Pediatric Epinephrine Dose
Calculate the correct pediatric epinephrine (adrenaline) dose for anaphylaxis by weight. Free online dosing tool with EpiPen Jr/EpiPen recommendations and safety guidelines for parents and caregivers.
About This Calculator
Our Pediatric Epinephrine Dose Calculator helps caregivers, parents, and healthcare providers determine the correct dose of epinephrine (adrenaline) for a child experiencing anaphylaxis — a life-threatening allergic reaction. The calculator uses the standard weight-based formula of 0.01 mg/kg of 1:1,000 epinephrine, with automatic capping at the maximum safe single dose based on the child's weight.
Epinephrine is the first-line treatment for anaphylaxis and must be administered immediately when symptoms of a severe allergic reaction appear. Delaying epinephrine administration is the most common cause of fatal anaphylaxis. The recommended route is intramuscular (IM) injection into the mid-outer thigh (anterolateral aspect), which provides the fastest and most reliable absorption. The standard concentration for auto-injectors is 1:1,000 (1 mg/mL).
Auto-injector selection is based on weight: EpiPen Jr (0.15 mg) for children weighing 10–25 kg, and EpiPen (0.3 mg) for children weighing 25 kg or more. For infants under 10 kg, individual dosing from an ampule and syringe is recommended in a medical setting. The dose can be repeated every 5–15 minutes if symptoms persist while awaiting emergency services.
Regional Notes
India: Epinephrine (adrenaline) 1:1,000 injection is available as 1 mg/mL ampules (1 mL) from manufacturers such as Neon Laboratories and Abbott. Auto-injectors (EpiPen) are imported and may require a prescription. Common brand names include Adrenaline Injection IP. Always carry two doses as per the World Allergy Organization guidelines.
United States: EpiPen (0.3 mg) and EpiPen Jr (0.15 mg) are FDA-approved auto-injectors. Generic epinephrine auto-injectors and authorized generics (e.g., AUVI-Q) are also available. Most states require schools to maintain stock epinephrine. The American Academy of Pediatrics recommends prescribing at least two auto-injectors for children at risk of anaphylaxis.
United Kingdom: The NHS prescribes EpiPen (0.3 mg) and EpiPen Jr (0.15 mg) auto-injectors. Emerade and Jext are also available as alternative brands. The Resuscitation Council UK guidelines recommend the IM route in the anterolateral thigh as the first-line treatment for anaphylaxis in both children and adults.
Frequently Asked Questions
What is the correct pediatric epinephrine dose for anaphylaxis?
The recommended pediatric epinephrine dose for anaphylaxis is 0.01 mg/kg of 1:1,000 (1 mg/mL) epinephrine administered intramuscularly (IM) in the anterolateral thigh. The maximum single dose is 0.3 mg for children under 30 kg and 0.5 mg for adolescents weighing 30 kg or more. For children 10–25 kg, use EpiPen Jr (0.15 mg); for children 25 kg and above, use EpiPen (0.3 mg).
How is pediatric epinephrine dose calculated by weight?
Pediatric epinephrine dose is calculated as weight in kg multiplied by 0.01. For example, a 20 kg child would receive 20 × 0.01 = 0.2 mg (0.2 mL of 1:1,000 epinephrine). The dose is capped at the maximum safe single dose: 0.3 mg for children and 0.5 mg for adolescents/adults. The concentration of standard epinephrine auto-injectors is 1:1,000 (1 mg/mL).
When should epinephrine be administered to a child?
Epinephrine should be administered immediately at the first sign of a severe allergic reaction (anaphylaxis), including difficulty breathing, wheezing, throat swelling, hives with vomiting, dizziness, or feeling of impending doom. Do not wait for symptoms to worsen or for medical help to arrive. Epinephrine is the first-line treatment for anaphylaxis and delaying administration increases the risk of a fatal outcome.
What is the difference between EpiPen and EpiPen Jr?
EpiPen contains 0.3 mg of epinephrine and is recommended for children weighing 25 kg (55 lbs) or more and adults. EpiPen Jr contains 0.15 mg of epinephrine and is recommended for children weighing 10–25 kg (22–55 lbs). Both deliver epinephrine intramuscularly into the anterolateral thigh and are designed for use by non-medical caregivers in emergency situations.
Can epinephrine be given to infants under 10 kg?
For infants under 10 kg, epinephrine should be administered in a medical setting using a 1:1,000 ampule and a syringe at the standard dose of 0.01 mg/kg IM. Auto-injectors like EpiPen Jr are not recommended for this weight range because they deliver a fixed dose (0.15 mg) that may exceed the calculated dose. Neonates and small infants require individualized dosing with weight-based measurement.
How often can epinephrine be repeated in anaphylaxis?
Epinephrine doses can be repeated every 5–15 minutes if symptoms persist or worsen while waiting for emergency medical services. There is no maximum total number of doses when treating anaphylaxis — the benefits of epinephrine far outweigh the risks. Patients should be transported to the emergency department after receiving epinephrine, as biphasic reactions can occur hours after the initial episode.
Are there side effects of epinephrine in children?
Common side effects of epinephrine include pallor, tremor, anxiety, palpitations, headache, and dizziness. These are typically short-lived and result from the medication's action on alpha and beta-adrenergic receptors. Serious side effects such as cardiac arrhythmias are rare at appropriate IM doses. The risk of untreated anaphylaxis (which can be fatal) far exceeds the risk of epinephrine side effects.
Should epinephrine be injected into muscle or under the skin?
Epinephrine for anaphylaxis should be injected intramuscularly (IM) into the mid-outer thigh (anterolateral aspect), not subcutaneously. The IM route provides faster and more reliable absorption with higher peak plasma concentrations compared to subcutaneous administration. Auto-injectors are designed with a needle length that ensures intramuscular delivery in most patients, even through clothing.