Emergency and Critical Care

Epinephrine Infusion Rate Calculator (mcg/kg/min to mL/h)

Calculates epinephrine infusion rate (mcg/kg/min → mL/h). Not for bolus dosing.

Primary source: Surviving Sepsis Campaign 2021. Российские КР по СЛР.

Aleksandr A. Aulov, MD, internal medicine Last clinical review: April 28, 2026

Online calculation

Patient weight

Body weight

Epinephrine dose

Therapeutic range 0.05–1 mcg/kg/min

mcg/kg/min

Drug in solution

Standard: 5 mg (5 ampoules of 1 mg) in 50 mL

Solution volume

Standard for syringe pump: 50 mL

About this score

Epinephrine is a potent mixed α/β-agonist with dose-dependent effects. This calculator is designed for continuous infusion (mcg/kg/min), not for bolus dosing during CPR (1 mg IV bolus every 3–5 min).

Dose-dependent infusion effects: < 0.05 mcg/kg/min — β1 effect predominates (inotropic, chronotropic); 0.05–0.3 mcg/kg/min — mixed effect; > 0.3 mcg/kg/min — α1 effect predominates. At doses > 1 mcg/kg/min, the risk of tachyarrhythmias and peripheral ischemia rises sharply.

Use in infusion: second line in septic shock after norepinephrine, cardiogenic shock with severe hypotension, anaphylactic shock (after the initial bolus). Standard dilution: 5 mg (5 ampoules of 1 mg) in 50 mL — concentration 100 mcg/mL.

When to use

Septic shock — added to norepinephrine when target SBP ≥ 65 mm Hg is not achieved.
Cardiogenic shock with severe hypotension and reduced cardiac output (combined β- and α-effect).
Anaphylactic shock — after the initial bolus (0.3–0.5 mg IM), switch to infusion if hypotension persists.
Post-cardiac arrest syndrome — hemodynamic support after ROSC.

Clinical example

Case

70-kg patient in the post-resuscitation period after cardiac arrest. BP 80/50 mm Hg on norepinephrine 0.5 mcg/kg/min, reduced cardiac output on echocardiography. Epinephrine 0.05 mcg/kg/min added. Dilution: 5 mg in 50 mL.

Calculation

Concentration: 5000/50 = 100 mcg/mL. Rate: 0.05×70×60/100 = 2.1 mL/h.

Interpretation and management

Low starting dose with predominant β1 effect — increased inotropy and heart rate, support of cardiac output. Monitor BP, lactate, glucose (β2 raises glucose), troponin (β-stimulation increases myocardial oxygen demand). Titrate to response.

Limitations and cautions

Peripheral administration is acceptable only at concentrations up to 10 mcg/mL and for no more than 6 hours — otherwise risk of tissue ischemia.
Hyperglycemia and lactic acidosis, even with adequate perfusion, reflect a β2 effect and are not markers of deterioration.
At high doses, risk of severe tachyarrhythmias (VT/VF).
Not for bolus correction of blood pressure (outside CPR) — continuous infusion in critical care only.

Frequently asked questions

Epinephrine or norepinephrine in septic shock?

Norepinephrine is first-line. Epinephrine is added second when the target SBP is not reached at a norepinephrine dose ≥ 0.5 mcg/kg/min (or given together with vasopressin).

What dilution is used for bolus administration?

This calculator is not for bolus dosing. In CPR — 1 mg IV undiluted every 3–5 minutes. In anaphylaxis — 0.3–0.5 mg IM (not IV).

What does "epinephrine-induced hyperglycemia" mean?

The β2 effect stimulates glycogenolysis and gluconeogenesis — blood glucose may rise by 3–5 mmol/L. This is not a reason to reduce the dose if it is indicated; correct with insulin.

Can it be stopped abruptly?

No. Taper by 0.02–0.05 mcg/kg/min every 15–30 minutes while monitoring BP and cardiac output. Abrupt discontinuation can cause refractory hypotension.

All clinical calculators in one place

Validated scores and formulas with full interpretation, clinical examples and source references. Open access, no registration required.

65+ calculators · scores and formulas · interpretation with management notes

Browse all calculators

АА

Aleksandr A. Aulov Physician, internal medicine, Sechenov School — independent medical education platform. Calculators are compiled from the original publications and current clinical guidelines. Interpretation thresholds follow the source study unless stated otherwise.

This calculator is intended for healthcare professionals. Do not use it for self-diagnosis or self-treatment. Management decisions are made by the treating clinician based on the full clinical picture of the individual patient.