Indications & Dosage

Indications:

Epinephrine is used in anaphylaxis/anaphylactoid reactions; cardiac arrest; and asthma as complication or
manifestation of anaphylaxis.

Dosage and Administration:
Epinephrine (Epicare) is usually given by intramuscular injection although it may also be given subcutaneously. In extreme emergencies, where a more rapid effect is required, Epinephrine (Epicare) may be given as dilute solution (1 in 10,000 or 1 in 100,000) by very slow intravenous injection or by slow intravenous infusion. Epinephrine (Epicare) has sometimes been injected directly in the heart but current guidelines for the management of cardiac emergencies recommend intravenous injection; this may be into a central vein or peripherally, but in the latter case should be followed by 20 mL of intravenous fluid.

Adult Dose: in anaphylactic shock is 500 micrograms (0.5 mL of a 1000 solution) by intramuscular injection repeated as necessary every 5 minutes. A dose of 300 micrograms (0.3 mL of a 1 in 1000 solution) may be appropriate for emergency self-administration by auto injector.

Pediatric Dose: is usually 10 micrograms/kg by intramuscular injection

Advanced cardiac life support the initial dose for adults is 1 mg intravenously (10 mL of a 1 in 10000 solution) and this may be repeated as often as every 2 to 3 minutes throughout the resuscitation procedure. The dose for children is 10
micrograms/kg intravenously. Higher intravenous doses have been used in both adults and children for the second and subsequent doses but are no longer generally recommended.