Adenosine

ADENOCARD

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Adenosine ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Adenosine ballicule

Adenosine ADENOCARD mascot mnemonic cartoon — Visual mnemonic: Adenosine mascot
**“A dino sign”**

What it isEndogenous purine nucleoside acting at A1 to A3 receptors; IV bolus for supraventricular tachycardia.

Why this oneSeconds-long half-life allows transient AV block to terminate re-entrant SVT, then vanish.

What limits itGive it fast into a large vein with a flush, and warn the patient about the brief sense of doom. Dipyridamole potentiates it; theophylline blocks it.

Adenosine molecular structure (skeletal formula) — Molecular structure: Adenosine

Principal riskA brief but severe sense of doom; theophylline blocks it

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Sedation liability0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

FDA label

Read the full label on DailyMed ↗

NO BOXED WARNINGS

FDA dosing	Population	Start	Target	Max
Paroxysmal supraventricular tachycardia (conversion)	Adult	6 mg rapid IV bolus	If no response in 1–2 min, 12 mg rapid IV bolus; may repeat 12 mg once	12 mg per dose
Paroxysmal supraventricular tachycardia (conversion)	Pediatric <50 kg	0.05–0.1 mg/kg rapid IV bolus	Increase by 0.05–0.1 mg/kg each repeat until sinus rhythm	0.3 mg/kg single dose
Paroxysmal supraventricular tachycardia (conversion)	Pediatric ≥50 kg	Adult dose (6 mg)	12 mg if needed	12 mg per dose

Renal Undefined

Hepatic Undefined

Doses greater than 12 mg are not recommended for adult or pediatric patients.

Instructions

For rapid bolus IV use only, over 1–2 seconds.
Give directly into a vein or into an IV line as close to the patient as possible, followed by a rapid saline flush.
Inspect for particulate matter and discoloration before use.

Available strengths

inj 3 mg/mL (6 mg/2 mL · 12 mg/4 mL)

Contraindications

Second- or third-degree A-V block (unless functioning pacemaker)
Sinus node disease — sick sinus syndrome or symptomatic bradycardia (unless functioning pacemaker)

Cautions

Prolonged asystole, ventricular tachycardia/fibrillation, and Torsade de Pointes reported.
Bronchospasm — caution in obstructive lung disease.
Transient new arrhythmias/heart block at the time of conversion.
Seizure activity and loss of consciousness reported.

Adverse reactions

Facial flushing (18%)
Shortness of breath/dyspnea (12%)
Chest pressure (7%)
Nausea (3%)
Headache, lightheadedness/dizziness
Chest pain, hypotension

Pregnancy No animal or human studies; as a naturally occurring substance fetal effects not anticipated, but use during pregnancy only if clearly needed (former Category C).

Lactation Undefined

Cost

Adenosine (ADENOCARD)

Strength		#/mo	generic $/unit	CostPlus
3 mg/mL	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Adenosine is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

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Self-check

How long is adenosine’s half-life?
Seconds.
Which drug blocks adenosine’s effect?
Theophylline.