Paroxysmal supraventricular tachycardia: Treatment of paroxysmal supraventricular tachycardia; when clinically advisable, appropriate vagal maneuvers should be attempted prior to adenosine administration.
Note: Not effective for conversion of atrial fibrillation, atrial flutter, or ventricular tachycardia.
- hypersensitivity to adenosine or any component of the formulation
- second- or third-degree AV block, sick sinus syndrome, or symptomatic bradycardia (except in patients with a functioning artificial pacemaker)
- known or suspected bronchoconstrictive or bronchospastic lung disease, asthma.
Adult
Note: Recommended for hemodynamically stable patients who do not respond to vagal maneuvers or for hemodynamically unstable patients. Preparations should be made for synchronized direct-current cardioversion in case adenosine is ineffective.
IV: Initial: 6 mg over 1 to 2 seconds via a peripheral line, followed immediately by a 20 mL NS flush (Note: Initial dose should be reduced to 3 mg if administered via a central line or when administered by any route to patients with a heart transplant); if initial dose is not effective within 1 to 2 minutes, administer 12 mg using the same procedures; may repeat a second 12 mg dose if needed
Pediatric
Hemodynamically unstable:
Infants, Children, and Adolescents: Rapid IV, Intraosseous: Initial: 0.1 mg/kg (maximum initial dose: 6 mg/dose); if not effective, increase to 0.2 mg/kg (maximum dose: 12 mg/dose); follow each bolus with NS flush.
Hemodynamically stable:
Infants, Children, and Adolescents <50 kg: Rapid IV: : Initial dose: 0.05 to 0.1 mg/kg via peripheral or central line; maximum initial dose: 6 mg/dose; if not effective within 1 to 2 minutes, increase dose by 0.05 to 0.1 mg/kg increments every 1 to 2 minutes to a maximum single dose of 0.3 mg/kg or 12 mg (whichever is less) or until termination of paroxysmal supraventricular tachycardia (PSVT); follow each bolus with NS flush.
Children and Adolescents ≥50 kg: Rapid IV: Initial: 6 mg via peripheral line, if not effective within 1 to 2 minutes, 12 mg may be given; may repeat 12 mg bolus if needed; follow each bolus with NS flush.
IV: For rapid IV bolus use; administer IV push over 1 to 2 seconds at a peripheral IV site as proximal as possible to trunk (not in lower arm, hand, lower leg, or foot); immediately after each bolus, administer a rapid NS flush (20 mL). Use of 2 syringes (one with adenosine dose and the other with NS flush) connected to a T-connector or stopcock is recommended. Alternatively, if no stopcock is available or the patient only has a single-port IV, prepare a single syringe with adenosine 6 mg and 18 mL of NS and administer at a peripheral IV site.
Solution, Intravenous: 6 mg/2 mL (2 mL) vial
- Cardiovascular:
- Cardiac arrhythmia (transient and new arrhythmia after cardioversion; eg, atrial premature contractions, atrial fibrillation, premature ventricular contractions; 55%)
- Chest pressure (and discomfort; 7% to 40%)
- Atrioventricular block (infusion 6%; third-degree <1%)
- Depression of ST segment on ECG (3%)
- Hypotension (<1% to 2%)
- Central nervous system:
- Headache (2% to 18%)
- Dizziness (≤12%)
- Nervousness (2%)
- Paresthesia (≤2%)
- Numbness (1%)
- Dermatologic:
- Facial flushing (18% to 44%)
- Diaphoresis (<1%)
- Gastrointestinal:
- Gastrointestinal distress (13%)
- Nausea (3%)
- Neuromuscular & skeletal:
- Neck discomfort (includes throat, jaw; <1% to 15%)
- Upper extremity discomfort (≤4%)
- Respiratory:
- Dyspnea (12% to 28%)
- Hyperventilation (<1%)
