Adenosine Drug Interactions - Drug - Drug Interactions

Adenosine Drug Interactions

Adenosine + Dipyridamole

Dipyridamole markedly reduces the bolus dose of adenosine necessary to convert

supraventricular tachycardia to sinus rhythm (by about 4-fold). Profound bradycardia
occurred in a patient taking dipyridamole when an adenosine infusion was given for
myocardial stress testing.

The manufacturers advise the avoidance of adenosine in patients taking dipyridamole. If

adenosine must be used for supraventricular tachycardia in a patient taking dipyridamole,
use an initial bolus dose of 0.5 to 1 mg. If adenosine is considered necessary for
myocardial imaging in a patient taking dipyridamole, the dipyridamole should be stopped
24 hours before imaging, or the dose of adenosine should be greatly reduced. This may
be insufficient for extended-release dipyridamole preparations, and in this case it has
been suggested that the dipyridamole will need to be stopped several days before the test.

Adenosine + Theophylline

Theophylline can inhibit the effects of adenosine infusions used in conjunction with
radionuclide myocardial imaging. Theophylline may antagonise the effect of adenosine
when used to treat supraventricular arrhythmias.

Theophylline, aminophylline and other xanthines should be avoided for 24 hours before
using an adenosine infusion for radionuclide myocardial imaging. Adenosine bolus
injections for the termination of paroxysmal supraventricular tachycardia may still be
effective in patients taking xanthines. The usual dose schedule should be followed.
However, note that adenosine has induced bronchospasm and it has been suggested
that adenosine should be avoided in patients with asthma, and used cautiously in those
with obstructive pulmonary disease. Xanthines, such as intravenous aminophylline,
may be used to terminate any persistent adverse effects of adenosine infusions given for
myocardial imaging.

Refer: Stockley’s Drug Interactions

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