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ADENOSINE 3 MG/ML SOLUTION FOR INJECTION

Active substance(s): ADENOSINE

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Product Name:
Adenosine 3mg/ml
Type of Packaging:
PACKAGE INSERT
Material number:
M0xxxxx/xx UK/IE
Pharma-Code (Laetus)
x
Dimension:
180 x 588 mm 2 Seiten

Territory:

UK/IE
Dosage:

Colour:
BLACK
DIE CUT

1. Draft
02.07. 2015 08.20 Uhr
1. Correction 24.07. 2015 06.10 Uhr
2. Correction 27.07. 2015 08.26 Uhr

Variable Data:

2-D-Matrix Code
M0xxxxx/xx UK/IE
EAN
Code: x
Font:

Interstate

Smallest Size: 8 Pt.

Operator: Christian Nagy +43(0) 34 52 72266-22

PACKAGE LEAFLET: INFORMATION FOR THE USER

Adenosine 3 mg/ml solution for
injection in pre-filled syringe

Read all of this leaflet carefully before you start
using this medicine because it contains important
information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or

nurse.
- If you get any side effects, talk to your doctor or

nurse. This includes any possible side effects not

listed in this leaflet. See section 4.
What is in this leaflet
1. What Adenosine is and what it is used for
2. What you need to know before you use Adenosine
3. How to use Adenosine
4. Possible side effects
5. How to store Adenosine
6. Contents of the pack and other information
1. What Adenosine is and what it is used for
Adenosine contains a medicine called adenosine. This
belongs to a group of medicines called ’antiarrhythmics’.
Adenosine works by slowing down electrical impulses
between the upper and lower chambers of the heart. This
slows the fast or uneven heartbeats called ’arrhythmias’.
Adenosine is used in adults:
• During a test. This is to help doctors find out what

type of arrhythmia (uneven heartbeat) you have
• To bring your heart beat back to normal if you have

a type of arrhythmia called ‘paroxysmal

supraventricular tachycardia (SVT)’ or ‘Wolff-

Parkinson-White Syndrome’.
2. What you need to know before you use Adenosine
Do not use Adenosine if:
- you are allergic to adenosine or any of the other

ingredients of this medicine (listed in section 6).

Signs of an allergic reaction include: a rash,

swallowing or breathing problems, swelling of your

lips, face, throat or tongue
- you have problems with your heart rhythm and

do not have a pacemaker (second or third degree

atrioventricular block, sick sinus syndrome)
- you have very low blood pressure (severe

hypotension)
- you have asthma or any other severe breathing

problem
- you have a type of heart failure where your heart is

not pumping out enough blood
- you have been told you have ‘Long QT syndrome’.

This is a rare heart problem that can lead to a fast

heart beat and fainting
Do not have this medicine if any of the above applies
to you. If you are not sure, talk to your doctor, nurse or
pharmacist before you are given Adenosine.
Warnings and precautions
Talk to your doctor or nurse before using Adenosine
if you have:
- low blood volume (hypovolaemia) which is not

corrected by medicines
- narrowing of the left main artery supplying blood to

your heart (left main coronary stenosis)
- been told that you have a heart problem whereby

the electrical impulses in parts of your heart take

longer than normal to discharge and then recharge

(prolonged QT interval)
- narrowing of the main arteries in the neck (carotid

artery). This means that not enough blood is getting

to the brain (cerebrovascular insufficiency)
- heart disease due to narrowing of your heart valves

(stenotic valvular heart disease)
- a left-right shunt in your heart. This will mean blood

goes directly from the left side of your heart to the

right side
- problems with a part of your nervous system called

the ‘autonomic nervous system’
- inflammation of the membrane surrounding your

heart (pericarditis) or a build-up of fluid around your

heart (pericardial effusion)
- had severe heart failure
- had a recent heart attack or if you have had a heart

transplant in the last year
- any minor problem with your heart (first degree

AtrioVentricular block or bundle branch block). These

conditions may be temporarily aggravated when you

are given adenosine.
- an unusual heart rhythm, for example your heartbeat

is very fast or uneven (atrial fibrillation or atrial

flutter) and in particular if you have a condition where

your heart has abnormal electrical activity

(‘accessory conduction pathway’)
- difficulty in breathing (bronchospasm)
- ever had fits or convulsions
If you get a very slow heartbeat (severe bradycardia),
respiratory failure, a heart problem that can be fatal
(asystole), severe chest pains (angina) or very low blood
pressure (severe hypotension), then treatment with
adenosine should be stopped.
If you are not sure if any of the above applies to you, talk
to your doctor or nurse before being given Adenosine.
Other medicines and Adenosine
Tell your doctor or nurse if you are using, have recently
used or might use any other medicines, including
medicines obtained without a prescription.
This is because adenosine can affect the way some other
medicines work. Also some medicines can affect the way
adenosine works.
In particular, check with your doctor, nurse or pharmacist
if you are taking any of the following:
• Dipyridamole (a medicine used to thin the blood).

Make sure your doctor knows you are taking

dipyridamole. Your doctor may decide you should

not have Adenosine or may tell you to stop taking

dipyridamole 24 hours before you are given

Adenosine or may need to give you a lower dose of

Adenosine
• Aminophylline or theophylline (medicines used to

help breathing). Your doctor may tell you to stop

taking it 24 hours before you are given Adenosine
• Caffeine (sometimes found in headache medicines)
Adenosine with food and drink
Food and drinks containing caffeine such as tea, coffee,
chocolate and cola should be avoided for at least 12 hours
before you are given Adenosine.
Pregnancy, breast-feeding and fertility
Talk to your doctor or nurse before having this medicine
if:
• You are pregnant, might become pregnant, or think

that you may be pregnant. You should not be given

Adenosine if you are pregnant or think you may be

pregnant, unless clearly necessary
• You are breast-feeding. You should not be given

Adenosine if you are breast-feeding

If you are pregnant or breast-feeding, think you

may be pregnant or are planning to have a baby, ask

your doctor or pharmacist for advice before taking

this medicine.
Adenosine contains sodium
Adenosine contains 3.54 mg sodium per ml (3.54 mg/
1 ml pre-filled syringe, 7.08 mg/2 ml pre-filled syringe and
14.16 mg/4ml pre-filled syringe).
This should be taken into consideration by patients on a
controlled sodium diet.

3. How to use Adenosine
How Adenosine is given
Adenosine is a medicine for use in hospitals
It will be given to you by a doctor or nurse as an injection
into your vein
Your heart and blood pressure will be closely monitored
How much Adenosine is given
If you are not sure why you are being given Adenosine or
have any questions about how much Adenosine is being
given to you, speak to your doctor, nurse or pharmacist.
Adults
• The first dose is 3mg given over 2 seconds. This is

given by rapid injection into your vein
• If the first dose does not bring your heart beat to

normal then you will be given a second dose. The

second dose is 6 mg given as a rapid injection
• If the second dose does not bring your heart beat to

normal then you will be given a third dose: The third

dose is 12mg given as a rapid injection
• You should not have any more doses after the 12mg

dose
Infants and Children
These pre-filled syringes are not suitable for
administration of small volumes required for children.
Older people
See recommended dose for adults.
If you are given more Adenosine than you should
As this medicine is given to you by a doctor or nurse it
is unlikely that you will be given too much. Your doctor
will carefully work out how much Adenosine you should
be given.
If you have more of this medicine than you should, the
following effects may happen:
• Very low blood pressure (severe hypotension)
• Slow heartbeat (bradycardia)
• A heart problem (asystole)
Your doctor will be monitoring your heart throughout the
procedure.
As the length of time adenosine stays in the blood is very
short, any side effects of too much Adenosine would
quickly stop when the injection is stopped. Sometimes you
may need an injection of a medicine called aminophylline
or theophylline to help with any side effects.
If you have any further questions on the use of this
medicine, ask your doctor or nurse.
4. Possible side effects
Like all medicines, this medicine can cause side effects,
although not everybody gets them.
While you are being given Adenosine you may have some
of the following side effects.
If any of the following side effects get worse, tell your
doctor or nurse and they may stop the injection:
The side effects normally settle within seconds or
minutes after the injection is finished but you should tell
your doctor or nurse if any of them happen.
Very common (may affect more than 1 in 10 people)
• Reddening of skin with a feeling of heat (flushing)
• Slow heartbeat (bradycardia)
• Skipped heart beats or extra heart beats
• A heart problem called an atrioventricular block

where the heart starts to beat slowly
• Severe heart problems which can be fatal (asystole)

or uneven heartbeat
• Shortness of breath or the urge to breathe deeply

(dyspnoea)
• Chest pain or pressure on the chest
Common (may affect up to 1 in 10 people)
• Feeling dizzy or light-headed
• Feeling sick (nausea)
• Headache
• Unusual skin sensations such as burning
• Feeling nervous
Uncommon (may affect up to 1 in 100 people)
• Blurred vision
• Being aware of your heartbeat or feeling it ‘racing’

(palpitations)
• Metallic taste in your mouth
• Breathing more quickly or more deeply than normal

(hyperventilation)
• Feeling pressure in your head, or weighed down

feeling in your arms
• Feeling of general discomfort, weakness or pain
• Sweating
Very rare (may affect up to 1 in 10,000 people)
• Severe breathlessness or problems in breathing
• Redness, pain or swelling at the site of injection
• Feeling uncomfortable during the injection
• Worsening of high blood pressure that affects the

brain (intracranial hypertension)
• Very slow, fast or uneven heartbeats
• Severe bradycardia (very slow heartbeat)
Not known (frequency cannot be estimated from the
available data) loss of consciousness or fainting
• Fits (convulsions)
• Feeling sick (vomiting)
• Low blood pressure
• Your heart does not work properly to circulate blood

around your body (cardiac arrest). This can be fatal.
• Your lungs do not work
• Stopping breathing (respiratory arrest)
• Allergic reaction (including rapid swelling and skin

reactions such as urticaria and rash)
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist
or nurse. This includes any possible side effects not listed
in this leaflet. You can also report side effects directly;
For UK - Via the Yellow Card Scheme at:
www.mhra.gov.uk/yellowcard
For Ireland – Via;
HPRA Pharmacovigilance
Earlsfort Terrace
IRL - Dublin 2
Tel: +353 1 6764971
Fax: +353 1 6762517
Website: www.hpra.ie
e-mail: medsafety@hpra.ie
By reporting side effects you can help provide more
information on the safety of this medicine.
5. How to store Adenosine
This medicine will be kept by your doctor, nurse or
pharmacist in a safe place where children cannot see or
reach it.
Keep this medicine out of the sight and reach of children.
Do not use this medicine, after the expiry date which is
stated on the carton. The expiry date refers to the last
day of that month.
Adenosine should not be refrigerated.
The product is for single use only and should be used
straight away after opening. Any portion of the pre-filled
syringe not used at once should be disposed of.
Adenosine should not be used if your doctor or nurse
notice any particles in the solution or any discolouration
before they give you the medicine.
If the appearance of the medicine has changed, the prefilled syringe must be thrown away.
Do not throw away any medicines via wastewater or
household waste. Your doctor and nurse will throw away
medicines you no longer use. These measures will help
protect the environment.

M0xxxxx/xx UK/IE
V001

6. Contents of the pack and other information
What Adenosine contains
• The active substance is adenosine. . Each 1 ml single

dose pre-filled syringe contains 3 mg of adenosine.

Each 2 ml single dose pre-filled syringe contains

6 mg of adenosine. Each 4 ml single dose

pre-filled syringe contains 12 mg of adenosine. The

other ingredients are: sodium chloride and water for

injections.

10 pre-filled syringes

5 ml plastic pre-filled syringe containing 2 ml (6 mg/2 ml)
closed with a halobutyl tip cap
Packs containing:
1 pre-filled syringe
6 pre-filled syringes
10 pre-filled syringes

What Adenosine looks like and contents of the pack
Adenosine is a clear, colourless solution for injection.
Adenosine is supplied as packs containing 1, 6 or 10 prefilled syringes.

5 ml plastic pre-filled syringe containing 4 ml (12 mg/4
ml) closed with a halobutyl tip cap
Packs containing:
1 pre-filled syringe
6 pre-filled syringes
10 pre-filled syringes

Not all pack sizes may be marketed.

Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Special precautions for disposal
Do not use if any particles or discolouration are noticed
in the solution.
Any unused medicinal product or waste material should
be disposed of in accordance with local requirements.

Marketing Authorisation Holder
Fresenius Kabi Limited
Cestrian Court,
Eastgate Way,
Manor Park,
Runcorn,
Cheshire,
WA7 1NT
UK

Instructions for use of pre-filled syringe:
When using the 5 ml pre-filled syringe containing 4 ml
(12 mg adenosine/4 ml) to administer only a 6 mg dose,
2 ml must be first discarded from the syringe before
administering the remaining 2 ml to the patient.

Manufacturer
Fresenius Kabi Austria GmbH
Hafnerstrasse 36,
8055 Graz,
Austria
This medicinal product is authorised in the Member
States of the EEA under the following names:
Belgium






Denmark
Italy
Ireland



Netherlands






Norway






Poland
Portugal
Spain






Unithed
Kingdom

Adenosine Fresenius Kabi 3 mg/ml,
oplossing voor injectie in een
voorgevulde spuit
Adenosin Fresenius Kabi
Adenosina Kabi
Adenosine 3 mg/ml solution for
injection in pre-filled syringe
Adenosine Fresenius Kabi 3 mg/ml,
oplossing voor injectie in een
voorgevulde spuit
Adenosin Fresenius Kabi 3 mg/ml
injeksjonsvæske,
oppløsning
i
ferdigfylt sprøyte
Adenosine Kabi
Adenosina Kabi
Adenosina Kabi 3mg/ml solución
inyectable
en
jeringa
precargada
Adenosine 3 mg/ml solution for
injection in pre-filled syringe

Use Aseptic Technique

1. Remove tip cap

This leaflet was last revised in July/2015
-----------------------------------------------------------------------
The following information is intended for healthcare
professionals only:
Adenosine3 mg/ml solution for injection in pre-filled
syringe
Please refer to the Summary of Product Characteristics
(SmPC) for further details on this product.

2. Hold plunger and push barrel forward to relieve any
resistance that may be present.

Qualitative and quantitative composition
1 ml solution contains 3 mg of adenosine.
Each 1 ml single dose pre-filled syringe contains 3 mg of
adenosine.
Each 2 ml single dose pre-filled syringe contains 6 mg of
adenosine.
Each 4 ml single dose pre-filled syringe contains 12 mg
of adenosine.
For the full list of excipients, see section 6.1.
Pharmaceutical form
Solution for injection in pre-filled syringe
Therapeutic indications
Rapid conversion to a normal sinus rhythm of paroxysmal
supraventricular tachycardias, including those associated
with accessory by-pass tracts (Wolff-Parkinson-White
Syndrome).
Diagnostic Indications
Aid to diagnosis of broad or narrow complex
supraventricular tachycardias. Although Adenosine will
not convert atrial flutter, atrial fibrillation or ventricular
tachycardia to sinus rhythm, the slowing of AV conduction
helps diagnosis of atrial activity.
Sensitisation of
investigations.

intra-cavitary

electrophysiological

Posology and method of administration
Adenosine is intended for hospital use only with
monitoring
and
cardiorespiratory
resuscitation
equipment available for immediate use.
Adenosine should only be used when facilities exist for
cardiac monitoring. Patients who develop high-level AV
block at a particular dose should not be given further
dosage increments.
Posology
Adult:
Initial dose: 3mg given as a rapid intravenous bolus (over
2 seconds).
Second dose: If the first dose does not result in elimination
of the supraventricular tachycardia within 1 to 2 minutes,
6mg should be given also as a rapid intravenous bolus.
Third dose: If the second dose does not result in
elimination of the supraventricular tachycardia within
1 to 2 minutes. 12mg should be given also as a rapid
intravenous bolus.
Additional or higher doses are not recommended.
Paediatric population
These pre-filled syringes are not suitable for paediatric
use.
Elderly
See dosage recommendations for adults.
Diagnostic dose
The above ascending dosage schedule should be
employed until sufficient diagnostic information has
been obtained.
Method of administration: Adenosine should be
administered by rapid intravenous (IV) bolus injection
into a vein or into an IV line. If given into an IV line it
should be injected through as proximally as possible, and
followed by a rapid saline flush. If administered through
a peripheral vein, a large bore cannula should be used.
Pharmaceutical particulars
List of excipients
Sodium chloride
Water for injections
Incompatibilities
In the absence of compatibility studies, this medicinal
product must not be mixed with other medicinal products.
Shelf life
24 months.
The product should be used immediately after opening.
Special precautions for storage
Do not refrigerate.
Nature and contents of container
1 ml plastic pre-filled syringe containing 1 ml (3mg/1ml),
closed with a halobutyl tip cap
Packs containing:
1 pre-filled syringe
6 pre-filled syringes

3. Pull the barrel down until air is expelled from the
syringe.

Expand view ⇕

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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