# Epinephrine: veterinary dose and monograph

> Epinephrine is a veterinary drug. CRITICAL emergency drug — CPR, anaphylaxis, severe bronchospasm. Indications include cardiopulmonary arrest (CPR — low or high dose protocols); anaphylaxis (severe, with hypotension / bronchoconstriction); severe bronchospasm (refractory to other bronchodilators). This monograph lists 14 reference doses for dogs, cats, cattle, horses, goats and sheep and 2 more species, each with route, frequency and source, plus meat and milk withdrawal periods for food animals.

Source: https://vetmasterji.com/drugs/epinephrine · Last reviewed: 2026-10-01

## 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

*Epinephrine doses for dogs*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| CPR — low-dose (preferred) | 0.01–0.02 mg/kg | IV | q3–5 min | — |
| CPR — high-dose (refractory) | 0.1–0.2 mg/kg | IV | after 2–3 low doses fail | — |
| Anaphylaxis | 0.005–0.02 mg/kg | IM | q5–10 min | — |
| Refractory hypotension — CRI | 0.05–0.4 µg/kg/min | IV | CRI | — |

- 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

*Epinephrine doses for cats*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| CPR — low-dose | 0.01–0.02 mg/kg | IV | q3–5 min | — |
| Anaphylaxis | 0.01–0.02 mg/kg | IM | q5–10 min | — |

- 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

*Epinephrine doses for cattle*

| Indication | Dose | Route | Frequency | Duration | Withdrawal |
| --- | --- | --- | --- | --- | --- |
| Anaphylaxis | 0.01–0.02 mg/kg | IM | q5–10 min | — | Withdrawal NOT established — treat as extra-label |

- 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

*Epinephrine doses for horses*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| Anaphylaxis (IV) | 0.005–0.01 mg/kg | IV | may repeat in 15 min | — |
| Anaphylaxis (IM) | 0.02 mg/kg | IM | may repeat in 15 min | — |
| Newborn foal CPR | 0.01–0.02 mg/kg | IV | every 3 min until ROSC | — |

- 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

*Epinephrine doses for goats*

| Indication | Dose | Route | Frequency | Duration | Withdrawal |
| --- | --- | --- | --- | --- | --- |
| Anaphylaxis | 0.01–0.02 mg/kg | IM | may repeat in 15 min | — | Withdrawal NOT established — treat as extra-label |

- 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

*Epinephrine doses for sheep*

| Indication | Dose | Route | Frequency | Duration | Withdrawal |
| --- | --- | --- | --- | --- | --- |
| Anaphylaxis | 0.01–0.02 mg/kg | IM | may repeat in 15 min | — | Withdrawal NOT established — treat as extra-label |

- 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

*Epinephrine doses for pigs*

| Indication | Dose | Route | Frequency | Duration | Withdrawal |
| --- | --- | --- | --- | --- | --- |
| Anaphylaxis | 0.01–0.02 mg/kg | IM | q5–10 min | — | Withdrawal NOT established — treat as extra-label |

- 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.

*Epinephrine doses for buffalo*

| Indication | Dose | Route | Frequency | Duration | Withdrawal |
| --- | --- | --- | --- | --- | --- |
| Anaphylaxis | 0.01–0.02 mg/kg | IM | q5–10 min | — | Withdrawal NOT established — treat as extra-label |

- 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

*Epinephrine doses for birds*

| Indication | Dose | Route | Frequency | Duration |
| --- | --- | --- | --- | --- |
| CPR | 0.1 mg/kg | IV | as needed | — |

- 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

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

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

> **Caution:** 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

> **Caution:** 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

### What is the dose of Epinephrine for dogs?

Reference doses for Epinephrine in dogs: 0.01–0.02 mg/kg IV q3–5 min (CPR — low-dose (preferred)); 0.1–0.2 mg/kg IV after 2–3 low doses fail (CPR — high-dose (refractory)); 0.005–0.02 mg/kg IM q5–10 min (Anaphylaxis); 0.05–0.4 µg/kg/min IV CRI (Refractory hypotension — CRI). Confirm against the label and the patient before use.

### What is the dose of Epinephrine for cats?

Reference doses for Epinephrine in cats: 0.01–0.02 mg/kg IV q3–5 min (CPR — low-dose); 0.01–0.02 mg/kg IM q5–10 min (Anaphylaxis). Confirm against the label and the patient before use.

### What is the dose of Epinephrine for cattle?

Reference doses for Epinephrine in cattle: 0.01–0.02 mg/kg IM q5–10 min (Anaphylaxis). Confirm against the label and the patient before use.

### What is the withdrawal period for Epinephrine?

Cattle, IM (Anaphylaxis): Withdrawal NOT established — treat as extra-label; Goats, IM (Anaphylaxis): Withdrawal NOT established — treat as extra-label; Sheep, IM (Anaphylaxis): Withdrawal NOT established — treat as extra-label; Pigs, IM (Anaphylaxis): Withdrawal NOT established — treat as extra-label. Follow the product label and national regulations where they differ.

### When should Epinephrine not be used?

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.

### What are the side effects of Epinephrine in animals?

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

## Sources

- Plumb's Veterinary Drug Handbook
- Papich, Papich Handbook of Veterinary Drugs, 5th edition

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VetMasterJi is a clinical decision-support and education platform for veterinary professionals and students. It does not provide veterinary advice, diagnosis or treatment for specific animals. All drug doses, calculators and differentials are references that must be independently verified before clinical use; the attending registered veterinarian remains solely responsible for every clinical decision.