This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo

Adenosine intravenous infusion 30mg/10ml

Updated 2 Feb 2023 | Supraventricular arrhythmias


Infusion of adenosine

Drugs List

  • ADENOSCAN 30mg/10ml intravenous infusion
  • adenosine 30mg/10ml intravenous infusion
  • Therapeutic Indications


    Coronary vasodilator in myocardial imaging where exercise inappropriate


    Monitor heart rate and blood pressure at 1 minute intervals. Measure blood pressure in the arm opposite to adenosine infusion.

    Adenosine should be administered following the same procedure as for exercise testing.

    Patients who develop high-level AV block at a particular dose should not be given further dosage increments.


    140 micrograms/kg/minute for 6 minutes (total dose 0.84 mg/kg) by continuous peripheral intravenous infusion using an infusion pump.

    To avoid adenosine bolus effect, use separate venous sites for adenosine and radionuclide, and inject radionuclide three minutes after start of adenosine infusion. The optimal vasodilator protocol is achieved with 6 minutes of adenosine infusion.

    Guide for adjustment of infusion rate of undiluted adenosine in line with body weight

    Patient weight : Infusion rate
    45 to 49 kg: 2.1 ml/minute
    50 to 54 kg: 2.3 ml/minute
    55 to 59 kg: 2.6 ml/minute
    60 to 64 kg: 2.8 ml/minute
    65 to 69 kg: 3.0 ml/minute
    70 to 74 kg: 3.3 ml/minute
    75 to 79 kg: 3.5 ml/minute
    80 to 84 kg: 3.8 ml/minute
    85 to 89 kg: 4.0 ml/minute
    90 to 94 kg: 4.2 ml/minute
    95 to 99 kg: 4.4 ml/minute
    100 to 104 kg: 4.7 ml/minute


    (See Dosage; Adult).


    For administration in its undiluted form as a continuous peripheral intravenous infusion using an infusion pump.

    This medication is for single use only. Use immediately after opening.


    Children under 18 years
    Family history of long QT syndrome
    Chronic obstructive pulmonary disease
    Decompensated cardiac failure
    Long QT syndrome
    Non-paced second degree atrioventricular block
    Non-paced sinus node dysfunction
    Non-paced third degree atrioventricular block
    Severe hypotension
    Unstable angina

    Precautions and Warnings

    Left-to-right cardiovascular shunt
    Predisposition to seizures
    Restricted sodium intake
    Atrial fibrillation
    Autonomic neuropathy
    Bundle branch block
    Cardiac failure
    Cerebral arteriosclerosis
    Cerebrovascular insufficiency
    First degree atrioventricular block
    Flutter with accessory pathway
    Heart transplant within 1 year
    History of seizures
    History of torsade de pointes
    Left main coronary artery stenosis
    Obstructive valvular heart disease
    Pericardial effusion
    Recent myocardial infarction

    Contains more than 1 mmol (23 mg) sodium per dose
    Correct hypovolaemia prior to administration
    Treatment to be initiated by specialist
    Resuscitation facilities must be immediately available
    Monitor cardiac function by ECG
    Monitor patients with first degree AV block
    May cause bronchospasm
    May cause convulsions
    Discontinue if bronchospasm or decreased respiratory function occur
    Discontinue if persistent or symptomatic hypotension occurs
    Discontinue if severe bradycardia occurs
    Discontinue if sustained second or third degree AV block occurs
    Discontinue treatment if angina appears or worsens
    Avoid food/drink containing xanthines for 24 hours prior to administration

    Life threatening arrhythmias may occur; monitor ECG continuously.

    Severe bradycardia has been reported. Some occurred in early post-transplant patients; in the other cases occult sino-atrial disease was present. Any occurrence of severe bradycardia should be taken as a warning of underlying disease and adenosine should be discontinued in these cases. Severe bradycardia would favour the occurrence of torsades de pointes, especially in patients with prolonged QT interval.

    Side effects are generally of short duration, however serious reactions can occur. Discontinuation of the infusion may be necessary if the effect is intolerable. Methylxanthines, such as intravenous aminophylline or theophylline have been used to terminate persistent side effects.

    If use of adenosine is considered essential, treatment with concomitant dipyridamole should be stopped 24 hours before administration of adenosine.

    Pregnancy and Lactation


    Use adenosine with caution in pregnancy.

    Animal studies are insufficient with respect to reproductive toxicity. In pregnant sheep, constant infusions and single injections of adenosine produced alterations in maternal heart rate and a decrease in diastolic pressure but no changes in maternal systolic pressure or arterial blood gases and had no effect on the foetal heart rate, arterial pressure or arterial blood gases.

    It is unknown whether adenosine can cause harm when administered to pregnant women. However, adenosine is an endogenous purine-based nucleotide found in all the cells of the body. Adenosine has a very short half life (less than ten seconds) and has to be administered intravenously. Briggs comments the maternal administration of large intravenous doses of adenosine may potentially produce foetal toxicity that has been observed with other endogenous agents (e.g. adrenaline). Schaefer states no specific foetal effects have been described so far, whether that pregnant women or the foetus is the patient. A number of reports have described the safe use of adenosine to treat maternal or foetal supraventricular tachycardia during all phases of gestation (Briggs, 2011). Schaefer (2007) comments that if a pregnant women is exposed to adenosine then it dose not necessitate termination of pregnancy. In the case of first trimester exposure, a detailed ultrasound should be offered. Adenosine is not recommended during pregnancy unless the physician considers the benefits to outweigh the potential risks.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Use adenosine with caution in breastfeeding.

    Adenosine is used only by intravenous injection in acute situations, therefore it is doubtful that any reports will be located describing the use of adenosine during breastfeeding. It is unknown whether adenosine metabolites are excreted in human milk, however due to its short half-life it is unlikely that any of the drug will pass into milk. The manufacturer states that adenosine should not be used during breastfeeding. Schaefer (2007) concludes that because of its extremely short half-life, and the very brief time for which it is used, adenosine should not be considered a cause for concern during breastfeeding. Weaning is not necessarily required.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Abdominal discomfort
    Atrial extrasystoles
    Atrial fibrillation
    Atrioventricular block
    Blurred vision
    Burning sensation
    Cardiac arrest
    Chest pain
    Discomfort in back
    Discomfort in limb
    Dry mouth
    Impaired consciousness
    Injection site reactions
    Intracranial hypertension
    Metallic taste
    Nasal congestion
    Neck and jaw discomfort
    Nipple discomfort
    Reflex tachycardia
    Respiratory arrest
    Respiratory failure
    Sensation of pressure
    Sinus pause
    Sinus tachycardia
    Skipped beat
    ST segment depression
    Throat discomfort
    Torsades de pointes
    Transient rhythm disturbances
    Urinary urgency
    Ventricular excitability disorders
    Ventricular extrasystoles
    Ventricular fibrillation
    Ventricular tachycardia


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: June 2014

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

    Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press Accessed on June 16th, 2014.

    Martindale: The Complete Drug Reference, 37th edition (2011) ed. Sweetman, S. Pharmaceutical Press, London.

    Summary of Product Characteristics: Adenoscan. Sanofi. Revised November 2013.

    Summary of Product Characteristics: Adenosine 30mg/10ml solution for infusion. Focus Pharmaceuticals Ltd. Revised April 2014.

    Summary of Product Characteristics: Adenosine 30mg/10ml solution for infusion. Wockhardt UK Ltd. Revised December 2012.

    Access the full UK drug database with a FREE Medscape UK Account
    It takes just a few minutes, and you’ll get unlimited access to information on over 11,000 UK drugs.
    Register for Free

    Already a member? Log in

    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

    FDB Logo

    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.