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Pediatric Epinephrine Dose Calculator

Created by Łucja Zaborowska, MD, PhD candidate
Reviewed by Bogna Szyk, Jack Bowater and Aleksandra Zając, MD
Based on research by
Preparing for Pediatric Emergencies: Drugs to Consider Mary A. Hegenbarth, MD; and the Committee on Drugs; PEDIATRICS; 2008
Last updated: Feb 19, 2024


The pediatric epinephrine dose calculator allows you to estimate the amount of epinephrine required for a child, no matter the route of administration, be it Intravenous (IV), Intramuscular (IM), Subcutaneous (SC), Endotracheal (ET) or via a nebulizer.

We will also provide you with essential information on the epinephrine dose for anaphylaxis in pediatrics, as well as the dose of an EpiPen for kids.

For the convenience of use, our pediatric epinephrine (adrenaline) dose calculator will equip you with results in both mL and mg.

If you're looking for everyday calculations instead, try our pediatric paracetamol dosage calculator and general pediatric dose calculator.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace professional medical advice, diagnosis, or treatment. All information on this website is for informational purposes only and is not intended to and should not serve as a substitute for medical consultation. Always seek the advice of a health provider.

How to calculate epinephrine dose in pediatrics?

dose needed (mg) = child weight (kg) × dosage of Epi (mg/kg)

The pediatric epinephrine dose depends on a route of administration and the age of the child:

Values for older infants and children (>28 days old):

  • Intravenous, into the vein (IV) - 0.01 mg/kg of 1:10,000 solution;
  • Intramuscular, into the muscle (IM)/ Subcutaneous (SC) - 0.01 mg/kg of 1:1,000 solution;
  • Endotracheal, into the trachea (ET) - 0.1 mg/kg of 1:1,000 solution; and
  • Nebulizer, inhalation - 0.5 mg/kg of 1:1,000.

You need to remember to:

  • Check the maximum dose (in the section below);
  • Measure the current weight of the child; and
  • Check the type of solution used.

Values for newborn infants (<28 days old):

  • Intravenous (IV): 0.01-0.03 mg/kg of 1:10,000 solution; and
  • Endotracheal (ET): 0.03-0.1 mg/kg of 1:10,000 solution.

➡️ In case you need any other specialist calculators, make sure to check out the following:

❗ This tool shouldn't be used as a substitute for clinical knowledge and/or consultation with a medical specialist. Always consult your doctor.

What's the maximum dose of epinephrine for a child?

The maximum pediatric Epi dose depends on the route of administration, as well as the reason for use.

  • Intravenous administration

Maximum dose for pediatric use is 1 mg.

Reason: Cardiopulmonary resuscitation (IV infusion requires a different dosage!).

  • Intramuscular or subcutaneous injections

Maximum dose: 0.3 - 0.5 mg.

Reason: Severe aggravation of asthma - SC, allergic reaction (anaphylaxis).

  • Endotracheal administration

Maximum dose: 10 mg.

Reason: Cardiopulmonary resuscitation.

  • Nebulizer

Maximum dose: 5 mg.

Reason: Obstruction of the airways caused by croup (acute laryngotracheobronchitis - LTB)

Epinephrine dose for anaphylaxis in pediatrics

Anaphylaxis is a severe allergic reaction which may have fatal consequences. We can treat this reaction with an intramuscular or subcutaneous injection of epinephrine - we can perform them with either a regular syringe, or with an automatic EpiPen.

The pediatric EpiPen dose is fixed and depends on the weight of the child, which makes it easier to use:

  • Junior - 0.15 mg of epinephrine (for patients with 15 - 30 kg)
  • Regular - 0.3 mg of epinephrine (for patients with 30 kg or more)

An IM Epi dose for pediatrics using a regular syringe is 0.01 mg/kg of a 1:1,000 solution (0.01 ml/kg).

During anaphylactic shock, do not forget about the rapid infusion of fluids! Calculate your patient's maintenance fluids!

Epinephrine 1:1,000 vs. 1:10,000

We can administer epinephrine (adrenaline) dose in pediatrics with two different solutions, namely 1:1,000 and 1:10,000. No matter the concentration, we still need to provide the same amount of adrenaline: the critical difference lies in the volume of the solution required:

  • 1 mg/kg of 1:1,000 solution equals 1 mL/kg; and
  • 1 mg/kg of 1:10,000 solution equals 10 mL/kg.

FAQ

How do I calculate the epinephrine dose for a 41 lbs child (intravenous administration)?

To calculate the epinephrine dose for a 41 lbs child, follow these steps:

  1. Convert the weight from lbs to kg by multiplying 41 lbs with 0.4536. Our result is 18.598 kg.

  2. Insert the child’s weight in kg and the required dose of 0.01 mg/kg (1:10,000 solution) into the following formula:

    dose needed (mg) = child weight (kg) × dosage of Epi (mg/kg)

  3. The result is 0.186 mg.

Why does the dosage change with different routes of administration?

The dosages vary depending on the route of administration since medications are absorbed differently in various forms. As a result, the bioavailability of a drug also varies depending on its administration method. Bioavailability indicates the extent to which a drug is effective, with a 100% bioavailability for drugs administered intravenously. Therefore, it is not surprising that a lower dose of epinephrine is required when administered intravenously.

What is epinephrine?

Epinephrine, also known as adrenaline, is an endogenous hormone produced in the adrenal medulla. It belongs to the group of catecholamines and plays a crucial role in the hormonal regulation of our organism.

What does epinephrine do?

Here are the main effects of epinephrine, which play a decisive role especially in emergency situations:

  • Increase in heart rate;
  • Increase in breathing;
  • Increase in vascular tone
  • Increase in blood pressure; and
  • Increase in blood sugar.

What is epinephrine used for?

Epinephrine is mainly used for these important indications:

  • Cardiopulmonary resuscitation;
  • Anaphylactic shock;
  • Asthma; and
  • Additive for local anesthesia.

Is adrenalin the same as epinephrine?

Yes, both terms refer to the same hormone. Adrenalin was originally a brand name meanwhile epinephrine is the International Nonproprietary Name (INN). You may also know the substance under the trade name Suprarenin.

Can you be allergic to epinephrine?

An allergy to epinephrine is very rare, as it is an endogenous substance. An allergy to other ingredients of the drug is more likely.

Łucja Zaborowska, MD, PhD candidate
Child's weight
lb
Administration
IV / IM / SC
Required dose 1:1,000
mL
Required dose 1:10,000
mL
💉 Maximum dose for an IV route: 1 mg
Recommended solution: 1:10,000
💉 Maximum dose for an IM/SC route: 0.3-0.5 mg
Recommended solution: 1:1,000
Always double-check the calculations, the dosing information and contraindications on the leaflet. Consult a health provider before administering.
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