Name: ADENOSINE (AdenocardR)
Classification: Antiarrhythmic: 
  • produces short acting AV block to aid in the diagnosis of supraventricular tachycardias
  • may convert PSVT to sinus rhythm when verapamil is not effective or is contraindicated

Bolus Dose:

  • Administer each dose into a port as close to the patient as possible.
    Administer each dose undiluted by IV direct. Administer within 1-2 seconds.
  • After each IV direct dose, administer a 20 mL sodium chloride 0.9% flush. Administer the flush as quickly as possible.

First dose:

6 mg IV direct by rapid bolus

Second dose if no response within 1-2 minutes:
12 mg IV direct by rapid bolus

Third dose if no response within 1-2 minutes:
12 mg IV direct by rapid bolus

Maximum total dose of 30 mg.

Administration: IV Infusion:
  • not given by IV infusion
Adverse Effects:
  • cardiovascular
    • sinus bradycardia, sinus arrest, atrial fibrillation, AV block (usually < 1 minute)
    • hypotension
  • non-cardiovascular
    • flushing and dyspnea
    • headache, cough, malaise, or nausea usually lasting <1 minute due to very short half life
Drug Interactions:
  • adenosine + aminophylline/theophylline = decreased adenosine effect
  • adenosine + digoxin = bradycardias and increased AV blocks
  • adenosine + verapamil = bradycardias and increased AV blocks
  • adenosine + beta blockers = bradycardias and increased AV blocks
Monitoring Therapy:
  • continuous heart rate and cardiac rhythm
  • blood pressure
Adult Critical Care Protocol:
  • May be administered IV direct by an Adult Critical Care Nurse.
  • A physician must be present during administration.
  • This drug must be given by rapid BDC bolus.
  • Resuscitation equipment should be on hand.

Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: September 17, 2018

LHSCHealth Professionals

Last Updated September 20, 2018 | © 2007, LHSC, London Ontario Canada