, the nurse should give 2 tablets.

The same formula can be used for dosage calculations where the medication is
available as amount per certain volume.

In these types of calculations, the volume available on hand is the QUANTITY.

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Example 3: Dilantin-125 is available as 125 mg/5 mL. Dilantin-125, 0.3 g PO, is
ordered. How much should the nurse administer to the patient?

Step 1: Determine your givens. Amount desired (D) = 0.3 g

Amount on hand (H) = 125 mg
Quantity = 5 mL
Step 2: Convert 0.3 g to mg (since the
ordered dose is in grams but the drug is 0.3 g x 1,000 mg/g = 300 mg
available on hand in milligrams).

Step 3: Plug in what you know into the

formula and simplify. x 5mL = 12 mL

Therefore, the nurse would administer 12 mL.

Example 4: Furosemide is available as 40 mg in 1 mL. 10 mg is ordered to be

administered through an IV. What amount of furosemide should the nurse administer?

Step 1: Determine your givens. Amount desired (D) = 10 mg

Amount on hand (H) = 40 mg
Quantity = 1 mL
Step 2: Plug in what you know into the
formula and simplify. x 1mL = 0.4 mL

Therefore, the nurse should administer 0.4 mL of furosemide.

Dosage Calculations based on Body Weight

Dosage calculations based on body weight are required when the dosage ordered and
administered is dependent on the weight of the patient. For example, many pediatric
drugs are ordered and given per weight (usually in kg).
Dosage calculations based on body weight are calculated in two main stages.

Stage 1: Using the formula below, calculate the total required dosage based on given
the body weight.

Weight (kg) x Dosage Ordered (per kg) = Y (Required Dosage)

Stage 2: Apply the x Q formula to calculate the actual amount of medication to be

administered.

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Example 1: Medrol 4 mg/kg is ordered for a child weighing 64.8 lb. Medrol is available
as 500 mg/4mL. How many milliliters of medication must the nurse administer?

Step 1: Determine your Weight: 64.8 lb

givens.
Step 2: Convert 64.5 lb to
kg since the infant’s weight
is given in pounds (lb) but
the dosage ordered is in mg
per kilogram.
Step 3: Calculate the
required dosage (mg) of
medication based on the
child’s weight.
Dosage ordered: 4mg/kg
Available on hand: 500 mg/4mL
64.8 lb ÷ 2.2 lb/kg = 29.45 kg
Therefore, the infant’s weight is 29.45 kg.
Weight (kg) x Dosage Ordered (per kg) =
Y (Required dosage)
29.45 kg x 4 mg/kg = 117.8 mg

Therefore, the required dosage of medication is 58.64

mg.
Step 4: Calculate the
volume of medication (mL) x Quantity = Y
to be administered based on
what’s available on hand.
x 4 mL = 0.942 mL

Therefore, the nurse must administer 0.942 mL of medication.

Example 2: A doctor prescribes 250 mg of Ceftin to be taken by a 20.5 lb infant every 8

hours. The medication label indicates that 75-150 mg/kg per day is the desired dosage
range. Is this doctor's order within the desired range?

Step 1: Determine your Weight: 20.5 lb

givens. Dosage ordered: 250 mg
Desired dosage range: 75-150 mg/kg

Step 2: Convert 20.5 lb to 20.5 lb ÷ 2.2 lb+/kg = 9.32 kg

kg since the infant’s weight
is given in pounds (lb) but
the medication label is in mg
per kilogram.

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Step 3: Calculate the Weight (kg) x Dosage Ordered (per kg) = Y
minimum and maximum
dosage for a 9.32 kg infant. Minimum dosage:
9.32 kg x 75 mg/kg = 699 mg

Step 4: Calculate the
amount of medication the
doctor has ordered for one
day or 24 hours.
Maximum dosage:
9.32 kg x 150 mg/kg = 1398 mg
24 hr ÷ 8 hr = 3
The doctor has ordered the medication to be given 3
times per day.
Every dose is 250 mg.
250 mg x 3 = 750 mg

Therefore, the doctor has ordered 750 mg of medication

Step 5: Compare the total
amount of medication
ordered for one day to the
dosage range listed on the
medication label.
per day.
750 mg is within the desired range of 699-1398 mg since
699 < 750 < 1398
Therefore, the doctor has ordered a dosage within the
desired range.

Calculation of Intravenous Drip Rates

In these types of calculations, for a given volume, time period, and drop factor (gtts/mL),
the required IV flow rate in drops per minute (gtts/min) is calculated.

Note: Since a fraction of a drop is not possible to give to a patient, it is usual to round
the answers to the nearest whole number.

Formula:
Volume (mL)
x Drop Factor (gtts/mL) = Y (Flow Rate in gtts/min)
Time (min)

Example 1: Calculate the IV flow rate for 250 mL of 0.5% dextrose to be administered
over 180 minutes. The infusion set has drop factor of 30 gtts/mL.

Step 1: Determine your givens. Volume: 250 mL

Time: 180 min

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 Drop factor: 30 gtts/mL
Step 2: Use the formula to
calculate the IV flow rate. No unit ( )
conversions are required.
Remember to round the final
answer to the nearest whole
number. ( )

Therefore, the IV flow rate is 42 gtts/min.

Example 2: The infusion set is adjusted for a drop factor of 15 gtts/mL. Calculate the IV
flow rate if 1500 mL IV saline is ordered to be infused over 12 hours.

Step 1: Determine your givens. Volume: 1500 mL

Time: 12 hours
Drop factor: 15 gtts/mL
Step 2: Convert 8 hours into 12 h x 60 min/h = 720 min
minutes.
Step 3: Use the formula to
calculate the IV flow rate ( )
(gtts/min).

( )

Therefore, the IV flow rate is 31 gtts/min.

Calculation of Flow Rate for an Infusion Pump

Infusion pumps do not have a calibrated drop factor. The flow rate depends on the

volume of fluid ordered and the time of infusion.

Formula:
Volume (mL)
= Y (Flow Rate in mL/h)
Time (h)

Example 1: 1200 mL D5W IV is ordered to infuse in 10 hours by infusion pump.

Calculate the flow rate in milliliters per hour.

Step 1: Determine your givens. Volume: 1200 mL

Time: 10 h

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Step 2: Since the volume is given in mL
and the time is given in hours, the flow
rate can be calculated in one step using
the formula.
Step 3: Use the formula to calculate the
IV flow rate (gtts/min).

Therefore, the IV flow rate is 120 mL/hr.

Example 2: 600 mL of antibiotic is to be infused over the 180 minutes by an infusion

pump. Calculate the flow rate (mL per hour).

Step 1: Determine your givens. Volume: 600 mL

Time: 180 min
Step 2: Convert 180 min into hours since 180 min ÷ 60 min/h = 3 h
the flow rate must be stated in mL/h.

Step 3: Calculate the flow rate in mL/h

using the formula.

Therefore, the flow rate is 200 mL/h.

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 How to Solve Drug Dosage Problems

General Information ----------------------------------------- ----- ------------------ page 2

Converting between units ----------------------------------------------------------- page 4

Converting between metric units --------------------------------------------------- page 5

Calculating Drug Dosages ----------------------------------------------------------- page 6

Ratio (Rainbow) Method

Proportion Method

Formula Method

Dimensional Analysis

Useful Formulas for Calculating Drug Calculation Problems ---------------page 7-9

Calculating BSA

Calculating a child’s dosage from an adult dosage

Calculating flow rate in ml/h

Calculating flow rate in gtt/min

Calculating Heparin dosages

Converting from °F to °C or °C to °F

Helpful Websites ---------------------------------------------------------------------- page 9

Provided by the Academic Center for Excellence 1 How to Solve Drug Dosage Problems
Reviewed August 2012
 General Information
There are three different types of measurements you will encounter when dealing with
medications: Household, Apothecary, and Metric.

Type Number Solids Liquids

Whole numbers and Teaspoons (tsp, t) Drop (gtt)
Fractions before unit. Tablespoons (Tbs,T) Ounce (oz)
Household Ex: 1 ½ T Pounds (lb) Cup (c)
Pint (pt)
Quart (qt)
Glass
Whole numbers, Grains (gr) Minum (m)
Apothecary Fractions, and Roman Drams (dr or Ʒ) Fluid Dram (dr or
Numerals after unit. Ʒ)
Ex: gr 15 ½ or dr iss
Whole numbers and Grams (g) Liters (L)
Metric decimals before unit Meter (m)
(always put a 0 in front
of the decimal.
Ex: 0.15 mL

Note: When two system-to-system conversion factors exist, consider the unit of the final
answer. For example, if it is necessary in the drug dosage problem to convert a dosage
from grains to mg, use the gr 1 = 60 mg conversion factor.

Approximate Conversion Factors

Solid conversions
gr 1 = 60 mg
gr 15 = 1 g
2.54 cm = 1 in
2.2 lb = 1 kg

Fluid conversions
1 oz = dr 8 or Ʒ 8
m 15 = 1 mL = 1 cc
4 mL = fluid dr 1 = Ʒ 1
15 mL = 3 t = 1 T
30 mL = 1 oz

Extended conversions
1 kg = 1000 g = 2.2 lbs
1 L = 1000 mL = 33 1/3 oz = 200 t = 66 2/3 T = Ʒ 250

Provided by the Academic Center for Excellence 2 How to Solve Drug Dosage Problems
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 Visual Conversions
“The Grain Clock”
Convert grains to mg
gr 1 = 60 mg
1 hour = 60 min

gr ¾ = 45 mg gr ¼ = 15 mg
¾ hour = 45 min ¼ hour = 15 min

gr ½ = 30 mg
½ hour = 30 min

Inches to centimeters

USA

World

1 inch = 2.54 cm

Roman Numerals
½ = ss or ss 5 = v or v
1 = I or i or i 10 = x or x
2 = II or ii or ii 15 = xv or xv
3 = III or iii or iii 19 = xix [10 + (10-1)] or xix
4 = IV or iv (i before v = 5-1) or iv 20 = xx or xx

Provided by the Academic Center for Excellence 3 How to Solve Drug Dosage Problems
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 Converting Between Units
Use of One Conversion Factor:

To convert from one unit to another, begin with the unit assigned. Next find a conversion
factor that relates the unit assigned to the unit needed. Then multiply the unit assigned by the
found conversion factor. This calculation results in the new unit.

Example: Convert 120 mg to gr________.

Step one: Think of a conversion factor that relates mg and gr. 60 mg = gr 1 (This
can be used as either 60 mg/gr 1 or gr 1/60 mg)

Step two: set up the multiplication equation.

Note: when using the conversion 120 mg • gr 1 = gr _____

factor, always place the needed unit on top. 60 mg

Step three: Solve the equation.

First cancel mg units, 120 mg • gr 1 = gr _____

60 mg
Then solve the equation 120 • gr 1 ÷ 60 = gr 2

Therefore: 120 mg = gr 2

Use of Multiple Conversion Factors:

If a conversion factor for the two units does not exist, then proceed through another unit
to obtain the unit needed.

Example: Convert 1 T to _____oz.

Step one: Try to find a conversion factor that relates tablespoons to ounces. Looking
at the list, there is not a conversion factor relating tablespoons and ounces.
Therefore, two conversion factors are needed: 1 T = 15 mL and 30 mL = 1 oz.

Step two: Set up the equations

1 T • 15 mL = _____mL _____ mL • 1 oz = _____oz

1T 30 mL
Step three: Solve the equations.
1 T • 15 mL ÷ 1 T = 15 mL 15 mL • 1 oz ÷ 30 mL = 0.5 oz

Therefore: 1 T = 0.5 oz
Provided by the Academic Center for Excellence 4 How to Solve Drug Dosage Problems
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 Converting Between Metric Units

To convert between metric units, simply move the decimal place. The easiest way to
remember which way to move the decimal as well as the number of places to slide it is the
mnemonic: “King Henry died by drinking chocolate milk . . merrily.”

King Henry died by drinking chocolate milk merrily

symbol k h D b d c m† mc
name kilo hector Deca “base” deci centi milli micro
Ex. kg hg Dg gram dg cg mg mcg
† there are three decimal places between m and mc. This is commonly forgotten!

Using the “King Henry” method to convert between metric units involves locating the
starting place then sliding the decimal to the desired unit and adding zeros as needed.

Example 1: Convert 25.3 g to __________mg

Step one: The given unit is gram, so start at “b”.

Step two: The ending place is m, so slide the decimal from “b” to “m”.

Step three: King Henry died by drinking chocolate milk . . merrily

k h D b d c m . . mc

25.3 → 25. 3 0 0. → 25,300 mg Slide 3 decimal places to the right

Therefore: 25.3 g = 25,300 mg

Example 2: Convert 300 mcg to ________mg

Step one: The given unit is mc, so start at “mc”.

Step two: The ending place is m, so slide the decimal from “mc” to “m”.

Step three: King Henry died by drinking chocolate milk . . merrily

k h D b d c m . . mc

300 → 3 0 0. → 0.300 mg slide decimal 3 places to left (mc to m)

Therefore: 300 mcg = 0.300 mg

Provided by the Academic Center for Excellence 5 How to Solve Drug Dosage Problems
Reviewed August 2012
 Calculating Drug Dosages
When performing drug calculations, one of the following four methods should be used:
Ratio (Rainbow) Method, Proportion Method, Formula Method, or Dimensional
Analysis. Each of these methods works as well as the others. However, once the student
decides which method is the most comfortable for them, they should stick with that method
and not switch back and forth between the different methods.

Ratio (Rainbow):
Step one: Set up ratios.
Step two: Multiply means and extremes
Step three: Solve for “x” algebraically.
Proportion:
Step one: Set up proportions
Step two: Cross multiply
Step three: Solve for “x” algebraically
Formula:
D • Q = answer D (dose ordered) • Q (unit quantity) = answer
H H (on hand)
Dimensional Analysis:
D • Q = answer D (dose ordered) • Q (unit quantity) = answer
H H (on hand)

Use drug calculations when calculating the quantity of medications needed for a patient and
the strength of medication is already known.

Example: If the doctor orders 20 mg of Benadryl, and 10 mg tablets are available, how
many tablets should be given to the patient?

Ratio (Rainbow) Method

We know that 10 mg = 1 tablet, and we need 20 mg in an unknown number
of tablets.
Step one: Set up ratios.
10 mg : 1 tab = 20 mg : x tab

Notice that on both sides of the equation, mg comes first, then tablets. This
is very important. It does not matter which unit comes first, as long as units
are in the same order on both sides of the equal “=” sign.

Step two: Multiply means and extremes

10 mg • x tab = 1 tab • 20 mg

Step three: Solve for “x” algebraically.

x tab = 1 tab • 20 mg x = 2 tablets
10 mg
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 Proportion Method

Step one: Set up proportions

10 mg = 20 mg
1 tab x tab

Step two: Cross multiply

10 mg • x tab = 20 mg • 1 tab

Step three: Solve for “x” algebraically

x tab = 20 mg • 1 tab x = 2 tablets
10 mg

Formula Method

D • Q =____ So: 20 mg • 1 tab = 2 tablets

H 10 mg
Therefore: give the patient 2 tablets.

Dimensional Analysis
D • Q =____ So: 20 mg • 1 tab = 2 tablets
H 10 mg

Useful Formulas for Calculating Drug Calculation Problems

Calculating BSA (m²):

Lb x in or kg x cm •Round to hundredths place

3131 3600 after taking the square root

Example: If a patient weighs 140 lb and is 62 inches tall, calculate the BSA by
simply plugging the numbers into the formula and solving.

140 lb x 62 in
3,131
____
140 x 62 = 8,680 8,680 ÷ 3131 = 2.77 √2.77 = 1.66 m²
•Round to hundredths place
•Answer is always in m2

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Calculating a child’s dosage using an adult dosage:

Child’s BSA x adult dosage = child’s dosage

1.7 m²

Example: The normal adult dosage of a medication is 150 mg. The child weighs 32
kg and is 120 cm tall. How much medication should be given to the child?

Step one: Find the child’s BSA. To do so, use the formula given above.

32 kg x 120 cm = √1.0666… √1.0666… = 1.032792… m2 = 1.03 m2

3,600 •Round to hundredths place

Step two: Use the child’s dosage formula.

1.03 m² x 150 mg = 90.88 mg •Round to hundredths place
1.7 m²

Calculating Flow Rate in mL/h:

Total mL ordered = mL/h (must round to a whole number)

Total hours ordered

Example: Calculate the flow rate for an IV of 1,820 mL Normal Saline IV to infuse
in 15 h by controller. Flow rate = _________ mL/h

1,820 mL = 121.33 mL/h = 121 mL/h •Round to nearest whole number

15 h

Calculating Flow Rate in gtt/min:

Volume (mL) x drop factor (gtt/mL) = Rate (gtt/min) (MUST be whole #)

Time (min)

Example: The physician orders Lactated Ringer’s IV at 150 mL/h. The drop factor
is 15 gtt/mL. Find the flow rate in gtt/min.

150 mL x 15 gtt = 37.5 = 38 gtt/min

60 min 1 mL

Provided by the Academic Center for Excellence 8 How to Solve Drug Dosage Problems
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Calculating Heparin Dosages:

Order: D5W Heparin 40,000 U in 1,000 mL D5W to infuse at 40 mL/h. What is the
hourly heparin dosage?

Find how many Units are in 40 mL.

40,000 U = x U Cross multiply

1,000 mL 40 mL

x U • 1,000 mL = 40,000 U • 40 mL then divide by 1,000 mL

40,000 U • 40 mL = 1,600,000 U = 1600 U/hr

1,000 mL 1000

Converting from ºF to ºC or ºC to ºF:

ºF = 1.8 (ºC) + 32 •Carry to hundredths and round to tenths

ºC = ºF – 32
1.8

Example: What is 212 ºF in Celsius?

ºC = ºF – 32 ºC = 212 – 32 ºC = 180 ºC = 100º

1.8 1.8 1.8

Example: What is 37 ºC in Fahrenheit?

ºF = 1.8 (ºC) + 32 ºF = 1.8 (37) + 32 ºF = 66.6 + 32 ºF = 98.6º

Helpful Websites
There are many helpful drug dosage calculation websites. The following links include
practice problems and solutions. We encourage you to use them to your advantage. After all,
the best way to become proficient at solving drug dosage problems is to PRACTICE!

http://nursesaregreat.com/articles/drugcal.htm

http://www.testandcalc.com/drugcalc_legacy/index.asp

http://www.unc.edu/~bangel/quiz/quiz5.htm

http://nursing.flinders.edu.au/students/studyaids/drugcalculations/page.php?id=1
Provided by the Academic Center for Excellence 9 How to Solve Drug Dosage Problems
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 Medication calculations
There are 4 basic steps to solving proportion problems:

1) Set up a known ratio.

2) Set up a proportion with known and desired units. Use x for the quantity that is
desired or unknown.
3) Cross multiply.
4) Solve for x.

Example:

Dose Ordered: Medication B 15 mEq po every day.

Available: Medication B 10 mEq/5ml.
How many ml's will you give?

a) Set up proportion. (Units are matched therefore no need to convert- mEq to mEq and
ml to ml)

b) Cross multiply and solve for x. (Solve for X to determine the number
of tablets, milligrams, milliliters, etc.,
10𝑚𝐸𝑞 15𝑚𝐸𝑞 you will administer to the patient by
=
5𝑚𝑙 𝑋𝑚𝑙 cross- multiplying)

75
10x=75 x= 10 15 mEq= 7.5 ml

Calculating IV Flow Rates:

To find hourly rate (stated in mls per hour)

Total volume of solution in ml’s = x ml’s

Total amount of time in hours

Example: 1000 cc IV solution ordered to infuse over 8 hours.

1000 ml = 125
8 hrs.
Answer: 125 ml/hour

Example: 1000 ml solution to infuse over 6 hours.

REV: 6/2019, OTD

1000 ml = 166.6 = 167
6 hrs.

Answer: 167 ml or ml/hr

(Remember: when answer does not come out evenly, round off to the nearest whole
number. If 5 & greater round up, below 5, round down.)

To find flow rate stated in drops per minute:

Drop factor is the number of drops it takes to equal 1 ml with a specific type of IV
tubing. The drop factor is stated on the tubing package.

ml/hr. x drop factor = gtts/min

total amount of time in minutes

Example: IV order D51/2 NS at 120 ml/hr

The drop factor is a 15 gtts/ml and the flow rate is 120 ml/hr.

120ml/hr x 15 gtts/ml = 1800 = 30 gtts/min

60 mins/hr 60

IV drip calculations

Order is written as mg/hr.

Example:

Order: Fentanyl 5 mg/hr. The bag is labeled 250 mg in 500 ml of solution.

How fast will the IV need to be infused to give the correct dose?

1. The IV rate will be as an hourly rate, so no conversion needs to be

made for time. If the order was written with a different time, you
would need to calculate the mg/hr. (use ratio and proportion)

2. Put the problem in ratio and proportion.

5 mg = 250 mg 5 (500) = 250 x 2500 x = 10 ml/hr IV rate

x ml 500 ml 250
C. When the order is written as unit of mcg/kg/min.

Example: Dopamine order: 5 mcg/kg/min. Bag is labeled:. Dopamine 400 mg in 250ml

NS. Pt weight= 63 kg.

Dose ordered x weight (if weight based) x volume x time

Have (dose of drug you have; must match units in dose ordered)

** Remember that pumps deliver ml/hr, so drips that deliver per minute need to have
time conversion factored in (60 min/1 hr); those drips that are delivered per hour do not
need this time conversion

1. Desired (dose ordered) = 5 mcg/kg/min x (pt weight) 63 kg

2. Have = 400 mg Dopamine; must convert to mcg by multiplying by 1000

3. Volume = 250 ml (volume in IV bag)

4. Also include time conversion of 60 min/hr

5 mcg/kg/min x 63 kg x 250 ml x 60 min/hr = 4725000

400,000 mcg (400 mg x 1000 mcg/1 mg) 400,000

Answer: 11.8 ml/hr----this is what the pump must be set at (-round up to 12ml/hr)

Order: Dopamine 20 mcg/Kg/minute. The bag is labeled Dopamine 100 mg/50 ml.
The patient weighs 88 lbs. How fast will the IV run to give the dose?

1. Must convert pounds to kg 88 ÷ 2.2 = 40kg

Dose ordered x weight (if weight based) x volume x time

Have (dose of drug you have; must match units in dose ordered)

20 mcg/kg/min x40 kg x50 ml x 60 min = 2400000 = 24 ml /hr

100,000 mcg/ml 100,000