From the Guidelines
For supraventricular tachycardia (SVT), the initial dose of adenosine is 6 mg given as a rapid IV push over 1-2 seconds, followed immediately by a saline flush, as recommended by the most recent guidelines 1. The dose is based on the patient's response to the initial dose, with a second dose of 12 mg given if the first dose does not terminate the SVT within 1-2 minutes.
- Key considerations for adenosine administration include:
- Rapid IV push administration to ensure efficacy
- Immediate saline flush to facilitate rapid distribution
- Potential for transient side effects, such as flushing, chest pain, and dyspnea
- Contraindications, including second or third-degree heart block, sick sinus syndrome without a pacemaker, and asthma or severe COPD
- The guidelines also recommend considering alternative treatments, such as vagal maneuvers or other antiarrhythmic agents, if adenosine is ineffective or contraindicated 1.
- It is essential to monitor the patient closely after adenosine administration, as the drug has a very short half-life and may require repeated doses or alternative treatments to maintain sinus rhythm.
- The most recent guidelines emphasize the importance of individualizing treatment based on patient-specific factors, such as medical history and current symptoms 1.
From the FDA Drug Label
The recommended adenosine injection dose is 0.14 mg/kg/min infused over six minutes (total dose of 0.84 mg/kg) Recommended dose is 0.14 mg/kg/min infused over six minutes as a continuous peripheral intravenous infusion (total dose of 0. 84 mg/kg)
The dose of adenosine for SVT (Supraventricular Tachycardia) is 6-12 mg, administered as a rapid intravenous bolus. However, the provided drug labels do not directly support this answer for the specific indication of SVT. The FDA drug label does not answer the question.
From the Research
Adenosine Dose for SVT
- The initial dose of adenosine for treating acute supraventricular tachycardia (SVT) is 6 mg given by rapid intravenous bolus injection, followed by up to two additional 12-mg boluses if necessary 2.
- In some cases, higher doses of adenosine may be effective in terminating SVT, such as 24 mg or 36 mg 3.
- The use of adenosine in the treatment of SVT is supported by several studies, which have shown its effectiveness in terminating the arrhythmia 4, 5, 2, 6.
- However, adenosine may cause adverse effects such as flushing, dyspnea, headache, cough, chest pain, sinus bradycardia, atrial fibrillation, ventricular arrhythmias, and various degrees of AV block 2, 6.
- The choice of adenosine versus other treatments, such as calcium channel antagonists, should be based on individual patient factors and the specific clinical situation 6.
Comparison with Other Treatments
- Adenosine and calcium channel antagonists, such as verapamil, are both effective treatments for SVT, but they have different side effect profiles 6.
- Adenosine may cause more minor adverse events, such as nausea and chest tightness, but it may also be more effective in certain situations 6.
- The use of adenosine versus other treatments should be guided by the specific clinical context and the individual patient's needs 4, 5.