regadenoson: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
regadenoson: clinical details
Prescribing considerations
- Diagnostic use in adults only; administer in a medical facility with continuous ECG capability, frequent vital-sign assessment and resuscitation resources.
- Review recent myocardial infarction or active ischaemic symptoms, blood-pressure control, volume status, atrial fibrillation or flutter, long-QT syndrome and seizure risk.
- Use caution in asthma, COPD or suspected bronchoconstrictive disease; bronchodilator therapy and resuscitative measures should be available.
- Review methylxanthines, dipyridamole and medicines that lower seizure threshold before the procedure.
- Aminophylline can attenuate severe or persistent reactions but should not be used solely to terminate a regadenoson-induced seizure.
Contraindications and cautions
- Hypersensitivity to regadenoson or an excipient
- Second- or third-degree AV block or sinus-node dysfunction without a functioning pacemaker
- Unstabilised unstable angina
- Severe hypotension
- Decompensated heart failure
Monitoring
- Monitor ECG, heart rate and blood pressure until they return to the patient's pre-administration state.
- Observe for myocardial ischaemia, conduction disturbance, clinically significant blood-pressure change, bronchoconstriction, hypersensitivity, neurological events and seizures.
- Keep the patient sitting or lying during early monitoring and ensure trained staff and resuscitation equipment are immediately available.
Clinical pharmacology
Regadenoson is a relatively selective, low-affinity A2A adenosine-receptor agonist that produces rapid, short-lived coronary hyperaemia. Its concentration-time profile is multiphasic; elimination is substantially renal, with much excreted unchanged.
Formulation and product differences
- The selected UK product is a clear, colourless solution for intravenous injection in a single-use glass vial.
- Excipients include phosphate salts, propylene glycol, disodium edetate and water for injections.
- Do not mix with other medicines where compatibility has not been established; inspect for particles or discolouration before use.
regadenoson preparations and strengths
Injection
Route: Parenteral
Strengths: 400 micrograms
regadenoson interactions
The procedure team should review all medicines, drinks and supplements beforehand. Important interactions include:
Caffeine and other methylxanthines
They block adenosine receptors and can reduce the vasodilator effect, potentially impairing the diagnostic test.
Theophylline or aminophylline
These can oppose regadenoson's effect; aminophylline may also worsen or prolong a regadenoson-associated seizure.
Dipyridamole
It raises adenosine concentrations and may alter or intensify the response.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.