Adenosine (intravenous route)


    Brand Name

    US Brand Name

    Adenocard

    Adenoscan


    Description

    Adenosine injection is used in combination with Thallium-201 as a pharmacologic stress agent for myocardial perfusion scintigraphy in patients unable to undergo adequate exercise stress. This medicine works by dilating the arteries of the heart and increase blood flow to help identify coronary artery disease.

    This medicine is to be given only by or under the direct supervision of a doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of adenosine injection in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of adenosine injection in the elderly.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Aminophylline
    • Carbamazepine
    • Cobicistat
    • Darunavir
    • Dimenhydrinate
    • Dyphylline
    • Epinephrine
    • Inotersen
    • Pentoxifylline
    • Theophylline
    • Verapamil

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Dipyridamole

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Caffeine

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Angina, unstable or
    • Unstable heart or blood vessel problem (eg, cardiovascular instability)—Avoid use, as this medicine may increase the risk for heart attack.
    • Atrial fibrillation (heart rhythm problem), or history of or
    • Breathing problems or lung disease (eg, bronchitis, emphysema) or
    • Hypertension (high blood pressure) or
    • Hypotension (low blood pressure) or
    • Seizures or
    • Stroke, history of—Use with caution. May make these conditions worse.
    • Heart block, second or third degree (type of abnormal heart rhythm), without a pacemaker or
    • Sinus node disease (such as sick sinus syndrome), without a pacemaker—Should not be used in patients with these conditions, unless patients have a pacemaker that works.
    • Breathing problems or lung disease (eg, asthma)—Should not be used in patients with these conditions.
    • Heart or blood vessel disease (eg, coronary artery stenosis, ischemia, pericardial effusion, pericarditis) or
    • Heart valve disease or
    • Hypovolemia (low blood volume), uncorrected—May increase risk for more serious side effects.

    Proper Use

    A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed into one of your veins.


    Precautions

    It is very important that your doctor check your progress very closely while you are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it.

    Heart attack and death may occur after receiving this medicine. Make sure your doctor knows if you have any heart problems (eg, unstable angina or cardiovascular instability) before you have a heart stress test. Check with your doctor right away if you have chest pain or discomfort, nausea, pain or discomfort in arms, jaw, back or neck, sweating, or vomiting.

    Do not take anything that contains caffeine before you receive this medicine. This includes medicines, foods, and beverages with caffeine, such as coffee, tea, and cola drinks.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    More common

    • Chest discomfort
    • difficult or labored breathing
    • lightheadedness or dizziness
    • throat, neck, or jaw discomfort
    • tightness in the chest

    Less common

    • Chest pain
    • confusion
    • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
    • fainting
    • fast, slow, or irregular heartbeat
    • sweating
    • troubled breathing
    • unusual tiredness or weakness

    Rare

    • Fast, irregular, pounding, or racing heartbeat or pulse
    • headache
    • nervousness
    • pounding in the ears

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Diarrhea
    • feeling of warmth
    • indigestion
    • loss of appetite
    • nausea or vomiting
    • passing of gas
    • redness of the face, neck, arms, and occasionally, upper chest
    • stomach pain, fullness, or discomfort

    Rare

    • Area of decreased vision
    • cough
    • discomfort in the back, ears, or tongue
    • drowsiness
    • dry mouth
    • metallic taste
    • mood changes
    • shakiness in the legs, arms, hands, or feet
    • stuffy nose
    • trembling or shaking of the hands or feet

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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