Epinephrine Drip Rate Calculator
Calculate infusion rates for vasopressor therapy
How to Calculate Epinephrine Drip Rates
Epinephrine (Adrenaline) is a potent vasopressor and inotrope used in critical care to manage hypotension, bradycardia, and cardiac arrest. Calculating the correct drip rate is vital for patient safety, as the therapeutic index is narrow.
The Infusion Rate Formula
To determine the rate in milliliters per hour (mL/hr) to set on an IV pump, you must first determine the concentration of the solution and the desired dose.
1. Calculate Concentration (mcg/mL):
First, convert the total milligrams (mg) in the bag to micrograms (mcg) and divide by the volume.
Concentration = (Total mg × 1000) ÷ Total Volume (mL)
2. Calculate Flow Rate (mL/hr):
Depending on your institutional protocol, you may dose in mcg/min or mcg/kg/min.
- For mcg/min: Rate (mL/hr) = (Dose × 60) ÷ Concentration
- For mcg/kg/min: Rate (mL/hr) = (Dose × Weight in kg × 60) ÷ Concentration
Common Epinephrine Concentrations
Standard concentrations help reduce medication errors. The most common preparations seen in ICUs and Emergency Departments include:
- Standard Concentration: 4 mg in 250 mL D5W or NS (16 mcg/mL)
- Quad Strength: 16 mg in 250 mL (64 mcg/mL)
- Code Dilution: 1 mg in 250 mL (4 mcg/mL)
Clinical Dosing Guidelines
While protocols vary, general starting doses for Epinephrine continuous infusions are:
- Post-Cardiac Arrest / Profound Hypotension: 0.1 to 0.5 mcg/kg/min OR 2 to 10 mcg/min.
- Symptomatic Bradycardia: 2 to 10 mcg/min.
- Anaphylactic Shock: 0.1 to 1 mcg/kg/min (titrated to effect).
Always titrate to the target Mean Arterial Pressure (MAP) or heart rate as defined by the ordering physician.