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How to Prescribe Continuous Adrenaline Infusion

Key takeaways

  • The formula for continuous adrenaline infusion volume is Weight (kg) x Dose (mcg/kg/min) x 1440 ÷ presentation of adrenaline in mcg.
  • For a 5kg patient at 0.1 mcg/kg/min using 1mg/mL adrenaline, the calculation yields 0.72 mL (720 mcg) of adrenaline needed.
  • The minimum dilution to achieve a maximum concentration of 64 mcg/mL requires a total volume of 11.25 mL (720 mcg ÷ 64 mcg/mL).
  • The final prescription is Adrenaline (1 mg/mL) 0.72 mL plus 0.9% Saline 10.53 mL, for a total volume of 11.25 mL infused IV via pump at 0.47 mL/h.
  • The maximum safe final concentration for continuous adrenaline infusion is up to 100 mcg/mL (0.1 mg/mL), and any drip rate producing a higher concentration is blocked as too concentrated.

How to prescribe Continuous Adrenaline?

Title graphic showing an infusion pump next to IV fluid bags with the text 'How to prescribe Continuous Adrenaline?'

How to prescribe Continuous Adrenaline?

An infusion pump is shown, illustrating the topic of continuous adrenaline infusion prescribing.

Adrenaline Presentation and Formula

Infographic showing adrenaline presentation of 1mg/mL, patient weight of 5kg, prescribed dose of 0.1mcg/kg/min, manufacturer concentration of 64 mcg/mL, and the dosing formula.

Adrenaline presentation 1mg/mL

  • Weight: 5kg
  • Prescribed dose: 0.1mcg/kg/min

CONCENTRATION INDICATED BY THE MANUFACTURER: 64 MCG/ML

Formula

Weight x dose x 1440 ÷ presentation of adrenaline in mcg

Calculation and Prescription

Infographic showing the calculation of adrenaline dose as 0.72mL, the minimum dilution volume of 11.25mL, and the final prescription for infusion pump administration at 0.47 mL/h.

Calculation

5 x 0,1 x 1440 ÷ 1000 (mcg) = 0.72 mL (720 mcg)

Minimum dilution according to the desired concentration of 64 mcg/ml, that is, 11.25 mL of total volume (720 mcg/64 mcg)

Prescription

  • Adrenaline (1 mg/mL) = 0.72mL
  • 0.9% Saline solution = 10.53 mL
  • Total volume of 11.25 mL IV via infusion pump at 0.47 mL/h

Neofast Method

Infographic describing the Neofast method for calculating continuous medication dosing by entering desired dose, patient weight, and desired drip rate, with results generated in seconds.

Neofast Method

Fill in

  • Desired dose ✓
  • Patient weight ✓
  • Desired drip rate ✓

And don’t worry about the minimum dilution because Neofast will signal when the drip rate is insufficient.

Results in seconds!

Where the software draws the line

Two screenshots of the Neofast app interface for adrenaline continuous medication dosing, one showing a blocked entry for too concentrated drip and another showing a safe calculation result with final concentration and dilution details.

Where the software draws the line.

Screen 1 – Neofast: Continuous medication
  • Adrenaline (Epinephrine)
  • IV continuous
  • 1mg/mL
  • Weight (kg): 5
  • Desired dose (mcg/kg/min): 0.1 (Suggested dose: 0.05 to 1 mcg/kg/min)
  • Intended drip (mL/h): 0.3

Minimum drip of 0.47 mL/h for 0.1mcg/kg/min for an adequate concentration of up to 64mcg/mL

Additional information / Bibliographical references

BLOCKED · TOO CONCENTRATED

References for every calculation

Screen 2 – Neofast: Continuous medication
  • Adrenaline (Epinephrine)
  • IV continuous
  • 1mg/mL
  • Weight (kg): 5
  • Desired dose (mcg/kg/min): 0.1 (Suggested dose: 0.05 to 1 mcg/kg/min)
  • Intended drip (mL/h): 0.5
Adrenaline (Epinephrine) IV continuous – 1mg/mL
Dose0.72mL
Dilute with NS11.28mL
Final concentration0.06 mg/mL
Total in 24 hours12mL

Note: the final concentration of continuous infusion is up to 100 mcg/mL (0.1 mg/mL).

Intermittent dose of adrenaline

SAFE · WITHIN THE CEILING

Every rate is checked against a safe concentration ceiling — hyperconcentration is never allowed, and the safe minimum drip is flagged for you.

Frequently asked questions

What is the formula to calculate continuous adrenaline infusion dosing?

The formula is: Weight (kg) x Dose (mcg/kg/min) x 1440 ÷ presentation of adrenaline in mcg.

How do you calculate the adrenaline volume for a 5kg patient at 0.1 mcg/kg/min?

Using the formula 5 x 0.1 x 1440 ÷ 1000 (mcg) = 0.72 mL (720 mcg) of adrenaline (1 mg/mL presentation).

What is the minimum dilution volume for this adrenaline infusion?

Based on the desired concentration of 64 mcg/mL, the minimum total volume is 11.25 mL, calculated as 720 mcg ÷ 64 mcg/mL.

What is the final adrenaline infusion prescription and rate for a 5kg patient?

The prescription is Adrenaline (1 mg/mL) 0.72 mL plus 0.9% Saline solution 10.53 mL, for a total volume of 11.25 mL, infused IV via infusion pump at 0.47 mL/h.

What happens if the intended drip rate is too low for the desired adrenaline concentration?

If the intended drip rate (e.g., 0.3 mL/h) results in too concentrated a solution, the Neofast software blocks the prescription and flags it as ‘BLOCKED · TOO CONCENTRATED,’ since the minimum drip of 0.47 mL/h is required for an adequate concentration of up to 64 mcg/mL.

Dra. Marcela M Marques
Written by
Neonatologist & pediatric intensivist · CRM 12807/DF
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