1 mg of Epinephrine
1 mL of a 1:1000 epinephrine solution contains exactly 1 mg of epinephrine. 1
Understanding Epinephrine Concentrations
The 1:1000 concentration means:
- 1 mg per 1 mL (1 mg/mL)
- This is the standard concentration for intramuscular (IM) administration 2
Key Concentration Distinctions
It's critical to distinguish between the two primary epinephrine concentrations to avoid potentially fatal dosing errors:
1:1000 solution (1 mg/mL):
- Used for IM/subcutaneous routes
- Anaphylaxis treatment: 0.2-0.5 mg IM (0.2-0.5 mL) 2
- Pediatric dosing: 0.01 mg/kg IM (= 0.01 mL/kg of 1:1000) 3
1:10,000 solution (0.1 mg/mL):
- Used for IV/IO routes during cardiac arrest
- Contains 10 times less epinephrine per mL
- Pediatric cardiac arrest: 0.01 mg/kg IV (= 0.1 mL/kg of 1:10,000) 4
- Adult anaphylactic shock with IV access: 0.05-0.1 mg IV 2
Critical Safety Considerations
Common pitfall: Administering 1:1000 solution intravenously instead of 1:10,000 can result in a 10-fold overdose, causing severe cardiovascular complications including hypertension, arrhythmias, and myocardial ischemia 5, 6. Always verify the concentration matches the intended route before administration.
The FDA-approved formulation clearly states each 1 mL vial contains 1 mg epinephrine in the 1:1000 concentration 1. This solution appears clear and colorless when properly stored, and any discoloration (pink or brown) indicates degradation and the solution should be discarded 1.