What is the epinephrine (EpiPen) dose for a 13-year-old?

EpiPen Dosage for a 13-Year-Old

For a 13-year-old adolescent, the appropriate epinephrine auto-injector (EpiPen) dose is 0.3 mg, administered intramuscularly in the lateral thigh. 1, 2

Dosage Determination Based on Weight

The recommended epinephrine dosing for anaphylaxis follows these weight-based guidelines:

• Children ≥30 kg (66 lbs): 0.3 mg dose 1, 2
• Children <30 kg (66 lbs): 0.01 mg/kg up to 0.3 mg 1

Since most 13-year-olds weigh more than 30 kg (66 lbs), they should receive the 0.3 mg dose. This is delivered via the standard EpiPen (not the EpiPen Jr which contains 0.15 mg).

Administration Technique

For optimal effectiveness:

• Inject into the mid-outer thigh (vastus lateralis muscle)
• Can be administered through clothing if necessary
• Hold firmly in place during injection to prevent injury
• Intramuscular route is preferred over subcutaneous for faster absorption 3, 1

Timing and Repeat Dosing

• If symptoms persist or recur, a second dose may be given 5-15 minutes after the first dose 3, 1, 2
• Approximately 10-20% of patients require more than one dose 1
• Do not administer repeated injections at the same site to avoid tissue necrosis 2

Important Considerations

Route of Administration

Intramuscular injection in the lateral thigh is strongly preferred over subcutaneous administration because:

• IM injection leads to peak plasma concentrations in approximately 8 minutes
• Subcutaneous injection results in delayed absorption (34 minutes on average) 3, 4

Common Errors to Avoid

1. Delayed administration (most critical error)
2. Incorrect injection site (avoid deltoid)
3. Incorrect route (avoid subcutaneous)
4. Overreliance on antihistamines instead of epinephrine 1

Safety Profile

• Transient side effects may include pallor, tremor, anxiety, and palpitations
• These effects are similar to the body's natural "fight or flight" response
• There are no absolute contraindications to epinephrine use in anaphylaxis, as benefits outweigh risks 3, 1

After administration, the patient should be transported to an emergency department for further monitoring and treatment, as additional interventions may be necessary 3.