Precautions and warnings

Patients on dipyridamole (lower initial dose of adenosine of 0.5-1 mg); atrial fibrillation or flutter with accessory pathway; pregnant women; heart transplant patients; patients on dipyearidamole (lower initial dose of adenosine of 0.5-1 mg); patients on dipyridamole (lower initial dose of adenosine of 0.5-1 mg (conduction along anomalous pathway may increase).

Drug Interactions

Methylxanthines such as coffee, theophylline, and others counteract the effects of adenosine. Carbamazepine taken at the same time may raise the risk of heart block.
Dipyridamole potentiates the effects of adenosine, making it potentially fatal.

Contraindications

AV block in the second or third degree, sick sinus syndrome (unless a pacemaker is used), asthma, and hypersensitivity.

Mode of actions

Adenosine slows conduction across the AV node by binding to the A1 receptors. It also stimulates the A2 receptors, which promote peripheral and coronary vasodilation. The plasma half-life is quite short.

Dosage & Administration

Intravenous
Differential diagnosis of supraventricular tachycardias
Adult: Initially, 3 mg by rapid IV inj into a central or large peripheral vein over 2 sec with cardiac monitoring; 6 mg may be given after 1-2 minutes if necessary, then 12 mg after a further 1-2 minutes. Avoid increments if high level AV block occurs at any particular dose.
Child: Initially, 50-100 mcg/kg; if necessary, may increase dose by 50-100 mcg/kg increments at 1-2 minute intervals or until arrhythmia is controlled. Max dose: 300 mcg/kg.

Paroxysmal supraventricular tachycardia
Adult: Initially, 3 mg by rapid IV inj into a central or large peripheral vein over 2 sec with cardiac monitoring; 6 mg may be given after 1-2 minutes if necessary, then 12 mg after a further 1-2 minutes. Avoid increments if high level AV block occurs at any particular dose.
Child: Initially, 50-100 mcg/kg; if necessary, may increase dose by 50-100 mcg/kg increments at 1-2 minute intervals or until arrhythmia is controlled. Max dose: 300 mcg/kg.

Myocardial imaging
Adult: 140 mcg/kg/minute by infusion for 6 minutes. Inject radionuclide 3 minute after infusion.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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