Clinical medicine profile
Adenosine
Adenosine Receptor Agonist [EPC]
- Route
- See product SmPC
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Second- or third-degree AV block and sick sinus syndrome [unless pacemaker fitted]
- long QT syndrome
- severe hypotension
- decompensated heart failure
- chronic obstructive lung disease [including asthma].
Precautions
- Monitor ECG and have resuscitation facilities available
- atrial fibrillation or flutter with accessory pathway [conduction down anomalous pathway may increase]
- first-degree AV block
- bundle branch block
- left main coronary artery stenosis
- uncorrected hypovolaemia
- stenotic valvular heart disease
- left to right shunt
- pericarditis
- pericardial effusion
- autonomic dysfunction
- stenotic carotid artery disease with cerebrovascular insufficiency
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
By rapid intravenous injection into central or large peripheral vein, 6 mg over 2 seconds with cardiac monitoring; if necessary followed by 12 mg after 12 minutes, and then by 12 mg after a further 12 minutes; increments should not be given if high level AV block develops at any particular dose. Important: Patients with a heart transplant are very sensitive to effects of adenosine and should receive initial dose of 3 mg over 2 seconds, followed if necessary by 6 mg after 12 minutes, and then by 12 mg after a further 12 minutes. Also, if essential to give with dipyridamole reduce adenosine dose to a quarter of the usual dose.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
N/A short bolus.
- CrCl 0–120: See renal_dose_adjustment; confirm product SmPC.
Caution severe asthma.
Use, effects & interactions
Indications
- Rapid reversion to sinus rhythm of paroxysmal supraventricular tachycardias, including those associated with accessory conducting pathways (e.g.
- Wolff-Parkinson-White syndrome)
- aid to diagnosis of broad or narrow complex supraventricular tachycardias.
Adverse effects
- arrhythmia [discontinue if asystole or severe bradycardia occur], sinus pause, AV block, flushing, angina [discontinue], dizziness
- dyspnoea
- headache
- less commonly metallic taste
- palpitation, hyperventilation, weakness, blurred vision, sweating
- very rarely transient worsening of intracranial hypertension, bronchospasm, injection-site reactions
- also reported vomiting, syncope, hypotension [discontinue if severe], cardiac arrest, respiratory failure [discontinue], and convulsions.
Drug interactions
Open multi-drug checker ↗- Patients with a heart transplant are very sensitive to effects of adenosine and should receive initial dose of 3 mg over 2 seconds, followed if necessary by 6 mg after 1–2 minutes, and then by 12 mg after a further 1–2 minutes.
- Also, if essential to give with dipyridamole reduce adenosine dose to a quarter of the usual dose.
- Treatment of choice for terminating paroxysmal supraventricular tachycardia,
Mechanism & disposition
Slows conduction through AV node and interrupts AV reentry pathways.
Read complete mechanism
Slows conduction through AV node and interrupts AV reentry pathways. Mechanism is agent-specific. At receptor, enzyme, ion channel, transporter or microbial target level, the drug alters a physiological or pathological pathway to produce its therapeutic effect. Confirm precise molecular mechanism in current SmPC / pharmacology reference for this INN before high-stakes decisions.
Product-specific
Product-specific
See product SmPC
are product-specific. Consider food effects, protein binding, hepatic CYP/UGT
when adjusting for organ impairment, age and drug interactions. Verify parameters in the current SmPC.
Pregnancy, lactation & diet
Use only if potential benefit justifies potential risk; prefer agents with better reproductive data when alternatives exist.
Assess infant risk vs benefit of maternal therapy; prefer agents with lactation data.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.