regadenoson (Rx)

Brand and Other Names:Lexiscan
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

intravenous solution

  • 0.4mg/5mL

Pharmacologic Stress Agent

Indicated for radionuclide myocardial perfusion imaging (MPI) in patients unable to undergo adequate exercise stress

5 mL (0.4 mg) IVP

Administration

Administer as rapid (~10 sec) injection into a peripheral vein using 22 gauge or larger catheter or needle

Inspect visually, prior to admin, DO NOT administer if discolored or particulate matter present

Administer 5 mL saline flush, immediately after

Administer radionuclide myocardial perfusion imaging agent 10-20 sec after saline flush

  • Radionuclide may be injected directly into same catheter as regadenoson

Renal Impairment

No dose adjustment needed in renal impairment including patients end stage renal disease and/or dependent on dialysis

Safety and efficacy not established

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Interactions

Interaction Checker

and regadenoson

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (3)

              • caffeine

                caffeine decreases effects of regadenoson by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid methylxanthines for 12 hours before regadenoson administration.

              • dipyridamole

                dipyridamole, regadenoson. Mechanism: unspecified interaction mechanism. Contraindicated. Regadenoson's effects may be changed; mfr. recommends avoiding dipyridamole for 2 days prior to administration.

              • theophylline

                theophylline decreases effects of regadenoson by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid methylxanthines for 12 hours before regadenoson administration.

              Monitor Closely (0)

                Minor (0)

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                  Adverse Effects

                  >10%

                  Dyspnea (28%)

                  Headache (26%)

                  Rhythm conduction abnormalities (26%)

                  Flushing (16%)

                  PVCs (14%)

                  Chest Discomfort (13%)

                  Angina or ST segment depression (12%)

                  1-10%

                  Dizziness (8%)

                  Chest pain (7%)

                  PACs (7%)

                  Nausea (6%)

                  Ventricular conduction abnormalities (6%)

                  Abdominal discomfort (5%)

                  Dysgeusia (5%)

                  Feeling hot (5%)

                  First-degree AV block (3%)

                  <1%

                  Anaphylaxis, angioedema, cardiac arrest, respiratory arrest/distress, throat tightness, and urticaria/rashes, atrial fibrillation, seizures, cardiovascular accidents (stroke)

                  Postmarketing reports

                  Cardiovascular: Myocardial infarction, cardiac arrest, ventricular arrhythmias, supraventricular tachyarrhythmias including atrial fibrillation with rapid ventricular response (new-onset or recurrent), atrial flutter, heart block (including third-degree block), asystole, marked hypertension, symptomatic hypotension in association with transient ischemic attack, seizures and syncope

                  Central nervous system: Tremor, seizure, transient ischemic attack, and cerebrovascular accident including intracranial hemorrhage

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                  Warnings

                  Contraindications

                  2/3° AV block or sinus node dysfunction (unless patient has a functioning pacemaker installed)

                  Cautions

                  Appropriate bronchodilator therapy and resuscitative measures should be available prior to and following therapy; adhere to recommended duration of injection; longer injection times may increase duration and magnitude of increase in coronary blood flow

                  1° AV block

                  SA block

                  QT prolongation has occurred shortly after administration in postmarketing surveillence

                  Hypotension in association with transient ischemic attack, tremors, syncope, and seizures

                  Hypertension (transient) may occur following administration

                  Conduction disturbances; depresses SA and AV node conduction and may produce first, second, and third-degree heart block

                  Anaphylaxis, angioedema, cardiac or respiratory arrest, respiratory distress, decreased oxygen saturation, hypotension, throat tightness, urticaria and rashes have occurred

                  Adenosine receptor agonists may cause dyspnea, bronchoconstriction, and respiratory compromise; caution with asthma or bronchoconstrictive disease

                  Nucleoside transport inhibitors (eg, dipyridamole) and potentiate the vasoactive effects of regadenoson; withhold for 5 half-lives before regadenoson administration

                  Methylxanthines (eg, caffeine, theophylline) are adenosine receptor antagonists and inhibit regadenoson’s vasoactive effects; withhold methylxanthines for 5 half-lives before regadenoson administration

                  Aminophylline may increase risk of seizures associated with regadenoson injection

                  May lower seizure threshold; new-onset or recurrence of convulsive seizures has occurred following regadenoson injection; some seizures are prolonged and require emergent anticonvulsive management

                  Hemorrhagic and ischemic cerebrovascular accidents have occurred

                  New-onset or recurrent atrial fibrillation with rapid ventricular response and atrial flutter reported

                  Risk for myocardial infarction and death

                  • Avoid use for cardiac nuclear stress tests in patients with signs or symptoms of acute myocardial ischemia (eg, unstable angina, cardiovascular instability); use may increase risk of fatal MI
                  • Screen all nuclear stress test candidates for risks
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                  Pregnancy & Lactation

                  Pregnancy: No available data on therapy use in pregnant women to inform drug-associated risk; in animal reproduction studies, adverse developmental outcomes were observed with therapy administration to pregnant rats and rabbits during organogenesis only at doses that produced maternal toxicity

                  Lactation: There is no information on presence of regadenoson in human milk, effects on breastfed infant, or effects on milk production; because of potential risk of serious cardiac reactions in breastfed infant, advise nursing mother to pump and discard breast milk for 10 hr after therapy

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

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                  Pharmacology

                  Mechanism of Action

                  Low affinity agonist for the A2A adenosine receptor

                  Activation of the A2A adenosine receptor produces coronary vasodilation and increases coronary blood flow

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                  Images

                  BRAND FORM. UNIT PRICE PILL IMAGE
                  Lexiscan intravenous
                  -
                  0.4 mg/5 mL solution

                  Copyright © 2010 First DataBank, Inc.

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                  Patient Handout

                  Patient Education
                  regadenoson intravenous

                  NO MONOGRAPH AVAILABLE AT THIS TIME

                  USES: Consult your pharmacist.

                  HOW TO USE: Consult your pharmacist.

                  SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                  PRECAUTIONS: Consult your pharmacist.

                  DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                  OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                  NOTES: No monograph available at this time.

                  MISSED DOSE: Consult your pharmacist.

                  STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                  Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.

                  IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                  Formulary

                  FormularyPatient Discounts

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                  • Access your plan list on any device – mobile or desktop.

                  The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                  OR Other Restrictions
                  Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.