A dose control mechanism 10 for a syringe includes a plunger 14 having a coarse pitch screw 14B on its exterior surface, a housing 20 having a corresponding coarse pitch guide 20C along the interior surface of the housing 20, a screw 30 having a fine pitch screw 30B which interfaces with a fine pitch nut 18B of an adapter 18, wherein the plunger 14 has an internal annular space 14C within which screw 30 at least partially resides. An accurate dose drug delivery syringe includes such a dose control mechanism 10, a barrel 140, a plunger seal 136, and a barrel adapter assembly 150 having a barrel tip 152 and a needle 154. The syringe may be a fill-at-time-of-use syringe 100, a pre-filled syringe 200, or a safety syringe 300 having integrated needle retraction or needle sheathing safety features, or a combination thereof. Methods of assembly, manufacturing, and operation are similarly disclosed.
