How the dose is calculated
This calculator gives the paediatric weight-based dose. Adult cardiac arrest dosing (300 mg IV/IO bolus, with a repeat 150 mg dose if needed) is a fixed dose, not weight-based, and is shown below for reference.
Weight-based dosing (paediatric)
| Indication | Dose | Max single dose |
|---|---|---|
| Cardiac arrest (VF/pulseless VT) | 5 mg/kg IV/IO bolus | 300 mg |
| Perfusing tachyarrhythmia | 5 mg/kg IV over 20-60 min | 300 mg |
Fixed adult cardiac arrest dose
| Dose | Notes |
|---|---|
| 300 mg IV/IO bolus | Given after the 3rd defibrillation attempt in refractory VF/pulseless VT |
| 150 mg IV/IO | May repeat once if VF/pulseless VT persists/recurs |
Clinical use
- First-line antiarrhythmic in ACLS/PALS algorithms for shock-refractory VF or pulseless VT, given after the third shock alongside continued CPR.
- Also used for stable, perfusing tachyarrhythmias (e.g. VT, some SVTs) as a slower infusion with cardiac monitoring rather than a rapid bolus.
- Give via a large vein or central line where possible for infusions — peripheral extravasation and phlebitis are recognised complications with prolonged infusion.
Frequently asked questions
When is amiodarone given in a cardiac arrest?
After the third defibrillation attempt for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, given as a rapid bolus without interrupting chest compressions for longer than necessary.
What's the difference between the arrest dose and the perfusing arrhythmia dose?
In cardiac arrest it's given as a rapid IV/IO bolus; for a stable, perfusing tachyarrhythmia the same weight-based dose is given more slowly (over 20-60 minutes) with cardiac monitoring, since rapid administration in a conscious patient risks significant hypotension.
Is the adult cardiac arrest dose weight-based?
No — ACLS uses a fixed 300 mg (then 150 mg if repeated) dose for adults in cardiac arrest, unlike the paediatric weight-based dosing shown in the calculator above.
References
- American Heart Association. Pediatric Advanced Life Support (PALS) Guidelines.
- American Heart Association. Advanced Cardiovascular Life Support (ACLS) Guidelines.