A dose control mechanism for a syringe includes a plunger having a coarse pitch screw on its exterior surface, a housing having a corresponding coarse pitch guide along the interior surface of the housing, a screw having a fine pitch screw which interfaces with a fine pitch nut of an adapter, wherein the plunger has an internal annular space within which screw at least partially resides. An accurate dose drug delivery syringe includes such a dose control mechanism, a barrel, a plunger seal, and a barrel adapter assembly having a barrel tip and a needle. The syringe may be a fill-at-time-of-use syringe, a pre-filled syringe, or a safety syringe having integrated needle retraction or needle sheathing safety features, or a combination thereof. Methods of assembly, manufacturing, and operation are similarly disclosed.
