Ephedrix Dosage/Direction for Use

Epinephrine is usually given by intramuscular injection, although it may also be given subcutaneously. In extreme emergencies, where a more rapid effect is required, epinephrine may be given as a dilute solution (1 in 10,000 or 1 in 100,000) by very slow intravenous injection or by slow intravenous infusion. Alternatively, if intravenous access cannot be obtained, it may also be given by the intraosseous (usually into the marrow of the tibia) or endotracheal routes. Epinephrine 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.
The usual dose of epinephrine in anaphylactic shock is 500 micrograms (0.5 mL of a 1 in 1,000 solution) by intramuscular injection repeated as necessary every 5 minutes. A dose of 300 micrograms (0.3 mL of a 1 in 1,000 solution) may be appropriate for emergency self administration, for example by auto injector. The dose for children depends on age and weight, but is usually about 10 micrograms/kg by intramuscular injection.
In advanced cardiac life support the initial dose of epinephrine for adults is 1 mg intravenously (10 mL of a 1 in 10,000 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. Intraosseous doses for adults and children are the same as those used intravenously. Endotracheal doses for adults are 2 to 3 times the intravenous dose; children may be given 100 micrograms/kg.