Epinephrine: veterinary dose and monograph

At a glance

Drug class

Veterinary drug

Also known as

Adrenaline, Adrenalin, 1:1000, 1:10 000

Species with doses

Dogs, Cats, Cattle, Horses, Goats, Sheep, Pigs and Birds

General dose range

0.01–0.02 mg/kg IV q3–5 min during CPR — check the species tables for the indication

Routes

IV, IM

Last reviewed

1 October 2026

Indications

• Cardiopulmonary arrest (CPR — low or high dose protocols)
• Anaphylaxis (severe, with hypotension / bronchoconstriction)
• Severe bronchospasm (refractory to other bronchodilators)
• Adjunct to local anaesthetics (prolong action — except in extremities)
• Topical haemostasis (uncommon now)

Epinephrine dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• CPR — low-dose (preferred): Papich 5e: 10–20 µg/kg IV, increasing to 100 µg/kg for prolonged CPR. Plumb’s p.471: 0.01 mg/kg IV every 3–5 min (Scroggin & Quandt 2009); 0.01–0.02 mg/kg IV q3–5 min, or 0.03–0.1 mg/kg intratracheally diluted in 5–10 mL saline (Lopez Quintana 2009). Papich endotracheal dose 0.1–0.2 mg/kg. Use 1:10,000 (0.1 mg/mL) for IV — do not confuse with 1:1000.
• CPR — high-dose (refractory): Papich 5e: increase to 100 µg/kg IV for prolonged CPR. Plumb’s p.471 (Drobatz 2004): high dose 0.1–0.2 mg/kg IV or IO; low dose is usually tried first. Neonates: 0.1–0.3 mg/kg IV or IO when ventilation and compressions fail (Traas 2009).
• Anaphylaxis: Papich 5e: 5–10 µg/kg IV or IM, or 50 µg/kg endotracheally. Plumb’s p.471: 0.01–0.02 mg/kg IV (double via endotracheal tube), IM or SC in less severe cases (Cohen 1995); 0.2–0.5 mg TOTAL SC or IM (Wohl 2005). Papich: maximum 0.3 mg total for dogs under 40 kg, 0.5 mg over 40 kg per dose.
• Refractory hypotension — CRI: Papich 5e: 0.05 µg/kg/min IV. Plumb’s p.471: 0.05–0.4 µg/kg/min (Dodam; Mazzaferro 2005); 1–10 µg/kg/min only as a last line of defence under anaesthesia (Ko 2009).

Cats

• CPR — low-dose: Plumb’s p.471: cats — use the dog protocol, 0.01 mg/kg IV every 3–5 min (Scroggin & Quandt 2009). Papich 5e: 10–20 µg/kg IV, increasing to 100 µg/kg for prolonged CPR.
• Anaphylaxis: Plumb’s p.471: 0.01–0.02 mg/kg IV, doubled via endotracheal tube, or IM/SC in less severe cases (Cohen 1995); bronchoconstriction 0.02 mg/kg IV, IM, SC or IT (Johnson 2000). Papich 5e: 5–10 µg/kg IV or IM.

Cattle

• Anaphylaxis: Papich 5e: cattle 20 µg/kg IM (1 mL of 1:1000 per 45 kg) or 5–10 µg/kg IV. Plumb’s p.471 (Clark 1986): ruminants and swine 0.5–1 mL of 1:1000 per 100 lb SC or IM; dilute to 1:10,000 for IV; may repeat at 15-minute intervals.

Horses

• Anaphylaxis (IV): Papich 5e (large animals, 1:1000): 5–10 µg/kg IV, or 20 µg/kg IM. Plumb’s p.471: 3–5 mL of 1:1000 per 450 kg IM or SC (Robinson 1987). Dilute to 1:10,000 for IV use.
• Anaphylaxis (IM): Papich 5e: 20 µg/kg (0.02 mg/kg) IM, i.e. 1 mL of 1:1000 per 45 kg.
• Newborn foal CPR: Plumb’s p.471 (Corley 2003): 0.01–0.02 mg/kg IV (0.5–1 mL of 1:1000 for a 50 kg foal) every 3 minutes until spontaneous circulation returns; intratracheal 0.1–0.2 mL/kg.

Goats

• Anaphylaxis: Plumb’s p.471 (Clark 1986): ruminants 0.5–1 mL of 1:1000 per 100 lb (≈0.011–0.022 mg/kg) SC or IM; dilute to 1:10,000 for IV. Papich 5e (ruminants): 0.02 mg/kg (20 µg/kg) IM or 5–10 µg/kg IV.

Sheep

• Anaphylaxis: Papich 5e: sheep 20 µg/kg IM or 5–10 µg/kg IV. Plumb’s p.471 (Clark 1986): ruminants 0.5–1 mL of 1:1000 per 100 lb SC or IM.

Pigs

• Anaphylaxis: Papich 5e: pigs 20 µg/kg IM or 5–10 µg/kg IV. Plumb’s p.471 (Clark 1986): 0.5–1 mL of 1:1000 per 100 lb SC or IM; may repeat at 15-minute intervals.

Buffalo

No buffalo-specific doses are on file, so buffalo are dosed as cattle.

• Anaphylaxis: Papich 5e: cattle 20 µg/kg IM (1 mL of 1:1000 per 45 kg) or 5–10 µg/kg IV. Plumb’s p.471 (Clark 1986): ruminants and swine 0.5–1 mL of 1:1000 per 100 lb SC or IM; dilute to 1:10,000 for IV; may repeat at 15-minute intervals.

Birds

• CPR: Plumb’s p.471 (Harris 2003): birds 0.1 mg/kg IV or intracardiac.

Contraindications

CRITICAL emergency drug — usual contraindications (cardiac arrhythmia, hypertension, hyperthyroidism) are over-ridden by life-threat. Caution with halothane anaesthesia (sensitises myocardium to arrhythmia). Do NOT use with local anaesthetic blocks of digits / ears / tail / penis — vascular necrosis.

Species-specific warnings

Dogs: CPR low-dose 0.01 mg/kg IV every 3–5 min. Verify concentration (1:1000 vs 1:10 000) before drawing.

Cats: Cats SENSITIVE — start at low end of IM dose for anaphylaxis.

Horses: Adult horse anaphylaxis 5–10 mL of 1:1000 IV.

Adverse effects

• Tachyarrhythmia, ventricular fibrillation (rapid bolus)
• Hypertension
• Mydriasis
• Tremor
• Hyperglycaemia
• Local vasoconstriction → tissue necrosis if extravasated

Drug interactions

• Halothane / isoflurane: sensitises myocardium to arrhythmia — caution
• Beta-blockers: antagonise epinephrine's beta effects (leaves only alpha → severe hypertension)
• Tricyclic antidepressants / MAOIs: increased epinephrine effect
• Alpha-blockers: paradoxical hypotension (beta-2 unopposed vasodilation)

Pregnancy and lactation

Use in emergencies (anaphylaxis, CPR) regardless of pregnancy — benefit overwhelmingly outweighs theoretical risk. FDA Category C.

Monitoring

• ECG continuously during CPR and high-dose use
• Heart rate / blood pressure
• Pulse oximetry
• Clinical response to anaphylaxis (perfusion, bronchospasm)

Toxicity and overdose

Dose-error toxicity (1:1000 IV when 1:10 000 intended): severe hypertension, ventricular fibrillation, pulmonary oedema. Tissue extravasation: local necrosis (treat with phentolamine local infiltration).

Management: STOP epinephrine. Beta-blocker (esmolol, propranolol) for severe tachyarrhythmia. Phentolamine for severe hypertension or local extravasation. Symptomatic care.

Clinical pearls

• CPR low-dose 0.01 mg/kg IV (= 0.1 mL/kg of 1:10 000) every 3–5 min is the current AHA / RECOVER standard
• No IV access during arrest: intratracheal at 2–5× IV dose, diluted in saline 5–10 mL
• Anaphylaxis: 0.01–0.02 mg/kg IM is FIRST line — antihistamine and steroids are adjuncts, not substitutes
• ALWAYS verify the concentration on the vial before drawing — 1:1000 IV is a deadly error
• For halothane / isoflurane anaesthesia, intra-operative epinephrine use should be the lowest effective dose due to arrhythmia sensitisation
• Local lidocaine + epinephrine: do NOT use for digit / ear / tail / penis blocks (vascular necrosis)

Mechanism of action

Endogenous catecholamine — direct alpha-1, alpha-2, beta-1, beta-2 receptor agonist. Alpha-1: peripheral vasoconstriction → restores diastolic BP and coronary perfusion (the CHIEF benefit in CPR). Beta-1: increased HR, contractility, conduction velocity. Beta-2: bronchodilation, vasodilation in skeletal muscle. In anaphylaxis, all four effects are wanted simultaneously.

Formulations and products

• Epinephrine 1:1000 (1 mg/mL) — high concentration
• Epinephrine 1:10 000 (0.1 mg/mL) — IV / intratracheal use

Storage

15–25 °C protected from light. Discard if discoloured (oxidised → brown). Multidose vials: 28 d after broaching.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

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Frequently asked questions