MedBodh Clinical Education | 25 October 2026 coverage
Clinical Quick Note Sheet
Adrenaline (Epinephrine) IM for Anaphylaxis: Adult & Paediatric Dose, 1 mg/mL Conversion and Safety
Evidence-based, practical guide for medical professionals, students and hospital teams. Always verify product-specific labelling and current local protocols.
Clinical overview
Anaphylaxis is a rapidly progressive, potentially life-threatening systemic hypersensitivity reaction. Intramuscular epinephrine in the anterolateral thigh is first-line treatment. Antihistamines and corticosteroids are not substitutes. Emergency airway, oxygenation, fluid resuscitation and monitoring may be required.
Mechanism
Epinephrine stimulates alpha-1 receptors to counter vasodilation and mucosal oedema, beta-1 receptors to support cardiac output and beta-2 receptors to promote bronchodilation and reduce mediator release.
Dose and preparation
For the cited 1 mg/mL formulation, adults and children weighing at least 30 kg: 0.3–0.5 mg IM (0.3–0.5 mL), maximum 0.5 mg per injection. Children under 30 kg: 0.01 mg/kg IM (0.01 mL/kg), maximum 0.3 mg per injection. The label permits repeat dosing every 5–10 minutes if clinically required. Verify the exact product strength and local resuscitation protocol.
Paediatric calculation example
For a 15 kg child: 0.01 mg/kg × 15 kg = 0.15 mg, corresponding to 0.15 mL of 1 mg/mL solution. This is an arithmetic illustration; verify patient weight, dose, syringe and formulation before administration.
Route warning
IM anaphylaxis dosing must not be confused with IV epinephrine for cardiac arrest or carefully titrated IV infusion in shock. Intravenous use requires a distinct concentration, dilution, setting and specialist protocol. Never administer an undiluted 1 mg/mL anaphylaxis dose as a routine IV push.
Monitoring and precautions
Assess airway, breathing, circulation, oxygen saturation, blood pressure and clinical response. Watch for tachycardia, tremor, pallor, hypertension and arrhythmias. Delayed or recurrent reactions may require observation according to severity and local policy.
Frequently asked questions
Q: Can hydrocortisone replace IM adrenaline? No. Q: Where is the preferred injection site? Anterolateral thigh. Q: Is 1 mg/mL equivalent to 1:1000? Yes, but write mg/mL to reduce errors.
Source and further reading
Editorial note: Published for educational use. This is not a patient-specific prescription or a newly issued government order. Local guidelines and the actual drug label take precedence.