Monitor Closely (1)green tea decreases effects of adenosine by unspecified interaction mechanism. [29325] [45649] Reduce the initial dose to 3 mg if given by central access. Use of adenosine in patients with asthma has resulted in mild to moderate exacerbation of their symptoms. Weighing 50 kg or more: 12 mg/dose IV/IO, with maximum total dosage up to 30 mg per PSVT episode; safety and efficacy for coronary artery disease diagnosis have not been established.Weighing less than 50 kg: 0.3 mg/kg/dose IV/IO (Max: 12 mg); safety and efficacy for coronary artery disease diagnosis have not been established. (Theoretical interaction). Discontinue adenosine in any patient who develops persistent or symptomatic high-grade AV block. [29325] However, studies have shown that initial doses of 0.05 mg/kg/dose and 0.1 mg/kg/dose terminate the arrhythmia in less than 10% and less than 37% of pediatric patients who received these doses, respectively. Mechanism: pharmacodynamic synergism. Amlodipine; Olmesartan: (Moderate) Use adenosine with caution in the presence of calcium-channel blockers due to the potential for additive or synergistic depressant effects on the sinoatrial and atrioventricular nodes. Use Caution/Monitor. Adenosine is contraindicated in patients with sinus node disease, such as sick sinus syndrome or symptomatic bradycardia, and in patients with second- or third-degree AV block, except in patients with a functioning artificial pacemaker. While extracellular adenosine is primarily cleared from plasma by cellular uptake with a half-life of less than 10 seconds in whole blood, excessive amounts may be deaminated by an ecto-form of adenosine deaminase. Since adenosine significantly increases blood flow in normal coronary arteries with little or no increase in stenotic arteries, adenosine causes relatively less thallium-201 uptake in vascular territories supplied by stenotic coronary arteries (i.e., a greater difference is seen after adenosine between areas served by normal and areas served by stenotic vessels than is seen prior to adenosine). Dyspnea, throat tightness, flushing, erythema, rash, and chest discomfort have occurred after adenosine administration. Monitor Closely (1)nicotine inhaled increases effects of adenosine by unknown mechanism. Affected cytochrome P450 isoenzymes and drug transporters: none. This website also contains material copyrighted by 3rd parties. Mechanism: pharmacodynamic synergism. Send the page "" Dipyridamole: (Major) The vasoactive effects of adenosine are potentiated by dipyridamole; smaller doses of adenosine may be effective if used concurrently with dipyridamole. All rights reserved. Use Caution/Monitor. While no special cautions are recommended when adenosine is used therapeutically to treat supraventricular tachycardia, it may be advisable for patients to avoid nicotine products or tobacco prior to electrophysiologic studies or stress testing where adenosine will be administered. Minor/Significance Unknown. Mechanism: pharmacodynamic synergism. Mechanism: pharmacodynamic synergism. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

Adenosine slows conduction time through the A-V node, can interrupt the reentry pathways through the A-V node, and can restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT), including PSVT associated with Wolff-Parkinson-White Syndrome. Mechanism: pharmacodynamic synergism. Mechanism: pharmacodynamic synergism. US-based MDs, DOs, NPs and PAs in full-time patient practice can register for free on PDR.net. Use Caution/Monitor. Amlodipine; Benazepril: (Moderate) Use adenosine with caution in the presence of calcium-channel blockers due to the potential for additive or synergistic depressant effects on the sinoatrial and atrioventricular nodes. If you log out, you will be required to enter your username and password the next time you visit. [64934] An initial dose of 0.05 to 0.1 mg/kg IV, with the dose increased in 0.05 to 0.1 mg/kg increments, up to 0.3 mg/kg IV is FDA-approved. Do not store for later use.- Do not refrigerate- See package insert for detailed storage information- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees FAdenoscan:- Discard product if it contains particulate matter, is cloudy, or discolored- Discard unused portion. Adenosine will not effectively terminate atrioventricular node-independent tachycardias (e.g., atrial flutter, ectopic atrial tachycardia, atrial fibrillation). Mechanism: pharmacodynamic synergism. Levamlodipine: (Moderate) Use adenosine with caution in the presence of calcium-channel blockers due to the potential for additive or synergistic depressant effects on the sinoatrial and atrioventricular nodes. It is not known if adenosine is excreted into human milk. Minor (1)nebivolol, adenosine. adenosine, lily of the valley. In general, use adenosine use with caution in geriatric patients since this population may have a diminished cardiac function, nodal dysfunction, or concomitant diseases that may alter hemodynamic function and increase the risk of severe bradycardia or AV block. Minor (1)bisoprolol, adenosine. Consult cardiologist if considering treatment. Terms of Use. nadolol, adenosine. Mechanism: pharmacodynamic synergism. document.write(new Date().getFullYear()) PDR, LLC. Discontinue adenosine if a patient develops severe respiratory difficulties. Elevate extremity after administration. Most Use Caution/Monitor. Bradycardia. Adenosine is a potent peripheral vasodilator and can induce significant hypotension. Minor (1)labetalol, adenosine. Symptomatic treatment may be required. Minor/Significance Unknown. Minor/Significance Unknown. Minor (1)nadolol, adenosine. Bradycardia. The use of adenosine for myocardial perfusion imaging is contraindicated in patients with bronchoconstrictive or bronchospastic lung disease (e.g., asthma). Diltiazem: (Moderate) Use adenosine with caution in the presence of calcium-channel blockers due to the potential for additive or synergistic depressant effects on the sinoatrial and atrioventricular nodes. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Minor (1)betaxolol, adenosine. Minor/Significance Unknown. Bradycardia.

Minor/Significance Unknown.

[29325], 6 mg rapid IV/IO bolus followed immediately by a saline flush. Consider discontinuation of adenosine in a patient taking inotersen with a platelet count of less than 50,000 per microliter.

Telmisartan; Amlodipine: (Moderate) Use adenosine with caution in the presence of calcium-channel blockers due to the potential for additive or synergistic depressant effects on the sinoatrial and atrioventricular nodes. Otherwise, call a poison control center right away. nicotine intranasal increases effects of adenosine by unknown mechanism. Bradycardia. This process involves a specific transmembrane nucleoside carrier system that is reversible, nonconcentrative, and bidirectionally symmetrical. When possible, withhold dipyridamole for at least 5 half-lives before adenosine use for diagnostic imaging. Mechanism: pharmacodynamic synergism. Most Mechanism: pharmacodynamic synergism. The median effective dose was approximately 0.2 mg/kg in neonates and infants, leading some experts to recommend higher initial doses of 0.2 mg/kg/dose. provider for the most current information. Bradycardia. Minor (1)celiprolol, adenosine. Adenocard:- Discard product if it contains particulate matter, is cloudy, or discolored- Discard unused portion. When clinically advisable for PSVT, appropriate vagal maneuvers (eg, Valsalva maneuver), should be attempted prior to adenosine administration, Avoid use for cardiac nuclear stress tests in patients with signs or symptoms of acute myocardial ischemia (eg, unstable angina, cardiovascular instability); use may increase risk of fatal MI, Screen all nuclear stress test candidates for risks, Attach both syringes to IV injection port nearest to patient, Have adenosine in one port and NS flush in other port, Simply open stopcock to adenosine and push, Close stopcock and open port to NS and push, Eliminates possibility of adenosine traveling retrograde. Minor/Significance Unknown. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Avoid adenosine for cardioversion in patients with bronchoconstriction or acute bronchospasm (e.g., asthma). Nicardipine: (Moderate) Use adenosine with caution in the presence of calcium-channel blockers due to the potential for additive or synergistic depressant effects on the sinoatrial and atrioventricular nodes. 6 mg rapid IV/IO bolus followed immediately by a saline flush. Mechanism: pharmacodynamic synergism.

Bradycardia. Bradycardia. Minor/Significance Unknown. If necessary, give a second dose of 12 mg rapid IV/IO bolus followed by a saline flush. Minor (1)sotalol, adenosine. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients. Intraosseous AdministrationNOTE: Adenosine is not FDA-approved for intraosseous administration.During cardiopulmonary resuscitation, the same dosage of adenosine may be given via the intraosseous route when IV access is unsuccessful or not feasible. When used for supraventricular tachyarrhythmias in adults, reduce the initial adenosine dose to 3 mg. The effects of adenosine are antagonized by methylxanthines. Nifedipine: (Moderate) Use adenosine with caution in the presence of calcium-channel blockers due to the potential for additive or synergistic depressant effects on the sinoatrial and atrioventricular nodes. Mechanism: pharmacodynamic synergism. Intravenous injectionPrior to the administration of adenosine for paroxysmal supraventricular tachycardia (PSVT), attempt appropriate vagal maneuvers unless otherwise contraindicated.Administer undiluted by rapid intravenous bolus (over 1 to 2 seconds).Inject into the most proximal injection site or central venous line. The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents of long-term care facilities; adenosine is not typically given in the skilled care setting. Adenosine associated tachycardia and chest pain. Mechanism: pharmacodynamic synergism. Either increases toxicity of the other by pharmacodynamic synergism. While no special cautions are recommended when adenosine is used therapeutically to treat supraventricular tachycardia, it may be advisable for patients to avoid nicotine products or tobacco prior to electrophysiologic studies or stress testing where adenosine will be administered. Concomitant use has rarely been associated with ventricular fibrillation. Please confirm that you would like to log out of Medscape. Carbamazepine: (Major) Carbamazepine increases the degree of heart block produced by adenosine. When used for supraventricular tachyarrhythmias in adults, reduce the initial adenosine dose to 3 mg. Minor/Significance Unknown. Contact the applicable plan AV block / Early / 0.8-3.0myocardial infarction / Delayed / 0-1.0bradycardia / Rapid / 0-1.0ventricular fibrillation / Early / 0-1.0atrial fibrillation / Early / Incidence not knowncardiac arrest / Early / Incidence not knowntorsade de pointes / Rapid / Incidence not knownheart failure / Delayed / Incidence not knownasystole / Rapid / Incidence not knownventricular tachycardia / Early / Incidence not knownrespiratory arrest / Rapid / Incidence not knownbronchospasm / Rapid / Incidence not knownintracranial bleeding / Delayed / Incidence not knownseizures / Delayed / Incidence not knownstroke / Early / Incidence not known, dyspnea / Early / 12.0-28.0hypotension / Rapid / 0-2.0palpitations / Early / 0-1.0hypertension / Early / 0-1.0scotomata / Delayed / 0-1.0blurred vision / Early / 0-1.0chest pain (unspecified) / Early / Incidence not knownpremature ventricular contractions (PVCs) / Early / Incidence not knownsinus tachycardia / Rapid / Incidence not knownloss of consciousness / Rapid / Incidence not knowninfusion-related reactions / Rapid / Incidence not knownerythema / Early / Incidence not known, flushing / Rapid / 18.0-44.0headache / Early / 2.0-18.0dizziness / Early / 2.0-12.0nausea / Early / 3.0-3.0paresthesias / Delayed / 2.0-2.0diaphoresis / Early / 0-1.0cough / Delayed / 0-1.0urinary urgency / Early / 0-1.0nasal congestion / Early / 0-1.0xerostomia / Early / 0-1.0otalgia / Early / 0-1.0metallic taste / Early / 0-1.0emotional lability / Early / 0-1.0weakness / Early / 0-1.0back pain / Delayed / 0-1.0drowsiness / Early / 0-1.0tremor / Early / 0-1.0premature atrial contractions (PACs) / Early / Incidence not knownhyperventilation / Early / Incidence not knownvomiting / Early / Incidence not knowninjection site reaction / Rapid / Incidence not knownrash / Early / Incidence not known. Minor (1)pindolol, adenosine. commonly, these are "non-preferred" brand drugs. hawthorn increases effects of adenosine by pharmacodynamic synergism.

[52002] [52003] [56507] [56508], 0.1 mg/kg rapid IV/IO bolus followed immediately by a saline flush. Monitor Closely (1)sevelamer decreases levels of adenosine by increasing elimination. Not a Member? Olmesartan; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Use adenosine with caution in the presence of calcium-channel blockers due to the potential for additive or synergistic depressant effects on the sinoatrial and atrioventricular nodes.

Controlled studies in pregnant women show no evidence of fetal risk.

Adenosine is thought to exert its pharmacological effects through activation of purine receptors (cell-surface A1 and A2 adenosine receptors). Nicotine: (Major) Nicotine has been reported to enhance the cardiovascular effects of adenosine; an increase in angina-like chest pains, heart rate or a decrease in blood pressure may be noted. informational and educational purposes only. Minor/Significance Unknown. Use Caution/Monitor. Adenosine associated tachycardia and chest pain. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911.