Epinephrine 0.25mg/1ml

Epinephrine 0.25mg

Administration

IV Incompatibilities

Solution: Na-bicarbonate 5%, Ionosol PSL, Ionosol T/D5

Additive: Aminophylline, hyaluronidase, mephentermine, Na-bicarbonate

Syringe: Na-bicarbonate

Y-site: Ampicillin, thiopental

Not specified: Atropine, carbenicillin, diazepam, erythromycin, lidocaine

IV Compatibilities

Solution: D5W, D10W, dextrose-Ringer's, dextrose-saline, NS, LR, Ringer's

Additive: Amikacin, cimetidine, dobutamine, floxacillin, furosemide, metaraminol, ranitidine, verapamil

Syringe: Caffeine, doxapram, heparin, milrinone

Y-site: Amiodarone, atracurium, bivalirudin, CaCl2, Ca gluconate, cefpirome, cisatracurium, dexmedetomidine, diltiazem, dobutamine, dopamine, famotidine, fenoldopam, fentanyl, furosemide, heparin, Hextend, hydrocortisone Na succinate, hydromorphone, inamrinone, labetalol, levofloxacin, lorazepam, midazolam, milrinone, morphine SO4, nicardipine, nitroglycerin, norepinephrine, pancuronium, phytonadione, KCl, propofol, ranitidine, remifentanil, nitroprusside, tirofiban, vasopressin, vecuronium, vitamin B/C, warfarin

Not specified: Meperidine

IV Preparation

Dilute epinephrine in D5W or D5W 0.9% NaCl

Administration in saline solution alone is not recommended

Add 1 mL (1 mg) of epinephrine from its ampule to 1000 mL of a D5W containing solution

Each mL of this dilution contains 1 mcg of epinephrine

Solution: 1 mg in 250 mL D5W or NS (4 mcg/mL) to make up concentration of 15-60 mL/hr (1-4 mcg/min)

IV Administration

Correct blood volume depletion as fully as possible prior to administering any vasopressor

When, as an emergency measure, intraaortic pressures must be maintained to prevent cerebral or coronary artery ischemia, epinephrine can be administered before and concurrently with blood volume replacement

Whenever possible, administer epinephrine infusions into a large vein

Avoid using a catheter tie-in technique, because the obstruction to blood flow around the tubing may cause stasis and increased local concentration of the drug

Central line; infusion pump required

Do not mix with alkaline solutions

Discard after 24 hours or if solution is discolored or contains precipitate

Store in light-resistant container

Intraocular Preparation

Epinephrine must be diluted prior to intraocular use

Dilute 1 mL of epinephrine 1 mg/mL (1:1000) in 100 to 1000 mL of an ophthalmic irrigation fluid to create an epinephrine concentration of 1:100,000 to 1:1,000,000 (10-1 mcg/mL)

Use the irrigating solution as needed for the surgical procedure

Intraocular Administration

After dilution in an ophthalmic irrigating fluid, inject intracamerally

SC/IM Administration

SC or IM administration only

Inject IM or SC into the anterolateral aspect of the thigh, through clothing if necessary

Do not administer autoinjector IV; administer only in outer thigh to ensure SC or IM administration

Do not inject into buttock, or into digits, hands, or feet

To minimize the risk of injection-related injury, instruct caregivers to hold the child's leg firmly in place and limit movement prior to and during injection when administering to young children

Discard remaining volume after dose has been administered

In conjunction with use, seek immediate medical or hospital care

Storage

Injection

  • Unused vials
  1. Store at room temperature, 20-25°C (68-77°F)
  2. Protect from light until ready to use; do not refrigerate; protect from freezing
  3. Protect from alkalis and oxidizing agents
  • Diluted solutions
  1. Store at room temperature (25°C) or refrigeration (4°C) is 24 hr

Autoinjector

  • Store at room temperature 20-25°C (68-77°F); excursions permitted to 15-30°C (59-86°F; do not refrigerator
  • The trainer for AUVI-Q should not be used at temperatures <50ºF (10ºC) or >104ºF (40ºC)
  • Store the trainer for AUVI-Q in its outer case; keep away from dirt, chemicals, and water

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Epinephrine 0.25mg/1ml only for the indication prescribed.