How to Prepare 1:1000 Epinephrine
A 1:1000 epinephrine solution is already prepared and requires no dilution—standard epinephrine ampules contain 1 mg/mL, which is by definition a 1:1000 concentration (1 gram per 1000 mL = 1 mg per 1 mL). 1
Understanding the Concentration
- 1:1000 means 1 gram of epinephrine in 1000 mL of solution, which equals 1 mg per 1 mL 1
- Standard epinephrine ampules labeled as "1 mg/mL" are already at 1:1000 concentration and are ready to use without any preparation 1
- No dilution is needed for intramuscular or subcutaneous administration 1
Clinical Applications of 1:1000 Epinephrine
Anaphylaxis Treatment
- Administer 0.3-0.5 mg (0.3-0.5 mL) intramuscularly for adults 1
- For children, give 0.01 mg/kg (0.01 mL/kg) intramuscularly in the anterolateral thigh 2, 1
- The maximum single dose is 0.5 mg 2
- Repeat dosing may be required every 5-15 minutes if symptoms persist 2
Other Indications
- Severe asthma exacerbation: 0.01 mg/kg (maximum 0.3-0.5 mg) subcutaneously, repeated every 20 minutes up to 3 doses 1
- Croup/laryngotracheobronchitis: 0.5 mL/kg (maximum 5 mL) administered by nebulizer 1
Critical Safety Considerations
Avoiding Dosing Errors
- Never confuse 1:1000 with 1:10,000 concentration—using 1:1000 intravenously when 1:10,000 is indicated delivers 10 times the intended dose 1
- Serious adverse events occur when 1:1000 epinephrine is given intravenously instead of the appropriate 1:10,000 solution 2
- 1:1000 epinephrine is for intramuscular or subcutaneous use only; intravenous administration requires 1:10,000 concentration 2
Creating 1:10,000 Dilution (If Needed for IV Use)
- Take 1 mL of 1:1000 solution (1 mg) and add 9 mL of normal saline to create 10 mL of 1:10,000 solution (0.1 mg/mL) 1
- This diluted solution is appropriate for intravenous bolus administration 2