Atropine Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Bradyarrhythmia

0.4 to 1 mg IV one time. An effective dose within this range may be repeated every 1 to 2 hours as needed to achieve an adequate heart rate or within 5 to 10 minutes if the initial heart rate is inadequate. In rare instances, repeated doses as high as 2 mg are needed.

Usual Adult Dose for AV Heart Block

0.4 to 1 mg IV one time. An effective dose within this range may be repeated every 1 to 2 hours as needed to promote normal AV node conduction or within 5 to 10 minutes if the initial effect is inadequate to overcome the heart block. In rare instances, repeated doses as high as 2 mg are needed.

Usual Adult Dose for Organophosphate Poisoning

Mild symptoms of nerve agent (nerve gas) or insecticide exposure:
2 mg/0.7 mL (green) by AtroPen auto-injector into midlateral thigh followed by 2 additional 2 mg/0.7 mL (AtroPen) injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.

Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 2 mg/0.7 mL (green) by AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.

Usual Adult Dose for Anticholinesterase Poisoning

2 to 3 mg IV one time. Doses may be repeated as needed to prevent or treat signs of parasympathomimetic activity, coma, and/or cardiovascular collapse.

Usual Pediatric Dose for Bradyarrhythmia

0.01 to 0.03 mg/kg IV every 5 minutes for 2 to 3 doses as needed. The minimum dose is 0.1 mg and the maximum dose is 0.5 mg. The maximum total dose is 1 mg.

When treating bradycardia in neonates, reserve use for those patients unresponsive to improved oxygenation and epinephrine. Note: Doses less than 0.1 mg have been associated with paradoxical bradycardia.

Endotracheal: 0.04 to 0.06 mg/kg; may repeat once if needed.

Usual Pediatric Dose for AV Heart Block

0.01 to 0.03 mg/kg IV every 5 minutes for 2 to 3 doses as needed. The minimum dose is 0.1 mg and the maximum dose is 0.5 mg. The maximum total dose is 1 mg.

When treating bradycardia in neonates, reserve use for those patients unresponsive to improved oxygenation and epinephrine. Note: Doses less than 0.1 mg have been associated with paradoxical bradycardia.

Endotracheal: 0.04 to 0.06 mg/kg; may repeat once if needed.

Usual Pediatric Dose for Organophosphate Poisoning

Infants weighing less than 15 lbs. (generally less than six months of age): use 0.25 mg/ 0.3 mL (yellow)AtroPen auto-injector
Mild symptoms of nerve agent (nerve gas) or insecticide exposure:
0.25 mg/0.3 mL (yellow) AtroPen auto-injector into midlateral thigh followed by 2 additional 0.25 mg/0.3 mL (blue) AtroPen injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.
Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 0.25 mg/0.3 mL (yellow) AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.


15 to 40 pounds: use 0.5 mg/0.7 mL (blue) AtroPen auto-injector
Mild symptoms of nerve agent (nerve gas) or insecticide exposure:
0.5 mg/0.7 mL (blue) AtroPen auto-injector into midlateral thigh followed by 2 additional 0.5 mg/0.7 mL (blue) AtroPen injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.
Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 0.5 mg/0.7 mL (blue) AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.

40 to 90 pounds: use 1 mg/0.7 mL (dark red) AtroPen auto-injector
Mild symptoms of nerve agent (nerve gas) or insecticide exposure:
1 mg/0.7 mL (dark red) AtroPen auto-injector into midlateral thigh followed by 2 additional 1 mg/0.7 mL (dark red) AtroPen injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.
Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 1 mg/0.7 mL (dark red) AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness

More than 90 pounds: use 2 mg/0.7 mL (green) AtroPen auto-injector

2 mg/0.7 mL (green) AtroPen auto-injector into midlateral thigh followed by 2 additional 2 mg/0.7 mL (green) AtroPen injections given in rapid succession are recommended 10 minutes after receiving the first injection if the victim develops any of the following severe symptoms: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness.
Severe symptoms of nerve agent (nerve gas) or insecticide exposure:
3 injections of 2 mg/0.7 mL (green) AtroPen auto-injector into midlateral thigh in rapid succession. Severe symptoms are: strange or confused behavior, severe difficulty breathing or severe secretions from the lungs and airways, severe muscular twitching and general weakness, involuntary urination and defecation, convulsions or unconsciousness

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Caution is recommended when atropine is given to elderly patients because of the increased risk of side effects. The elderly appear to be more prone to the anticholinergic effects of atropine on the CNS, which can result in confusion, agitation, delirium, drowsiness, or coma.

Primary protection against exposure to chemical nerve agent and insecticide poisoning is the wearing of protective garments including masks, designed specifically for this use. Individuals should not reply solely upon the availability of antidotes such as atropine to provide complete protection from chemical nerve agent and insecticide poisoning.

Dialysis

Atropine is not significantly removed by hemodialysis.

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