At what weight should a pediatric patient be given the adult epinephrine dose?

• A. ≥33 kg or ≥73 lbs
• B. ≥22 kg
• C. ≥15 kg
• D. ≥40 kg

Answer: (A)

In pediatric epinephrine dosing for anaphylaxis, you base the dose on weight but cap each single dose at 0.3 mg (the adult dose). The standard adult dose is 0.3 mg given IM. Because 0.01 mg/kg times a child’s weight increases with weight, the point at which the calculated pediatric dose would reach or exceed 0.3 mg occurs around 33 kg (about 73 pounds). Once a child weighs 33 kg or more, you administer the fixed 0.3 mg dose rather than trying to push a higher pediatric amount. For lighter children, you dose by weight (up to the 0.3 mg cap), and dosing can be repeated per protocol if symptoms persist.