Adenosine

CLINICAL USE

Rapid reversion to sinus rhythm of

paroxysmal supraventricular tachycardias

Diagnosis of broad or narrow complex

supraventricular tachycardias

DOSE IN NORMAL RENAL FUNCTION

Initially: 3 mg over 2 seconds with cardiac
monitoring followed, if necessary, by 6 mg
after 1–2 minutes and then by 12 mg after a
further 1–2 minutes

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
267.2

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
0

%Excreted unchanged in urine &nbsp &nbsp :
<5

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
No data

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : seconds/
Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp :
Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
Not dialysed. Dose as in normal renal function

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
Not dialysed. Dose as in normal renal function

HDF/high flux &nbsp :
Unknown dialysability. Dose as in
normal renal function

CAV/VVHD &nbsp &nbsp &nbsp:
Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anti-arrhythmics: increased risk of

myocardial depression

Antipsychotics: increased risk

of ventricular arrhythmias with
antipsychotics that prolong the QT
interval

Beta-blockers: increased risk of myocardial

depression

Effect is enhanced and extended by

dipyridamole; therefore if use of adenosine
is essential, dosage should be reduced by a
factor of 4 (i.e. initial dosage of 0.5–1 mg)

Theophylline and other xanthines are

potent inhibitors of adenosine

ADMINISTRATION

Reconstition

–

Route

Rate of Administration

Rapid IV bolus (see dose)

Comments

Do not refrigerate

Administer into central vein, large

peripheral vein, or into an IV line. If IV
line used, follow dose by rapid sodium
chloride 0.9% flush

OTHER INFORMATION

Neither the kidney nor the liver is

involved in the degradation of exogenous
adenosine, so dose adjustments are not
required in hepatic or renal insufficiency

Unlike verapamil, adenosine may be used

in conjunction with a beta-blocker

Common side effects: facial flushing, chest

pain, dyspnoea, bronchospasm, nausea
and lightheadedness; the side effects are
short-lived

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