Cardiurex 2ml Injection

Cardiurex 2ml Injection contains Adenosine 6mg/2ml, an antiarrhythmic medication primarily used to rapidly restore normal heart rhythm in specific types of fast heartbeats.

Benefits

Adenosine works by slowing electrical impulses through the heart's AV node, which helps to interrupt re-entry pathways causing abnormal rhythms. This action allows the heart to return to a normal sinus rhythm. It also serves as a diagnostic aid in identifying certain types of arrhythmias and in cardiac stress testing for patients unable to exercise adequately.

Uses and Indications

• Rapid conversion to normal sinus rhythm of paroxysmal supraventricular tachycardia (PSVT), including cases associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome).
• Aid in the diagnosis of broad or narrow QRS complex supraventricular tachycardias.
• Used as a pharmacologic stress agent for myocardial perfusion scintigraphy in patients unable to undergo adequate exercise stress.

The Cardiurex 2ml Injection contains:

• Adenosine 6mg/2ml (3mg/mL) (active ingredient).
• Sodium chloride 9 mg/mL in Water for Injection (excipients).

Dosage and Administration

Cardiurex 2ml Injection is for rapid bolus intravenous use only and should be administered by a healthcare professional in a hospital setting with cardiac monitoring equipment available.

1. Adults: The initial recommended dose is 6 mg given as a rapid intravenous bolus over 1 to 2 seconds.
2. Repeat Administration: If the first dose does not eliminate the supraventricular tachycardia within 1 to 2 minutes, a 12 mg rapid intravenous bolus may be given. This 12 mg dose can be repeated a second time if necessary.
3. Pediatric Patients: For children weighing less than 50 kg, the initial dose is 0.05 to 0.1 mg/kg (maximum 6 mg). If ineffective, doses can be increased by 0.05 to 0.1 mg/kg increments every 1 to 2 minutes, up to a maximum single dose of 0.3 mg/kg or 12 mg, whichever is less.
4. Saline Flush: Each bolus injection should be immediately followed by a rapid saline flush (e.g., 20 mL normal saline) to ensure the solution reaches the systemic circulation.
5. Administration Site: Administer the injection as close to the venous access as possible, preferably into a large vein in the right arm, and elevate the patient's arm for 10-20 seconds after administration.

Storage and Disposal

• Store at controlled room temperature, typically between 20° to 25°C (68° to 77°F), with excursions permitted between 15° and 30°C (59° and 86°F).
• Do not refrigerate, as crystallization may occur. If crystallization is observed, dissolve crystals by warming to room temperature.
• The solution must be clear and particle-free at the time of use.
• This product contains no preservatives; discard any unused portion immediately after opening.
• Dispose of according to local, state, and federal guidelines.

Precautions and Safety

• Cardiurex 2ml Injection is contraindicated in patients with second- or third-degree A-V block (unless a functioning artificial pacemaker is present), sick sinus syndrome, symptomatic bradycardia (unless a functioning artificial pacemaker is present), or known hypersensitivity to adenosine.
• Avoid use in patients with chronic obstructive lung disease (such as asthma) or bronchoconstriction/bronchospasm, as respiratory compromise may occur.
• Use with caution in patients with severe hypotension, decompensated heart failure, left main coronary stenosis, uncorrected hypovolaemia, stenotic valvular heart disease, left to right shunt, pericarditis, pericardial effusion, autonomic dysfunction, or stenotic carotid artery disease with cerebrovascular insufficiency.
• Methylxanthines (e.g., caffeine, theophylline) and aminophylline are competitive antagonists of adenosine and should be avoided for 24 hours prior to administration.
• Dipyridamole potentiates the effects of adenosine; if co-administration is essential, dipyridamole should be discontinued 24 hours beforehand, or the adenosine dose should be significantly reduced.
• Carbamazepine may increase the degree of heart block produced by adenosine.

Side Effects and Risks

• Common side effects include facial flushing (18%), shortness of breath/dyspnea (12%), chest pressure/discomfort (7%), headache (2%), lightheadedness (2%), dizziness, tingling in arms, numbness, nausea, sweating, palpitations, and hypotension.
• Serious, though rare, side effects can include severe allergic reactions (skin rash, itching, hives, swelling of face/lips/tongue/throat), severe bradycardia, asystole (heart stops pumping), AV block, cardiac arrest, respiratory arrest, wheezing, trouble breathing, convulsions, and coronary artery spasm.
• These effects are generally transient due to adenosine's very short half-life.

Disclaimer

Use this medicine only under the prescription and guidance of a qualified doctor or pharmacist.