Adenosine

Adenosine
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gerald Chi

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Overview

Adenosine is an adenosine receptor agonist and antiarrhythmic that is FDA approved for the {{{indicationType}}} of paroxysmal supraventricular tachycardia (PSVT), including that associated with accessory bypass tracts (Wolff-Parkinson-White syndrome).. Common adverse reactions include chest discomfort, flushing, abdominal discomfort, pain of head and neck region, dizziness, headache, and dyspnea.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Paroxysmal Supraventricular Tachycardia

• Adenocard (adenosine injection) should be given as a rapid bolus by the peripheral intravenous route. To be certain the solution reaches the systemic circulation, it should be administered either directly into a vein or, if given into an IV line, it should be given as close to the patient as possible and followed by a rapid saline flush.

Adult Patients

• The dose recommendation is based on clinical studies with peripheral venous bolus dosing. Central venous (CVP or other) administration of Adenocard has not been systematically studied.

• Dosing Information

• Initial dose: 6 mg given as a rapid intravenous bolus (administered over a 1-2 second period).
• Repeat administration: If the first dose does not result in elimination of the supraventricular tachycardia within 1-2 minutes, 12 mg should be given as a rapid intravenous bolus. This 12 mg dose may be repeated a second time if required.

Pediatric Patients with a Body Weight < 50 kg

• Dosing Information

• Give 0.05 to 0.1 mg/kg as a rapid IV bolus given either centrally or peripherally. A saline flush should follow.
• Repeat administration: If conversion of PSVT does not occur within 1-2 minutes, additional bolus injections of adenosine can be administered at incrementally higher doses, increasing the amount given by 0.05 to 0.1 mg/kg. Follow each bolus with a saline flush. This process should continue until sinus rhythm is established or a maximum single dose of 0.3 mg/kg is used.

Pediatric Patients with a Body Weight ≥ 50 kg

• Administer the adult dose.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Supraventricular Tachycardia

• Developed by: ACCF/AHA

• Class of Recommendation: Class I

• Strength of Evidence: Category B

• Dosing Information

• 6 mg, followed by 12 mg as needed

Non–Guideline-Supported Use

Preventing Graft Occlusion Following Aortocoronary Bypass Surgery

• Dosing Information

• Intraoperative administration of blood cardioplegia containing containing 0.5–2 mM adenosine. Patients receiving adenosine cardioplegia were also given an infusion of adenosine (200 microg/kg/min) 10 minutes before and 15 minutes after removal of the aortic crossclamp.

Percutaneous Transluminal Angioplasty

• Dosing Information

• 20 mg in 50 milliliters (mL) saline infused at a rate of 2 mg/minute

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

There is limited information regarding FDA-Labeled Use of Adenosine in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Supraventricular Tachycardia

• Developed by: ACCF/AHA

• Class of Recommendation: Class IIa

• Strength of Evidence: Category B

• Dosing Information

• 0.05–0.3 mg/kg

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Adenosine in pediatric patients.

Contraindications

• Second- or third-degree A-V block (except in patients with a functioning artificial pacemaker)
• Sinus node disease, such as sick sinus syndrome or symptomatic bradycardia (except in patients with a functioning artificial pacemaker)
• Hypersensitivity to adenosine

Warnings

• Description

Precautions

• Description

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Clinical Trial Experience of Adenosine in the drug label.

Body as a Whole

Cardiovascular

Digestive

Endocrine

Hematologic and Lymphatic

Metabolic and Nutritional

Musculoskeletal

Neurologic

Respiratory

Skin and Hypersensitivy Reactions

Special Senses

Urogenital

Miscellaneous

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Adenosine in the drug label.

Body as a Whole

Cardiovascular

Digestive

Endocrine

Hematologic and Lymphatic

Metabolic and Nutritional

Musculoskeletal

Neurologic

Respiratory

Skin and Hypersensitivy Reactions

Special Senses

Urogenital

Miscellaneous

Drug Interactions

• Drug

• Description

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA):

• Pregnancy Category

Pregnancy Category (AUS):

• Australian Drug Evaluation Committee (ADEC) Pregnancy Category

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Adenosine in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Adenosine during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Adenosine with respect to nursing mothers.

Pediatric Use

There is no FDA guidance on the use of Adenosine with respect to pediatric patients.

Geriatic Use

There is no FDA guidance on the use of Adenosine with respect to geriatric patients.

Gender

There is no FDA guidance on the use of Adenosine with respect to specific gender populations.

Race

There is no FDA guidance on the use of Adenosine with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Adenosine in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Adenosine in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Adenosine in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Adenosine in patients who are immunocompromised.

Administration and Monitoring

Administration

• Oral

• Intravenous

Monitoring

There is limited information regarding Monitoring of Adenosine in the drug label.

Condition1

• Description

IV Compatibility

There is limited information regarding IV Compatibility of Adenosine in the drug label.

Overdosage

Acute Overdose

Signs and Symptoms

• Description

Management

• Description

Chronic Overdose

There is limited information regarding Chronic Overdose of Adenosine in the drug label.

Pharmacology

There is limited information regarding Adenosine Pharmacology in the drug label.

Mechanism of Action

Structure

This image is provided by the National Library of Medicine.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Adenosine in the drug label.

Pharmacokinetics

There is limited information regarding Pharmacokinetics of Adenosine in the drug label.

Nonclinical Toxicology

There is limited information regarding Nonclinical Toxicology of Adenosine in the drug label.

Clinical Studies

There is limited information regarding Clinical Studies of Adenosine in the drug label.

Condition1

• Description

How Supplied

Storage

There is limited information regarding Adenosine Storage in the drug label.

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

There is limited information regarding Patient Counseling Information of Adenosine in the drug label.

Precautions with Alcohol

• Alcohol-Adenosine interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

• Adenocard®

Look-Alike Drug Names

• A® — B®

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

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