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Adrenaline in adults with anaphylaxis

Authoring team

Doses of emergency drugs for anaphylaxis and angio-oedema (1,2):

Drugs

Adult or child older than 12 years

Child aged 6-12 years

Child aged 6 months - 6 years

Child aged under 6 months

Adrenaline (IM*) 1:1000 (repeat after 5 minutes if no better)

500 micrograms (0.5 mL)

(give 300 micrograms IM [0.3 mL] in a child who is small or prepubertal)

300 micrograms (0.3 mL)

150 micrograms (0.15 mL)

100-150 micrograms (0.1 to 0.15 mL)

* IM: intramuscular

Notes:

  • the majority of anaphylaxis episodes occurring in a community setting will respond to initial treatment with IM adrenaline, although currently around 10% receive more than one dose (2)
    • this may sometimes be due to the use of auto-injectors which cannot deliver an age/weight-appropriate dose in most patients
    • less than 1% of reactions are refractory to initial adrenaline treatment, and intensive care admissions for anaphylaxis are uncommon

Reference:

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