ADENOSINE

Antiarrhythmic medicine

Dosage Forms

Injection

3 mg/ml

Uses

  • Supraventricular tachycardia
  • Diagnosis of supraventricular arrhythmias

Dose and Duration

Give injection into a central or large peripheral vein to ensure that the medicine reaches the systemic circulation.
Follow injection by a rapid sodium chloride 0.9% flush

All uses
Adult and child > 12 years: initially 3 mg as a rapid IV bolus (over 2 seconds). If necessary, give additional 6 mg after 1‒2 minutes followed by 12 mg after a further 1‒2 minutes if necessary until tachycardia is terminated
Child 1 month‒12 years: initially 0.1 mg/kg. Repeat injection every 1‒2 minutes if necessary, increasing dose by 0.05‒0.1 mg/kg until tachycardia is terminated or maximum single dose of 0.5 mg/kg (12 mg)
Child 0‒1 year: initially 0.15 mg/kg; if necessary repeat injection every 1‒2 minutes increasing dose by 0.05‒0.1 mg/kg until tachycardia is terminated or maximum single dose of 0.3 mg/kg (12 mg) has been given

Contraindications

  • Hypersensitivity to adenosine
  • Sick sinus syndrome
  • Second or third degree AV (Atrioventricular) block
  • Asthma
  • Chronic obstructive lung disease
  • Severe hypertension
  • Long QT syndrome
  • Decompensated states of heart failure

Side Effects

  • Bradycardia, sinus pause, skipped beats, AV block, atrial arrhythmias, ventricular excitability disorders, hypotension, flushing
  • Dizziness, headache
  • Dyspnoea
  • Nausea
  • Chest pressure/pain
  • Anxiety

Interactions

  • Dipyridamole (increased effects/ toxicity of adenosine)
  • Aminophylline (antagonise effects of adenosine)
  • Theophylline (antagonise effects of adenosine)
  • Antiarrhythmics (increased myocardial depression)
  • Antipsychotics (increased ventricular arrhythmias when given with antipsychotics that prolong QT interval)
  • Beta-blockers (increased myocardial depression)

Pregnancy

  • Do not use

Breastfeeding

  • Can be used

⚠️ Caution

  • Cardio-respiratory resuscitation equipment must be readily available if adenosine is to be used
  • Patient should avoid food or drink containing xanthenes (e.g. tea, coffee, cola, chocolate) at least 12 hours before adenosine is to be used