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Ask the Allergist

When Should My Child Switch to the Adult Dose of Epinephrine?

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My child weighs 62 lbs and the doctor just prescribed the adult dose Epi-pen. I read the package insert after picking it up and it say for 66 lbs or more. Should I call the doctor back to ask for the Jr instead? I can’t afford to buy another set right now either. The Jr’s we have expire next month.

This is a great question. The regular EpiPen does contain 0.3 mg of epinephrine and the EpiPen Jr contains 0.15 mg of epinephrine. The package insert says the EpiPen (0.3 mg) is generally prescribed for patients 66 pounds or above.

Reliable, published studies have shown that for a 25 kg (55 lbs) child, the 0.15 mg autoinjector delivers only 60 percent of the ideal dose, while the 0.3 mg autoinjector delivers 120 percent of the ideal dose. Therefore, national guidelines for the management of anaphylaxis in children recommend that the switch from the 0.15 mg to 0.3 mg epinephrine autoinjector device should occur when the patient weighs approximately 55 pounds or above.

Finally, you can wait until the current EpiPen Jr expires next month and then move up to the new EpiPen prescription.

Allergy, Anaphylaxis, Medicines
Answered by

John M. James, MD, is a board-certified allergist. He is also President of Food Allergy Consulting and Education Services, LLC. He has worked as a medical specialist in the field of allergy, asthma, and immunology for over 30 years. Dr. James received his bachelor’s degree from the University of Arkansas and his Doctor of Medicine degree from the University of Tennessee. He is board certified by the American Board of Allergy and Immunology.

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