Adderall Dosage Calculator
Calculate appropriate Adderall (amphetamine) dosage by age, weight, and formulation. Includes titration schedules, IR vs XR guidance, and safety reference tables.
Pediatric Epinephrine Dose Calculator
Calculate pediatric epinephrine doses for anaphylaxis, cardiac arrest, bradycardia, croup, and asthma. Weight-based dosing with concentration conversions and autoinjector guidance.
🚨 EMERGENCY USE — Medical Disclaimer: This calculator is for educational and emergency reference only. Epinephrine dosing errors in children can be fatal. Always use standardized weight-based emergency references (Broselow tape) and verify with team before administering. In anaphylaxis, DO NOT delay — give epinephrine IM immediately.
kg
DOSE: 200 mcg (0.200 mg)
VOLUME: 0.20 mL of 1:1000
Route: Intramuscular (anterolateral thigh) | Every 5–15 minutes as needed
Calculated Dose⧉
200 mcg (0.200 mg)
0.01 mg/kg × 20 kg = 0.200 mg (capped at 0.5 mg)
Volume to Draw⧉
0.20 mL
Using 1:1000 concentration (1 mg/mL)
Route & Interval⧉
Intramuscular (anterolateral thigh)
Every 5–15 minutes as needed
Autoinjector Recommendation⧉
EpiPen Jr 0.15 mg
EpiPen Jr for 7.5-25 kg; EpiPen for ≥25 kg
Total Dose Given⧉
200 mcg across 1 dose(s)
Track cumulative dosing carefully
Dose per kg⧉
10.0 mcg/kg
Target: 10 mcg/kg for anaphylaxis im
📋 Pediatric Epinephrine Quick Reference
| Indication | Dose | Concentration | Route | Repeat |
|---|---|---|---|---|
| Anaphylaxis | 0.01 mg/kg (max 0.5 mg) | 1:1,000 | IM thigh | q5–15 min |
| Cardiac Arrest | 0.01 mg/kg (max 1 mg) | 1:10,000 | IV/IO | q3–5 min |
| Bradycardia | 0.01 mg/kg (max 1 mg) | 1:10,000 | IV/IO | q3–5 min |
| Severe Croup | 0.5 mL racemic 2.25% | 2.25% | Nebulized | ×1 after 30 min |
| Severe Asthma | 0.01 mg/kg (max 0.5 mg) | 1:1,000 | SC | q20 min ×3 |
⚖️ Weight-Based Dose Table (Anaphylaxis IM, 1:1000)
| Weight (kg) | Dose (mg) | Volume (mL) | Autoinjector |
|---|---|---|---|
| 5 kg | 0.05 mg | 0.05 mL | Vial only |
| 8 kg | 0.08 mg | 0.08 mL | EpiPen Jr 0.15 |
| 10 kg | 0.10 mg | 0.10 mL | EpiPen Jr 0.15 |
| 15 kg | 0.15 mg | 0.15 mL | EpiPen Jr 0.15 |
| 20 kg | 0.20 mg | 0.20 mL | EpiPen Jr 0.15 |
| 25 kg | 0.25 mg | 0.25 mL | EpiPen 0.3 |
| 30 kg | 0.30 mg | 0.30 mL | EpiPen 0.3 |
| 40 kg | 0.40 mg | 0.40 mL | EpiPen 0.3 |
| 50 kg | 0.50 mg | 0.50 mL | EpiPen 0.3 |
Planning notes, formulas, and examples
About the Pediatric Epinephrine Dose Calculator
This worksheet shows weight-based epinephrine reference doses and draw-up volumes for the five major pediatric emergency indications: anaphylaxis, cardiac arrest, symptomatic bradycardia, severe croup, and refractory asthma. Epinephrine (adrenaline) is the single most important drug in pediatric emergency medicine, and getting the dose right is literally a matter of life and death — particularly in small children where 10-fold dosing errors have been a documented cause of iatrogenic death.
The complexity of pediatric epinephrine dosing arises from multiple factors: different indications require different doses (0.01 mg/kg for anaphylaxis/cardiac arrest vs. fixed nebulizer doses for croup), different concentrations are used for different routes (1:1,000 for IM, 1:10,000 for IV), and different maximum doses apply (0.5 mg for anaphylaxis, 1 mg for cardiac arrest). Confusion between 1:1,000 and 1:10,000 concentrations — a 10-fold difference — is one of the most dangerous medication errors in emergency medicine.
This calculator eliminates concentration confusion by calculating the exact volume to draw for the specified concentration and route. It provides autoinjector recommendations (EpiPen vs. EpiPen Jr), tracks cumulative doses, and includes quick-reference tables for all indications. The display format is designed for quick reference during emergency review.
When This Page Helps
Epinephrine dosing errors in children are usually caused by concentration mix-ups, delayed treatment, or guessing the draw-up volume under pressure. This calculator keeps the indication, concentration, route, and weight-based dose aligned so the user can verify the exact volume before administration.
How to Use the Inputs
- Enter the child's body weight in kilograms (use Broselow tape if weight unknown).
- Select the age group for contextual reference.
- Choose the indication (anaphylaxis, cardiac arrest, bradycardia, croup, or asthma).
- Select the epinephrine concentration available.
- Enter how many doses have already been given (for cumulative tracking).
- Review the highlighted dose box showing mg, mcg, and volume to draw.
- Use the quick reference tables for verification.
Formula used
Anaphylaxis (IM): 0.01 mg/kg of 1:1,000 (max 0.5 mg)
Cardiac Arrest (IV/IO): 0.01 mg/kg of 1:10,000 (max 1 mg), q3–5 min
Bradycardia (IV/IO): 0.01 mg/kg of 1:10,000 (max 1 mg), q3–5 min
Croup (nebulized): 0.5 mL racemic 2.25% in 3 mL saline
Asthma (SC): 0.01 mg/kg of 1:1,000 (max 0.5 mg), q20 min ×3
Volume (mL) = Dose (mg) ÷ Concentration (mg/mL)Example Calculation
Result: 0.2 mg (200 mcg) IM = 0.2 mL of 1:1,000; or use EpiPen Jr 0.15 mg autoinjector
A 20 kg child in anaphylaxis receives 0.01 mg/kg × 20 kg = 0.2 mg epinephrine intramuscularly in the anterolateral thigh. This equals 0.2 mL drawn from a 1:1,000 vial. An EpiPen Jr (0.15 mg) is a reasonable alternative, delivering a slightly lower dose.
Tips & Best Practices
- In suspected anaphylaxis, epinephrine is typically the first medication discussed in emergency pathways; delayed treatment is associated with worse outcomes.
- Use a Broselow tape if the child's weight is unknown — it provides pre-calculated doses.
- Always verify the concentration on the vial before drawing up: 1:1,000 for IM, 1:10,000 for IV.
- Inject IM in the anterolateral thigh, not the deltoid — faster absorption and higher peak levels.
- After autoinjector use, hold in place for 10 seconds, then massage the site.
- Call 911 even after successful autoinjector use — biphasic anaphylaxis can recur hours later.
Concentration Confusion and Safety
The leading cause of epinephrine dosing errors is confusion between 1:1,000 (1 mg/mL, for IM) and 1:10,000 (0.1 mg/mL, for IV). Giving 1:1,000 concentration intravenously delivers 10 times the intended dose and has caused deaths. Many hospitals have adopted unit-dose labeling (mg/mL instead of ratio notation) and restrict 1:1,000 vials from resuscitation carts to reduce this error. Some newer protocols use only mg/mL terminology to eliminate ratio confusion entirely.
Biphasic Anaphylaxis
Up to 20% of anaphylaxis episodes have a biphasic pattern, where initial symptoms resolve then recur 1–72 hours later (most commonly 8–10 hours). This is why all patients who receive epinephrine for anaphylaxis should be observed for at least 4–6 hours (some guidelines recommend 24 hours for severe reactions). Patients discharged after anaphylaxis must be prescribed an epinephrine autoinjector and educated on its use.
Pediatric Cardiac Arrest Specifics
In pediatric cardiac arrest, epinephrine is given IV/IO at 0.01 mg/kg every 3–5 minutes. Unlike adult ACLS where vasopressin was briefly considered an alternative, pediatric guidelines exclusively recommend epinephrine. The first dose should be given as soon as IV/IO access is obtained. For shockable rhythms (VF/pVT), epinephrine is given after the second shock. For non-shockable rhythms (asystole/PEA), epinephrine is given immediately. High-quality CPR with minimal interruptions remains more important than any drug.
Sources & Methodology
Last updated:
Methodology
This worksheet shows weight-based epinephrine reference doses and draw-up volumes for emergency review. It is not an administration order.
Sources
- American Heart Association Pediatric Advanced Life Support guidelines (AHA)
- AAAAI anaphylaxis practice parameter (AAAAI/ACAAI)
- FDA epinephrine autoinjector labeling (FDA)
Frequently Asked Questions
1:1,000 contains 1 mg/mL and is used for IM injection (anaphylaxis) and SC injection. 1:10,000 contains 0.1 mg/mL and is used for IV administration (cardiac arrest, bradycardia). Using 1:1,000 IV instead of 1:10,000 delivers a 10-fold overdose, which can cause fatal hypertension and arrhythmias.
EpiPen Jr (0.15 mg) is recommended for children weighing 7.5–25 kg. EpiPen (0.3 mg) is for patients weighing 25 kg or more. For infants under 7.5 kg, epinephrine must be drawn from a vial using a weight-based dose.
The anterolateral thigh (vastus lateralis muscle) is the preferred IM injection site for all ages. It provides faster and higher peak absorption than deltoid or subcutaneous routes. For autoinjectors, inject through clothing if needed — do not delay.
Yes. Epinephrine overdose causes severe tachycardia, hypertension, ventricular arrhythmias, pulmonary edema, and can be fatal. This is why weight-based dosing and concentration verification are critical. However, in true anaphylaxis or cardiac arrest, the risk of not giving epinephrine far outweighs overdose risk.
For anaphylaxis IM: every 5–15 minutes if symptoms persist. For cardiac arrest IV: every 3–5 minutes during CPR. There is no absolute maximum number of doses in cardiac arrest. For anaphylaxis, if 2–3 IM doses fail, transition to IV epinephrine infusion.
If IV/IO access cannot be obtained, epinephrine can be given via endotracheal tube at 10× the IV dose: 0.1 mg/kg of 1:1,000 concentration. However, this route is unreliable and should only be used as a last resort — IO access is preferred over ET.
More in this topic
Aleve Dosage Calculator
Calculate Aleve (naproxen sodium) dosing by age, weight, and condition. Includes OTC max limits, dosing schedules, risk factors, and safety reference tables.
Amoxicillin Pediatric Dosage Calculator
Calculate pediatric amoxicillin doses by weight, indication, and formulation. Includes suspension volume, dosing schedules, and indication-specific reference tables.