What is the pediatric dosing for epinephrine in suspected anaphylaxis?

• A. 0.001 mg/kg IM
• B. 0.005 mg/kg IM
• C. 0.01 mg/kg IM, up to 0.3 mg per dose
• D. 0.1 mg/kg IM

Answer: (C)

Dosing in suspected pediatric anaphylaxis is weight-based and given intramuscularly to rapidly reverse airway edema and shock. The standard approach is 0.01 mg of epinephrine per kilogram of body weight, with a maximum single dose of 0.3 mg. This amount uses the 1:1000 concentration and provides enough adrenergic effect to reduce edema, improve bronchodilation, and support blood pressure, while keeping the risk of adverse effects in check. Doses that are too small won’t reverse symptoms quickly, while a dose as high as 0.1 mg/kg could cause significant side effects like tachycardia and hypertension. If symptoms persist, doses may be repeated per protocol.