The following adverse reactions are discussed in more detail in other sections of the prescribing information:
6.1 Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
The following adverse reactions, with an incidence of at least 1%, were reported with adenosine injection among 1,421 patients in clinical trials. 11% of the adverse reactions occurred several hours after adenosine injection administration. 8% of the adverse reactions began with adenosine infusion and persisted for up to 24 hours.
The most common (incidence ≥10%) adverse reactions to adenosine injection are flushing, chest discomfort, shortness of breath, headache, throat, neck or jaw discomfort, gastrointestinal discomfort, and dizziness (Table 2).
Table 2 Adverse Reactions in Clinical Trials (Frequency ≥1%)Adverse Reactions | Adenosine Injection N=1,421 |
Flushing | 44% |
Chest discomfort | 40% |
Dyspnea | 28% |
Headache | 18% |
Throat, neck or jaw discomfort | 15% |
Gastrointestinal discomfort | 13% |
Lightheadedness/dizziness | 12% |
Upper extremity discomfort | 4% |
ST segment depression | 3% |
First-degree AV block | 3% |
Second-degree AV block | 3% |
Paresthesia | 2% |
Hypotension | 2% |
Nervousness | 2% |
Arrhythmias | 1% |
Adverse reactions to adenosine injection of any severity reported in less than 1% of patients include:
Body as a Whole: | back discomfort, lower extremity discomfort, weakness |
Cardiovascular System: | myocardial infarction, ventricular arrhythmia, third-degree AV block, bradycardia, palpitation, sinus exit block, sinus pause, T-wave changes, hypertension (systolic blood pressure > 200 mm Hg) |
Respiratory System: | cough |
Central nervous System: | drowsiness, emotional instability, tremors |
Genital/Urinary System: | Vaginal pressure, urgency |
Special Senses: | blurred vision, dry mouth, ear discomfort, metallic taste, nasal congestion, scotomas, tongue discomfort |
6.2 Post-Marketing Experience
The following adverse reactions have been reported from marketing experience with adenosine injection. Because these reactions are reported voluntarily from a population of uncertain size, are associated with concomitant diseases and multiple drug therapies and surgical procedures, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Cardiac Disorders: | cardiac arrest, atrial fibrillation, cardiac failure, myocardial infarction, tachycardia, ventricular arrhythmia |
Gastrointestinal Disorders: | nausea and vomiting |
General Disorders and Administration Site Conditions: | chest pain, injection site reaction, infusion site pain |
Immune System Disorders: | hypersensitivity |
Nervous System Disorders: | cerebrovascular accident including intracranial hemorrhage, seizure activity including tonic-clonic (grand mal) seizures, loss of consciousness |
Respiratory, Thoracic and Mediastinal Disorders: | bronchospasm, respiratory arrest, throat tightness |