Bringing food allergy management and awareness to your community

Upsizing to an Adult Dose

PREVIOUS MYTH: Give antihistmaines first for anaphylaxis
NEXT MYTH: The autoinjector needle is huge


Staff Training: Food Allergies & Anaphylaxis in School – What School Staff Need to KnowStaff Training: Food Allergies & Anaphylaxis in School – What School Staff Need to Know

This 30 minute module is designed to assist the school nurse in staff training of management of life-threatening allergic reactions and increase food allergy awareness for all school staff including teachers, food service personnel, administrators, aides, specialists, coaches, bus drivers, custodians and others.


Epinephrine auto-injectors can’t be upsized to the 0.3mg dose until 66 lbs.



American Academy of Pediatrics publication suggests upsizing auto-injectors at 55 lbs (25 kg).



The appropriate weight for upsizing has been at times the center of confusion as the PDR uses a 66 lbs cut off (which would result in a considerable underdose). The issue of when to upsize has recently gained attention as more states are implementing stock auto-injector laws and standing orders need to designate a cutoff marker for when to updose. Also, as getting a weight may not be appropriate in these situations, alternative approaches to determining when to go the the adult doses like length, age and grade level are considerations.



  1. Sicherer and Simons. Self-injectable Epinephrine for First-Aid Management of Anaphylaxis. Pediatrics. 2007 Mar;119(3):638-46.



All information contained on the website is intended for informational and educational purposes. The information provided on this website is not intended to be a replacement or substitute for professional medical advice. Any information that you have received from should be verified with your licensed health care provider. Furthermore, decisions regarding medical care should not be based solely upon the content of this website but made after discussions with your health care provider. Consumers should never disregard or delay seeking medical advice due to the content of this site.

Your use of this site does not create a patient-physician relationship between you and

Medical information changes constantly. Therefore the information on this site or on the linked websites should not be considered current, complete or exhaustive, nor should you rely on such information to recommend a course of treatment for you or any other individual. Reliance on any information provided on this site or any linked websites is solely at your own risk.

Please note that AllergyHome is not affiliated with Boston Children’s Hospital

Accept Decline