Formulations

Epi injection is available in 1 mg/mL (1:1000), 0.1 mg/mL (1:10,000), and 0.5 mg/mL (1:2000) solutions. The usual adult dose given subcutaneously ranges from 0.3 to 0.5 mg. The intravenous route is used cautiously if an immediate and reliable effect is mandatory. If the solution is given by vein, it must be adequately diluted and injected very slowly. The dose is seldom as much as 0.25 mg, except for cardiac arrest, when larger doses may be required. Epi suspensions are used to slow subcutaneous absorption and must never be injected intravenously. Also, a 1% (10 mg/mL; 1:100) formulation is available for administration via inhalation; every precaution must be taken not to confuse this 1:100 solution with the 1:1000 solution designed for parenteral administration; inadvertent injection of the 1:100 solution can be fatal. Epi is unstable in alkaline solution; when exposed to air or light, it turns pink from oxidation to adrenochrome and then brown from polymer formation; thus, an antioxidant or acid must be included.

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