ADENOSINE

OTHER NAME(S):

Acide 5'-adénylique, Adenine Nucleoside, Adénine Nucléoside, Adenine Riboside, Adénine Riboside, Adenosina, Adénosine, Adenosine Phosphate, Adenosine 5'-Triphosphate Disodium, Adenosine; Adenosine Monophosphate (AMP), Adénosine Monophosphate (AMP); Adenosine-5-monophosphate (A5MP), Adénosine-5-monophosphate (A5MP); Adenosine Diphosphate (ADP), Adénosine Diphosphate (ADP); Adenosine Triphosphate (ATP), Phosphate d'Adénosine.

Overview

Overview Information

Adenosine is a chemical that is present in all human cells. People also use it for medicine. Adenosine comes in three different forms: adenosine, adenosine monophosphate (AMP), and adenosine triphosphate (ATP).

Adenosine is used as a prescription-only drug for a heart condition marked by episodes of rapid heart rate (paroxysmal supraventricular tachycardia). Adenosine, AMP, or ATP are also used for involuntary weight loss in people who are very ill, leg sores caused by weak blood circulation, male-pattern baldness, athletic performance, and many other conditions, but there is no good evidence to support most of these uses.

How does it work?

Adenosine blocks faulty circuitry in the heart, which causes irregular heart rhythm. Adenosine triphosphate (ATP) might prevent changes in energy metabolism that cause weight loss in people with advanced cancer.

Uses

Uses & Effectiveness?

Likely Effective for

  • A heart condition marked by episodes of rapid heart rate (paroxysmal supraventricular tachycardia). Adenosine is used as a prescription-only intravenous medicine to treat certain kinds of irregular heartbeat.

Possibly Effective for

  • Involuntary weight loss in people who are very ill (cachexia or wasting syndrome). Intravenous ATP seems to improve appetite, food intake, and quality of life in people with advanced non-small-cell lung cancer and other tumors.
  • Leg sores caused by weak blood circulation (venous leg ulcer). Intramuscular AMP might relieve fluid retention, itchiness, swelling and redness due to venous stasis ulcers.

Possibly Ineffective for

  • Pain after surgery. Giving adenosine by injection after surgery doesn't seem to reduce pain or the use of pain medication.
  • Nausea and vomiting after surgery. Giving adenosine by injection after surgery doesn't seem to reduce nausea or vomiting.

Insufficient Evidence for

  • Male-pattern baldness (androgenic alopecia). Early research shows that applying a solution of adenosine to the scalp two times daily for 6 months doesn't improve hair growth.
  • Athletic performance. Early research shows that taking ATP by mouth daily for 2 weeks can help healthy young men to maintain muscle strength for longer while sprinting.
  • Cold sores (herpes labialis). Early research shows that AMP given by injection into the muscle might help treat cold sores.
  • Shingles (herpes zoster). Early research shows that AMP given by injection into the muscle might be effective for treating shingles and preventing the nerve pain from shingles.
  • Lung cancer. Early research shows that ATP does not help to treat non-small-cell lung cancer.
  • Nerve pain. Early research shows that injecting adenosine into the space around the spinal cord might improve nerve pain.
  • A blood disorder called porphyria cutanea tarda.
  • A painful condition that affects the joints (bursitis).
  • Controlling blood pressure during anesthesia and surgery.
  • Cystic fibrosis.
  • Erectile dysfunction (ED).
  • High blood pressure in arteries in the lungs (pulmonary hypertension).
  • Itchiness.
  • Kidney failure.
  • Lung cancer.
  • Multiple sclerosis (MS).
  • Organ failure, including kidney failure.
  • Pain and swollen tendons (tendonitis).
  • Surgical pain.
  • Other conditions.
More evidence is needed to rate the effectiveness of adenosine for these uses.

Side Effects

Side Effects & Safety

Adenosine is LIKELY SAFE for most people when given by intravenous (IV) injection by qualified healthcare providers. This form of adenosine is approved by the U.S. Food and Drug Administration (FDA). Adenosine triphosphate (ATP) is POSSIBLY SAFE when given by injection by qualified healthcare providers. Adenosine monophosphate (AMP) is POSSIBLY SAFE when given by intramuscular injection (IM) by qualified healthcare providers. Injections of adenosine can cause breathing problems and chest pain, especially when given at high doses. Adenosine can also cause headache, heart pounding, low blood pressure, nausea, sweating, flushing, lightheadedness, sleep problems, coughing, and anxiety.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Not enough is known about the use of adenosine during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Gout: ATP can raise the level of uric acid in the blood stream and in the urine. This might trigger a case of gout. Gout causes red, hot, tender, swollen joints. The joint that is most often affected is at the base of the big toe.

Heart disease: ATP can cause reduced blood flow to the heart and chest pain. It might worsen symptoms in patients with heart diseases such as chest pain and heart attack.

Interactions

Interactions?

Major Interaction

Do not take this combination

!
  • Dipyridamole (Persantine) interacts with ADENOSINE

    The body breaks down adenosine to get rid of it. Dipyridamole (Persantine) can decrease the break down of adenosine. Decreasing the breakdown of adenosine can cause heart problems. Do not take adenosine if you are taking dipyridamole (Persantine).

Moderate Interaction

Be cautious with this combination

!
  • Carbamazepine (Tegretol) interacts with ADENOSINE

    Adenosine can slow down the heart beat. Taking carbamazepine (Tegretol) with adenosine might cause the heart to beat too slowly. Do not take adenosine if you are taking carbamazepine (Tegretol).

Minor Interaction

Be watchful with this combination

!
  • Medications for gout (Antigout drugs) interacts with ADENOSINE

    Gout is caused by a build-up of uric acid crystals in the joints. Adenosine can increase uric acid in the body and might reduce the effectiveness of medications for gout.
    Some medications for gout include allopurinol (Zyloprim), colchicine, probenecid (Benemid), and others.

  • Methylxanthines interacts with ADENOSINE

    Methylxanthines might block the affects of adenosine. Adenosine is often used by doctors to do a test on the heart. This test is called a cardiac stress test. Stop drinking black tea or other caffeine containing products at least 24 hours before a cardiac stress test.
    Methylxanthines include aminophylline, caffeine, and theophylline.

Dosing

Dosing

The following doses have been studied in scientific research:

ADULTS

BY IV:

  • For a heart condition marked by episodes of rapid heart rate (paroxysmal supraventricular tachycardia): Healthcare providers give adenosine by IV. A dose of 6 mg is given over 1-2 seconds. If this is not effective within 1-2 minutes, 12 mg can be given and repeated once if necessary.
  • For involuntary weight loss in people who are very ill (cachexia or wasting syndrome): Healthcare providers give ATP by IV at a dose of up to 75 mcg/kg per minute over 30 hours. This dose is given every 2-4 weeks for up to 28 weeks.
AS A SHOT:
  • For leg sores caused by weak blood circulation (venous leg ulcer): Healthcare providers give AMP as a shot. To start, the shot is given at a dosage of 25 mg once or twice weekly. Then 25 mg two to three times weekly can be given.

View References

REFERENCES:

  • Agteresch HJ, Dagnelie PC, Rietveld T, et al. Pharmacokinetics of intravenous ATP in cancer patients. Eur J Clin Pharmacol 2000;56:49-55.. View abstract.
  • Agteresch HJ, Dagnelie PC, van den Berg JW, Wilson JH. Adenosine triphosphate: established and potential clinical applications. Drugs 1999;58:211-32.. View abstract.
  • Agteresch HJ, Dagnelie PC, van der Gaast A, et al. Randomized clinical trial of adenosine 5'-triphosphate in patients with advanced non-small-cell lung cancer. J Natl Cancer Inst 2000;92:321-8.. View abstract.
  • Agteresch HJ, Rietveld T, Kerkhofs LG, et al. Beneficial effects of adenosine triphosphate on nutritional status in advanced lung cancer patients: a randomized clinical trial. J Clin Oncol 2002;20:371-8.. View abstract.
  • Aqel RA, Zoghbi GJ, Trimm JR, et al. Effect of caffeine administered intravenously on intracoronary-administered adenosine-induced coronary hemodynamics in patients with coronary artery disease. Am J Cardiol 2004;93:343-6. View abstract.
  • Eisenach JC, Curry R, Hood DD. Dose response of intrathecal adenosine in experimental pain and allodynia. Anesthesiology 2002;97:938-42.. View abstract.
  • Faghihi G, Iraji F, Rajaee Harandi M, et al. Comparison of the efficacy of topical minoxidil 5% and adenosine 0.75% solutions on male androgenic alopecia and measuring patient satisfaction rate. Acta Dermatovenerol Croat 2013;21(3):155-9. View abstract.
  • Haskell CM, Mendoza E, Pisters KM, et al. Phase II study of intravenous adenosine 5'-triphosphate in patients with previously untreated stage IIIB and stage IV non-small cell lung cancer. Invest New Drugs 1998;16:81-5.. View abstract.
  • Haskell CM, Wong M, Williams A, Lee LY. Phase I trial of extracellular adenosine 5'-triphosphate in patients with advanced cancer. Med Pediatr Oncol 1996;27:165-73.. View abstract.
  • Jatoi A, Loprinzi CL. Adenosine triphosphate: does it help cancer patients "get bigger and stronger"? J Clin Oncol 2002;20:362-3. View abstract.
  • Jin X, Mi W. Adenosine for postoperative analgesia: A systematic review and meta-analysis. PLoS One. 2017 Mar 23;12(3):e0173518. View abstract.
  • Kichenin K, Seman M. Chronic oral administration of ATP modulates nucleoside transport and purine metabolism in rats. J Pharmacol Exp Ther 2000;294:126-33.. View abstract.
  • Leij-Halfwerk S, Agteresch HJ, Sijens PE, Dagnelie PC. Adenosine triphosphate infusion increases liver energy status in advanced lung cancer patients: an in vivo 31P magnetic resonance spectroscopy study. Hepatology 2002;35:421-4.. View abstract.
  • Litmann L, Anderson JD, Monroe MH. Adenosine and Aggrenox: A hazardous combination. Ann Intern Med 2002;137:E-76. View abstract.
  • Neuzillet Y, Hupertan V, Cour F, et al. A randomized, double-blind, crossover, placebo-controlled comparative clinical trial of arginine aspartate plus adenosine monophosphate for the intermittent treatment of male erectile dysfunction. Andrology 2013;1(2):223-8. View abstract.
  • Purpura M, Rathmacher JA, Sharp MH, et al. Oral Adenosine-5'-triphosphate (ATP) Administration Increases Postexercise ATP Levels, Muscle Excitability, and Athletic Performance Following a Repeated Sprint Bout. J Am Coll Nutr. 2017 Mar-Apr;36(3):177-183. View abstract.
  • Sherlock CH, Corey L. Adenosine monophosphate for the treatment of varicella zoster infections: a large dose of caution. JAMA 1985;253:1444-5.
  • Sklar SH, Alexander EJ, Blue WT, Bodian CA. Herpes zoster: adenosine monophosphate for the prevention of post-neuralgia. JAMA 1985;254:912.
  • Sklar SH, Blue WT, Alexander EJ, Bodian CA. Herpes zoster. The treatment and prevention of neuralgia with adenosine monophosphate. JAMA 1985;253:1427-30.. View abstract.
  • Sklar SH, Buimovici-Klein E. Adenosine in the treatment of recurrent herpes labialis. Oral Surg Oral Med Oral Pathol 1979;48:416-7.. View abstract.
  • Underwood DA. Which medications should be held before a pharmacologic or exercise stress test? Cleve Clin J Med 2002;69:449-50. View abstract.
  • Williams M, Jarvis MF. Purinergic and pyrimidinergic receptors as potential drug targets. Biochem Pharmacol 2000;59:1173-85.. View abstract.

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

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