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Adenosine

Medical and Pharmacy Editor:

Brand Name: Adenoscan, Adenocard

Generic Name: adenosine

Drug Class: Antidysrhythmics, V

What Is Adenosine and How Does It Work?

Adenosine is a prescription drug used for conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PVST), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome). When clinically advisable, appropriate vagal maneuvers (Valsalva maneuver), should be attempted prior to adenosine administration.

Adenosine is available under the following different brand names: Adenocard, and Adenoscan.

Dosages of Adenosine:

Injectable solution

Dosage Considerations – Should be Given as Follows:

Paroxysmal Supraventricular Tachycardia

Adult Dosage

Dosing considerations

  • When clinically advisable for paroxysmal supraventricular tachycardia (PSVT), appropriate vagal maneuvers (Valsalva maneuver), should be attempted prior to adenosine administration

Pediatric Dosage

  • Under 50 kg: 0.05 to 0.1 mg/kg rapid intravenous pyelogram over 1-3 seconds or intraosseous infusion, no more than 0.2 mg/kg/dose, followed by rapid flush with up to 5 ml 0.9% sodium chloride
  • If necessary may give second dose of 0.2 mg/kg intravenous pyelogram/intraosseous infusion, not to exceed cumulative dose of 12 mg

Geriatric Dosage

  • Elderly may experience more adverse effects from adenosine; they may be more sensitive
  • PSVT (Adenocard)
  • 6 mg intravenously (IV) over 1-3 seconds (maybe given by intraosseous infusion [IO]) followed by rapid flush with 20 ml normal saline (NS), if no conversion within 1-2 minutes give 12 mg IV, repeat a second time if necessary (30 mg total)
  • Adenoscan (Diagnostic)
  • Stress testing (Adenoscan): 140 mcg/kg/minute intravenous infusion for 6 minutes

Stress Testing (Diagnostic)

Other Indications and Uses

What Are Side Effects Associated with Using Adenosine?

Side effects of adenosine include:

Postmarketing side effects of adenosine reported include:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Adenosine?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Adenosine has no known severe interactions with other drugs.

Adenosine has no known serious interactions with other drugs.

Moderate interactions of adenosine include:

Mild interactions of adenosine include:

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

What Are Warnings and Precautions for Adenosine?

Warnings

  • This medication contains adenosine. Do not take Adenocard or Adenoscan if you are allergic to adenosine or any ingredients contained in this drug
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

Effects of Drug Abuse

  • No information available

Short-Term Effects

  • See "What Are Side Effects Associated with Using Adenosine?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Adenosine?"

Cautions

  • Symptomatic slow heart rate (bradycardia), cardiac arrest, heart block, heart transplant patients, high blood pressure (hypertension), low blood pressure (hypotension), heart attack, frequent occurrence of pre-existing arrhythmias (proarrhythmic) events, low blood flow to the heart (unstable angina)
  • Adenocard: Caution with bronchoconstrictive or bronchospastic lung disease (asthma)
  • Cerebrovascular accident hemorrhagic and ischemic cerebrovascular accidents reported; hemodynamic effects of adenosine including low blood pressure or high blood pressure possibly associated with these adverse reactions
  • Nucleoside transport inhibitors (dipyridamole) and potentiate the vasoactive effects of adenosine; withhold for 5 half-lives before adenosine administration
  • Methylxanthines (caffeine, theophylline) are adenosine receptor antagonists and inhibit adenosine's vasoactive effects; withhold methylxanthines for 5 half-lives before adenosine administration
  • New-onset or recurrence of convulsive seizures reported following adenosine; some seizures are prolonged and require emergent anticonvulsive management; aminophylline may increase risk of seizures associated with adenosine;
  • methylxanthine use not recommended in patients who experience seizures in association with adenosine administration
  • Difficulty breathing, throat tightness, flushing, reddening of the skin, rash, and chest discomfort reported that may require symptomatic treatment; resuscitative measures may be necessary if symptoms progress; have trained personnel and treatment available during treatment
  • Arrhythmia at time of cardioversion (Adenocard): Ventricular fibrillation reported following administration, including both resuscitated and fatal events; in most instances, these cases were associated with the concomitant use of digoxin and, less frequently with digoxin and verapamil
  • Risk for myocardial infarction and death
  • Avoid use for cardiac nuclear stress tests in patients with signs or symptoms of acute myocardial ischemia (unstable chest pain [angina], cardiovascular instability); use may increase risk of fatal heart attack (myocardial infarction [MI])
  • Screen all nuclear stress test candidates for risks

Pregnancy and Lactation

  • Use adenosine during pregnancy with caution if benefits outweigh risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done
  • Adenosine use when breastfeeding has potential for serious adverse reaction in nursing infants. A decision to interrupt nursing after administration of adenosine should take into account the importance of the drug to the mother
Reviewed on 5/12/2017

Medscape. Adenosine.
https://reference.medscape.com/drug/adenocard-adenoscan-adenosine-342295#0
RxList. Adenocard Side Effects Center.
https://www.rxlist.com/adenocard-drug.htm

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