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Adrenaline (epinephrine) Intravenous for Adults

Who can administer

Administration RESTRICTED - see Appendix 1

Important information

  • For administration by infusion in specialist units only - (critical care only)
  • Resuscitation use: any area
  • Infusion route is an unlicensed method of administration
  • For Y-site compatibility see below

Available preparations

Adrenaline 1mg in 1ml ampoule (1:1000) (Mercury)

Adrenaline 1mg in 10ml pre-filled syringe (1:10,000) (Aurum)

Adrenaline 100 microgram in 1ml ampoule (Martindale)- for use in neonates

Reconstitution

Pre-filled syringe

  • Already in solution

Ampoule

  • Already in solution
  • Dilute further prior to administration
  • Draw up using a 5 micron filter needle

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Bolus intravenous injection

  • Resuscitation: as per Resus guidelines (pre-filled syringe) used as it is, ampoules diluted with 9ml Water for Injection

Continuous intravenous infusion (using an electronically controlled infusion device)

  • Central line administration
  • Prepare a solution containing either 3mg in 50ml, or 6mg in 50ml
  • A 3mg per 50ml solution contains 60 micrograms per ml
  • A 6mg per 50ml solution contains 120 micrograms per ml
  • Administer at a suitable rate, titrated to response - see 'dose' below

Dose in adults

Bolus intravenous injection: as per resuscitation guidelines

  • Pre-filled syringes are used as supplied
  • Ampoules are to be diluted before use

Continuous intravenous infusion (Critical care only) (ref 1)

  • Usual dose: initial rate 1 microgram per minute, titrated to effect
  • Dose range: 2 to 10 micrograms per minute (higher doses have been used in critical care)

Storage

Store below 250C

References

Adrenaline 1: 1,000 (Mercury) SPC August 2018

Adrenaline 1:10,000 (Martindale)  

(1) ACLS Core Drugs, American Heart Association 2006

Therapeutic classification

Adrenergic agent/inotrope