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South Australian Neonatal Medication Guidelines 

Adenosine 
 6mg/2mL injection 

  Department for Health and Wellbeing, Government of South Australia. All rights reserved. 

 

INFORMAL COPY WHEN PRINTED  Page 1 of 3 

OFFICIAL 
 

Note:

This guideline provides advice of a general nature.  This statewide guideline has been prepared to promote and facilitate 
standardisation and consistency of practice, using a multidisciplinary approach.  The guideline is based on a review of 
published evidence and expert opinion.  

Information in this statewide guideline is current at the time of publication.  

SA Health does not accept responsibility for the quality or accuracy of material on websites linked from this site and does not 
sponsor, approve or endorse materials on such links. 

Health practitioners in the South Australian public health sector are expected to review specific details of each patient and 
professionally assess the applicability of the relevant guideline to that clinical situation. 

If for good clinical reasons, a decision is made to depart from the guideline, the responsible clinician must document in the 
patient s medical record, the decision made, by whom, and detailed reasons for the departure from the guideline. 

This statewide guideline does not address all the elements of clinical practice and assumes that the individual clinicians are 
responsible for discussing care with consumers in an environment that is culturally appropriate and which enables respectful 
confidential discussion. This includes: 

  The use of interpreter services where necessary, 
  Advising consumers of their choice and ensuring informed consent is obtained, 
  Providing care within scope of practice, meeting all legislative requirements and maintaining standards of 

professional conduct, and  
  Documenting all care in accordance with mandatory and local requirements 

 

This is a High Risk Medication  
An overdose can be rapidly fatal. 

 

Dose and Indications 

1mg = 1000micrograms 

Write all doses in micrograms 

To Revert Paroxysmal Supraventricular Tachycardia (SVT) 

Intravenous 

100micrograms/kg/dose initially, increasing by 50-100 micrograms/kg/dose increments (to a 

maximum of 300micrograms/kg/dose) every 1 to 2 minutes until return of sinus rhythm. 

? All SVT requires cardiologist consultation, but this should not delay emergency 

management  

? SVT not responsive to a dose of 300microg/kg, may be managed with larger doses of up 

to 500microg/kg or other antiarrhythmics after consultation with a paediatric cardiologist 

? SVT with shock will require prompt DC cardioversion if difficult vascular access delays 

adenosine administration 

 

 

 



South Australian Neonatal Medication Guidelines 

Adenosine 
 6mg/2mL injection 
 

 

 
INFORMAL COPY WHEN PRINTED  Page 2 of 3 

OFFICIAL 
 

 

Preparation and Administration 

Intravenous 

Withdraw 1mL(3mg) from a 6mg/2mL adenosine injection and add to 2mL of compatible fluid 

(total volume 3mL) and shake gently to mix. The resulting solution contains 

1000micrograms/mL adenosine. 

 

Dose 
100 

micrograms 

150 

micrograms 

200 

micrograms 

250 

micrograms 

300 

micrograms 

350 

micrograms 

Volume 0.1mL 0.15mL 0.2mL 0.25mL 0.3mL 0.35mL 

 

For small volumes (e.g., less than 0.5mL) dilute further with 1 to 2mL of sodium chloride 0.9% 

Solution must be clear at time of administration. 

Administer by rapid intravenous bolus followed by rapid 0.9% sodium chloride flush. Give by 

large peripheral vein or central vein, via the most proximal IV site possible. 

To administer: 

? Withdraw the dose required from the diluted solution above 

? Prime a three-way tap and short extension tube with 0.9% sodium chloride flush and leave 

connected 

? Attach adenosine dose syringe to other port on three-way tap 

? Administer adenosine by rapid IV injection over 1 to 2 seconds 

? Follow instantaneously with a rapid flush over 1 to 2 seconds of 3 - 5mL 0.9% sodium 

chloride via other port on three-way tap. 

Do not refrigerate, crystallisation will occur. 

Compatible Fluids 

Glucose 5%, sodium chloride 0.9% 

Adverse Effects 

Adverse effects resolve rapidly on stopping treatment due to its short duration of action. 

Common 

Flushing, dyspnoea 

Infrequent 

Transient arrhythmias, hypotension 

 



South Australian Neonatal Medication Guidelines 

Adenosine 
 6mg/2mL injection 
 

 

 
INFORMAL COPY WHEN PRINTED  Page 3 of 3 

OFFICIAL 
 

 

Monitoring 

? Adenosine should only be used when facilities for cardiac monitoring and cardiorespiratory 

resuscitation exist. 

? Continuous electrocardiogram (ECG) is required during administration 

? Blood pressure 

Practice Points 

? Caffeine diminishes adenosine s affect by competitive antagonism. Larger doses may be 

required in patients receiving caffeine 

? Doses must be given by rapid intravenous push. Inject dose as close to intravenous site 

as possible with sufficient flush volume to ensure the bolus dose is administered to patient 

(and not still contained in the line) 

? Adenosine has a very short duration of effect (half-life of less than 10 seconds) making it 

necessary to give this agent as a rapid bolus 

? Diluting the ampoule assists with drawing up an accurate dose.  

 

Document Ownership &amp; History 

Developed by: SA Maternal, Neonatal &amp; Gynaecology Community of Practice 

Contact: Health.NeoMed@sa.gov.au 

Endorsed by:  Commissioning and Performance, SA Health 

Next review due:   28/03/2027 

ISBN number:  978-1-76083-495-1 

CGSQ reference:  NMG 016 

Policy history: Is this a new policy (V1)?  N 

 Does this policy amend or update and existing policy?   Y 

 If so, which version? V 2.0 

 Does this policy replace another policy with a different title?  N 

 If so, which policy (title)? 

 

Approval 
Date 

Version 
Who approved New/Revised 
Version 

Reason for Change 

28/3/2022  V3.0 
Domain Custodian, Clinical 
Governance, Safety and Quality 

Formal Review 

4/2017  V2.0 
SA Health Safety and Quality Strategic 
Governance Committee 

Complete review 

11/2012  V1.0 
SA Maternal &amp; Neonatal Clinical 
Network  

Original SA Maternal &amp; Neonatal 
Clinical Network approved version. 

 
 
 



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