Anaphylaxis Management with Epinephrine

Dosing and Administration

The American Academy of Pediatrics recommends that fixed doses in autoinjectors may lead to potential overdosing in small children or underdosing in larger adolescents 1
The therapeutic effects of epinephrine cannot be completely separated from its adverse effects, particularly in infants and children weighing less than 15kg, where the lowest available autoinjector dose may be too high 2
The American Heart Association notes that approximately 7-18% of people with anaphylaxis require more than one dose of epinephrine, and patients requiring more than one dose are more likely to be admitted to the hospital 4

The American Academy of Allergy, Asthma, and Immunology states that there are no absolute contraindications to using epinephrine in anaphylaxis, and the benefits of prompt epinephrine administration far outweigh the risks of these typically transient adverse effects 5
Delay in administering epinephrine is associated with increased morbidity and mortality, according to the American College of Allergy, Asthma, and Immunology 6

The mortality from anaphylaxis is remarkably low at less than 0.5% per episode when treated appropriately with epinephrine, highlighting its importance in anaphylaxis management 5