adenosine at a glance
Medicine class
Antiarrhythmic and coronary vasodilator.
Administration
Given into a vein by a trained healthcare professional.
Clinical setting
Hospital use with continuous heart monitoring and resuscitation facilities available.
Duration of effects
Effects begin and wear off very quickly because adenosine is rapidly removed from the blood.
What is adenosine used for?
Selected products are licensed for different hospital uses:
Rapid conversion of paroxysmal supraventricular tachycardia to sinus rhythm in adults and children.
Helping diagnose broad- or narrow-complex supraventricular tachycardias and supporting intracardiac electrophysiology investigations.
As a coronary vasodilator with radionuclide myocardial perfusion imaging in adults unable to exercise adequately or for whom exercise is inappropriate.
How does adenosine work?
Adenosine briefly slows conduction through the atrioventricular node. This can interrupt certain re-entry circuits causing supraventricular tachycardia and reveal atrial activity on an ECG. It also activates receptors in blood vessels, causing coronary vasodilation for perfusion imaging.
adenosine preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 30 mg/10 mL
Injection
Route: Parenteral
Strengths: 3 mg/mL
How to take adenosine
Adenosine is not taken at home. A healthcare professional gives an injection or infusion into a vein while monitoring the ECG, heart rate and blood pressure. Caffeine and other xanthines can reduce its effect, so follow hospital preparation instructions and disclose recently taken food, drinks and medicines.
The injection formulation is given rapidly into a vein or intravenous line.
The infusion formulation is given undiluted through a peripheral vein using an infusion pump.
Tell staff immediately if symptoms become difficult to tolerate.
adenosine side effects
Common or expected effects
- Chest pressure, discomfort or pain
- Flushing or feeling hot
- Shortness of breath or an urge to breathe deeply
- Headache, dizziness or light-headedness
- Temporary slowing, skipped beats or other rhythm changes
- Nausea or abdominal discomfort
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling and breathing difficulty
- Severe bronchospasm, respiratory failure or stopping breathing
- Severe low blood pressure, profound slowing of the heart or fainting
- Sustained or life-threatening arrhythmia, asystole or cardiac arrest
- Seizure
- Severe or persistent chest pain
adenosine in pregnancy
Information from pregnancy exposure is limited. Selected products are not recommended during pregnancy unless a clinician judges that expected benefit outweighs potential risk. Discuss pregnancy or possible pregnancy before administration.
adenosine while breastfeeding
It is unknown whether adenosine metabolites enter human milk. Selected product information states that these formulations should not be used during breastfeeding, so discuss breastfeeding with the clinical team before a planned test or treatment.
adenosine interactions
Tell the clinical team about all prescribed, non-prescription and caffeine-containing products before adenosine is given.
Dipyridamole
Reduces adenosine uptake and can substantially intensify or prolong cardiovascular effects; concomitant use is contraindicated for the selected infusion product.
Aminophylline, theophylline and other xanthines
Competitively oppose adenosine and may reduce or prevent the intended response.
Common questions about adenosine
Answers are fully visible for fast scanning and source review.
Why is adenosine given in hospital?
It can abruptly alter heart rhythm and blood pressure, so ECG monitoring, trained staff and resuscitation equipment must be immediately available.
How quickly does adenosine wear off?
Adenosine is removed from the blood within seconds, so most expected sensations settle rapidly after administration ends.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.