Regadenoson (Intravenous)

Regadenoson a drug that is used as a pharmacologic stress agent in hospitalized patients undergoing MPI tests.

Overview

Regadenoson injection is used in patients who are undergoing myocardial perfusion imaging tests in hospital. This form of testing is used for patients who are not able to be assessed through exercise stress testing. The drug works by causing the arteries of the heart to dilate, increasing the flow of blood through the heart in order to highlight evidence of coronary heart diseases.

The drug is given intravenously, only in a hospital or clinic setting and under the direction of a trained medical professional. Regadenoson is not used in a home setting and can only be obtained by trained medical staff on a prescription from the patient's treating specialist.

In the US, regadenoson is known by the brand name, Lexiscan.

Conditions treated

  • coronary heart disease

Type of medicine

  • vasodilator
  • intravenous injection
  • solution

Side effects

In addition to the effects that are needed, some medication can cause unwanted side effects. Not all the effects mentioned here will affect every patient, but if they do occur, further medical attention may be required.

If you notice any of the effects listed below following treatment with this drug, you must notify your nurse or treating specialist immediately.

  • weakness or unusual tiredness
  • shaking or trembling of the hands or feet
  • tightness in the chest
  • sweating
  • rash
  • itchy skin
  • hives
  • swollen eyelids, puffiness around the eyes, tongue, face, and lips
  • nausea
  • large, hive-like swelling on the face, hands, legs, tongue, eyelids, lips, throat, feet, or genitals
  • recurrent fast, or irregular heartbeat
  • fainting
  • lightheadedness, dizziness, or faintness, when rising suddenly from a lying or seated position
  • difficulty swallowing
  • difficult or labored breathing
  • confusion
  • chest pain or discomfort
  • pain in the jaw, arm, or back

Alert your nurse or doctor immediately if you notice any of the following symptoms, as these could indicate that you have overdosed:

  • redness of the upper chest, face, neck, and arms
  • increased heart rate
  • feeling of warmth
  • dizziness

Many of the side effects shown in the following bulleted list will not need further medical treatment. These effects will disappear during your treatment as your body gets used to the medicine. Your nurse or doctor may also be able to give you some helpful advice on how to mitigate the effects or prevent them from occurring altogether. If any of the effects are particularly annoying or are very slow to clear, have a chat with your nurse or treating physician:

  • stomach soreness or discomfort
  • muscle aches or cramps
  • loss of taste
  • joint pain
  • headache
  • difficulty moving
  • diarrhea
  • change in taste

If you notice any other side effects after being treated with Regadenoson, you must mention them to your treating physician or nurse.

Dosage

You will only be given this medicine when you are in a hospital or clinic setting, undergoing tests for coronary heart disease.

A doctor or other trained health professional will administer the drug through a cannula placed into one of your peripheral veins. A large catheter or 22 gauge needle will be used to deliver 0.4 mg of the solution over a rapid duration of approximately 10 seconds. Immediately following administration of regadenoson you will receive a 5ml saline flush.

Interactions

There are a number of medicines that should never be used together under any circumstances, because dangerous interactions may occur. However, in some circumstances, your doctor may decide that to use two or more medicines at the same time may be the best way to treat your health condition. To avoid an interaction, your GP may change the dose of some of the medicines you are taking, alter the frequency of the doses, or give you advice on other precautions that you can take.

It is not usually advisable to use regadenoson with any of the following medications. If both drugs are used together, your treating physician may change the dose of one or could discontinue one drug until after your treatment with regadenoson.

  • Theophylline
  • Pentoxifylline
  • Dyphylline
  • Dimenhydrinate
  • Aminophylline

Some drugs should not be used at the same time as you are eating or consuming particular food groups, as this could cause an interaction. In addition, using tobacco or alcohol with certain drugs can precipitate undesirable interactions. It is not recommended that you use caffeine while you are being treated with regadenoson.

Warnings

When you decide to agree to the use of a particular medication as part of your treatment or testing program, you should first weigh up the benefits of using the drug against the risks of doing so. Discuss the implications of being treated with regadenoson with your treating medical team before you are admitted to hospital to undergo tests for coronary heart disease.

If you have ever experienced an allergic reaction when being treated previously with this drug or to any other prescription medication, you must tell your doctor before you begin your course of treatment or tests. You must also mention any bad reactions you have had to particular food groups, food dyes, preservatives, or animal products. Your list of allergens should include over the counter products too, including cough and cold remedies, vitamins, and herbal preparations.

Although there are no studies to show that treatment with regadenoson causes specific issues in geriatric patients, elderly people may be more likely to have blood pressure problems. This may mean that extra caution should be exercised when using this drug in the treatment of elderly patients.

There is no evidence to suggest that using regadenoson in pregnant women poses any risk to the fetus. Nonetheless, you should mention to your doctor if you think you may be pregnant or if you are planning on becoming so during the course of your testing for coronary heart disease. It may be advisable to wait until after your treatment has been successfully completed before attempting to get pregnant.

It is not clear whether regadenoson can get into a mother's milk. However, if you are breastfeeding, you should consider the potential risks against the benefits of being treated with this drug. It may be advisable to find another way feeding your infant until your treatment with regadenoson has ended, and your midwife or GP will advise you further on this.

There are some existing and historical health conditions that can affect the use of regadenoson. Be sure to tell your GP if you have any other medical issues, especially the following:

  • unstable heart problems
  • unstable blood vessel problems
  • unstable angina

Regadenoson must not be used in patients with these conditions, as this medication can increase the danger of a heart attack.

Using regadenoson in patients with any of the following health conditions can make them worse and should, therefore, be used with caution:

Regadenoson must never be used in patients with the following conditions unless they have a fully functioning pacemaker:

  • second or third-degree heart block, without a pacemaker
  • sinus node dysfunction, without a pacemaker

Using regadenoson in patients who have the following conditions can increase the risk of serious side effects:

  • coronary artery stenosis, ischemia, pericarditis
  • heart valve disease
  • hypovolemia

During the course of your treatment with regadenoson, you must attend your GP regularly for progress checks. These visits are important, as they allow your GP to make sure that the treatment is effective.

Some people can suffer serious allergic reactions when they receive treatment with regadenoson. One such allergy is called anaphylaxis. This is a potentially life-threatening condition that must always be treated as an emergency. If you begin to notice any of the following symptoms within a few minutes of receiving regadenoson, you must notify your nurse or another member of your treating medical team immediately:

  • itching
  • rash
  • rapid heartbeat
  • lightheadedness
  • breathing problems
  • trouble swallowing
  • swelling of throat, mouth, face, or hands
  • chest pain

Regadenoson can result in the patient suffering a stroke or a heart attack, which could prove fatal. You must tell your treating physician if you have a history of heart problems, in particular, cardiovascular instability or unstable angina, before you undergo a heart stress test. If you begin to experience chest pains, discomfort in your jaw, back, arms, or neck, sweating, nausea, or vomiting, you must tell your nurse or doctor immediately.

If you are already taking dipyridamole (Persantine®), you must tell your GP before you go into hospital for your coronary heart disease tests. It may be necessary for you to stop using this medicine at least two days prior to testing.

Tell your doctor or nurse if you are currently taking aminophylline or theophylline before you receive treatment with regadenoson. You may be told to stop using these medicines for a minimum of 12 hours prior to your tests.

For the 12 hours preceding your tests when you will be treated with regadenoson, you must not eat or drink anything that contains caffeine.

Storage

Regadenoson should be stored at room temperature. The solution is not suitable for freezing or refrigeration. Keep the solution out of direct sunlight and away from heat sources.

Before the medication is used, it should be visually inspected to ensure that no particulate matter is present. Any solution that has particles floating in it or that appears discolored should not be used.

Summary

Regadenoson intravenous injection is used in myocardial perfusion imaging (MPI) tests in patients who are being tested for coronary heart disease. The testing is carried out in a hospital or clinic setting, always by a trained medical professional. MPI testing is typically carried out on patients who are unable to under exercise stress testing.

There are a number of existing and historical health conditions, particularly those relating to heart abnormalities that may be adversely affected by regadenoson. In addition, there is a range of medication that could cause an adverse interaction if used at the same time as regadenoson. For these reasons, you must always make full disclosure of your existing and historical medical conditions and drug use, including over the counter products.

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Last Reviewed:
January 31, 2018
Last Updated:
April 05, 2018
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