Active Ingredient: Epinephrine
For this indication, competent medicine agencies globally authorize below treatments:
For:
Intravenous, 0.05 milligrams epinephrine, 1 one dose.
Titrate using intravenous boluses of 0.5 ml 1:10,000 solution (0.05 mg) according to response.
For:
Intramuscular, 1 milligrams epinephrine, 1 one dose.
For intramuscular administration, a 1 mg/ml (1:1000) solution should be used.
For:
In case that patient weight is ≥ 30 kg, nasal, 2 milligrams epinephrine, 1 to 2 doses in total.
Nasal adrenaline is indicated in the emergency treatment of allergic reactions (anaphylaxis) due to insect stings or bites, foods, medicinal products and other allergens as well as idiopathic or exercise induced anaphylaxis. Treatment is indicated for adults and children with a body weight ≥30 kg.
The recommended initial dose is a single nasal administration of 2 mg adrenaline.
The patient should be advised to immediately seek emergency medical assistance for close monitoring of the anaphylactic episode and in the event further treatment is required.
In the absence of clinical improvement after approximately 10 minutes, or if deterioration occurs or symptoms reappear after the initial treatment, a second dose should be administered in the same nostril together with emergency medical help. A maximum of 4 mg (two doses) may be given unless instructed by a medical professional to give additional doses. It is recommended that patients should always carry two nasal sprays to treat an allergy emergency.
No pharmacokinetic data are available after nasal administration of adrenaline in patients aged 65 years or older. No dose adjustment is required.
The recommended posology in children with a body weight ≥30 kg is the same as adults.
The safety and efficacy of nasal adrenaline in children below 30 kg body weight has not been established. No data are available.
The patient/caregiver should be informed to seek emergency medical assistance immediately to have close monitoring of the anaphylactic episode and in the event further treatment is required.
For:
Regimen A: In case that patient age in years is ≥ 12, intramuscular, 0.5 milligrams epinephrine, once every 5 to 15 minutes.
Regimen B: In case that patient age in years is ≥ 12, intramuscular, 0.3 milligrams epinephrine, once every 5 to 15 minutes.
Regimen C: In case that patient age in years is ≥ 6 and patient age in years is < 12, intramuscular, 0.3 milligrams epinephrine, once every 5 to 15 minutes.
Regimen D: In case that patient age in months is ≥ 6 and patient age in years is < 6, intramuscular, 0.15 milligrams epinephrine, once every 5 to 15 minutes.
Regimen E: In case that patient age in months is < 6, intramuscular, 0.01 milligrams epinephrine per kilogram of body weight, once every 5 to 15 minutes.
The following doses of adrenaline (epinephrine) 1 mg/ml (1:1000) solution for injection are recommended:
| Age | Dose |
|---|---|
| Over 12 years | 0.5 mg IM (0.5ml 1mg/ml (1:1000) solution) 0.3 mg IM (0.3ml 1mg/ml (1:1000) solution) if the child is small or pre-pubertal) |
| 6 – 12 years | 0.3 mg IM (0.3ml 1mg/ml (1:1000) solution) |
| 6 months – 6 years | 0.15 mg IM (0.15ml 1mg/ml (1:1000) solution) |
| Under 6 months | 0.01 mg/kg IM (0.01ml/kg 1mg/ml (1:1000) solution) |
If necessary, these doses may be repeated several times at 5-15 minutes intervals according to blood pressure, pulse and respiratory function.
A small volume syringe should be used.
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