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Version control and change history 
 
Version Date from Date to Amendment 
1.0 Nov 2012 April 2017 Original version 
2.0 28 April 2017 Current Complete review 
    
    

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

 

Clinical Guideline 
Adenosine 
 
 
Policy developed by: SA Maternal &amp; Neonatal Clinical Community of Practice       
Approved by  
Safety &amp; Quality Strategic Governance Committee on:  28 April 2017 
Next review due:        30 April 2020 
 
 
 

  
 
 

Summary The purpose of the Adenosine Neonatal Medication Guideline is to 
guide nursing, medical and pharmacy staff in the dosing and 
administration of adenosine.  
 
 

Keywords Adenosine, neonatal medication guideline, supraventricular 
tachycardia, ECG, sinus rhythm, SVT, clinical guideline,  
Adenosine Neonatal Medication Guideline 
 

Policy history Is this a new policy?   N 
Does this policy amend or update an existing policy?  Y v1.0 
Does this policy replace an existing policy?  N 
If so, which policies?   
 

Applies to All Health Networks 
CALHN, SALHN, NALHN, CHSALHN, WCHN 
 

Staff impact All Clinical, Medical, Midwifery, Nursing,  Students, Allied Health, 
Emergency, Mental Health, Pathology, Pharmacy 
  

PDS reference CG005 
 

Neonatal Medication Guideline                                                             
 

 



South Australian Neonatal Medication Guidelines 

adenosine  
 6mg/2mL injection 

  Department of Health, Government of South Australia. All rights reserved 

 

ISBN number: 978-1-74243-374-5 
Endorsed by: South Australian Maternal, Neonatal &amp; Gynaecology Clinical Reference Group 
Last Revised: 27/04/2017 
Contact: South Australian Neonatal Medication Guidelines Workgroup at:         

 Health:NeoMed@sa.gov.au     Page 1 of 3 
 

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 2 minutes until return of sinus rhythm. 

Larger doses may be used after consultation with a paediatric cardiologist. 



South Australian Neonatal Medication Guidelines 

 adenosine 
 6mg/2mL injection 

ISBN number: 978-1-74243-374-5 
Endorsed by: South Australian Maternal, Neonatal &amp; Gynaecology Clinical Reference Group 
Last Revised: 27/04/2017 
Contact: South Australian Neonatal Medication Guidelines Workgroup at:         

 Health:NeoMed@sa.gov.au  Page 2 of 3 
 

Preparation and Administration 

Intravenous 

Withdraw 1mL from a 6mg/2mL adenosine injection and add 9mL of compatible fluid (total 

volume 10mL) and shake gently to mix. The resulting solution contains 300micrograms/mL. 

 

Dose 60 
micrograms 

90 
micrograms 

120 
micrograms 

150 
micrograms 

180 
micrograms 

Volume 0.2mL 0.3mL 0.4mL 0.5mL 0.6mL 

 

For small volumes dilute with 1 to 2mL of sodium chloride 0.9%  

Administer into a large vein as a rapid intravenous push (over 1 to 2 seconds) and follow with 

a rapid sodium chloride 0.9% flush. 

Discard diluted solution immediately after use.  

Do not refrigerate. 

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 

Monitoring  

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

resuscitation exist. 

? Continuous electrocardiogram (ECG) is required. 

? Blood pressure 



South Australian Neonatal Medication Guidelines 

 adenosine 
 6mg/2mL injection 

ISBN number: 978-1-74243-374-5 
Endorsed by: South Australian Maternal, Neonatal &amp; Gynaecology Clinical Reference Group 
Last Revised: 27/04/2017 
Contact: South Australian Neonatal Medication Guidelines Workgroup at:         

 Health:NeoMed@sa.gov.au  Page 3 of 3 
 

Version control and change history 

PDS reference: OCE use only 

 
Version Date from Date to Amendment 

1.0 Nov 2012 April 2017 Original version 

2.0 April 2017 Current Complete review 

    

    

 
 

 

Practice Points 

? 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. Large doses may be given 

undiluted 

Reference 

 

 


	Adenosine_Neo_Cover_v2
	Clinical Guideline
	Adenosine
	Policy developed by: SA Maternal &amp; Neonatal Clinical Community of Practice
	Approved by
	Safety &amp; Quality Strategic Governance Committee on:  28 April 2017
	Next review due:        30 April 2020

	Adenosine_Neo_v2

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