Who can administer
Administration RESTRICTED - see Appendix 1
Important information
- See monitoring requirements (below and overleaf)
- AdenoSCAN is only to be used in the Cardiac Angio laboratory
- While both preparations (AdenoCOR and AdenoSCAN) contain the same concentration of drug, they are licensed for different indications. See under ' dose' for more information
- Adenoscan is an unlicensed preparation in Ireland
Available preparations
AdenoCOR 6mg per 2mL vial
Adenosine 6mg per 2mL vial (Focus pharmaceuticals) - unlicensed preparation- stocked while licensed (AdenoCOR) version is in short supply (June 2023)
AdenoSCAN 30mg per 10mL vial
Reconstitution
Already in solution
Infusion fluids
Not required - product ready for use
Methods of intravenous administration
Intravenous bolus (for all uses except for cardiac angio)
- Using AdenoCOR, give as a rapid IV bolus over 2 seconds
- Inject as proximally as possible and follow with a rapid flush of Sodium chloride 0.9%
Intermittent intravenous infusion (in cardiac angio only)(administer using an electronically controlled infusion device)
- Using AdenoSCAN, administer undiluted, at a rate of 140microgram/kg/minute for six minutes.
- Give the radionuclide into a separate venous site, after the first 3 minutes of the Adenoscan infusion
Dose in adults
AdenoCOR
First dose
- Give 3mg, over two seconds, directly into a vein or an IV line, using the most proximal line available.
- Inject as proximally as possible and follow with a rapid flush of Sodium chloride 0.9%
- See under 'Further information' overleaf re dose adjustments required if patient is on dipyridamole
Subsequent doses
- If first dose of 3mg is ineffective within one to two minutes, a further 6mg dose should be given as a rapid IV bolus
- If the second dose is ineffective within one to two minutes, a further 12mg dose should be given as a rapid IV bolus
- Additional or higher doses are not recommended
- Patients who develop high-level AV block at a particular dose should not be given further dosage increments
AdenoSCAN for Cardiac Angio only (use undiluted)
- Administer 140microgram/kg/minute for six minutes using an infusion pump (give the radionuclide into a separate venous site, after the first three minutes of the Adenoscan infusion)
- Care should be taken if the patient is currently receiving dipyridamole - see under 'further information' overleaf
-
| Dose of 140mcg/kg/MINUTE using Adenoscan 30mg/10ml solution- rate in ml/HOUR |
| Weight |
50 |
55 |
60 |
65 |
70 |
75 |
80 |
85 |
90 |
95 |
100 |
105 |
110 |
115 |
120 |
125 |
| Rate (ml/HOUR) |
140 |
154 |
168 |
182 |
196 |
210 |
224 |
238 |
252 |
266 |
280 |
294 |
308 |
322 |
336 |
350 |
Monitoring
- Heart rate and blood pressure should be monitored very closely
- Monitor respiratory rate
- For AdenoSCAN: to avoid an adenosine bolus effect, blood pressure should be measured in arm opposite infusion
- Continuous ECG monitoring is essential during adenosine administration
- Cardiorespiratory resuscitation equipment must be available for immediate use
Further information
- Dipyridamole may markedly potentiate the action of adenosine, and therefore concomitant use should be avoided if possible
- If dipyridamole cannot be discontinued at least 24 hours before the adenosine (longer for Dipyridamole Slow Release formulations), the initial adenosine dose should be greatly reduced. (reduced about four-fold)(ref 1)
- Aminophylline, theophylline and other xanthines can inhibit the effect of adenosine and should be avoided for 24 hours prior to use of adenosine
- Food and drinks containing xanthines (tea, coffee, chocolate and cola) should be avoided for at least 12 hours prior to use of Adenosine.
Storage
- Store below 250C
- Do not refrigerate
References
Adenocor SPC May 2015
Adenoscan UK SPC 11th August 2021
1. Stockley's Drug interactions - checked online 2nd December 2021
Therapeutic classification
Drugs for arrhythmias
