Regadenoson
LEXISCAN
What it isSelective adenosine A2A agonist; pharmacologic cardiac stress testing.
Why this oneA single fixed-dose bolus replaces a weight-based adenosine infusion, with less bronchospasm from A2B and A3 sparing.
What limits itSeizures and, rarely, infarction can occur. Caffeine within twelve hours blunts it; aminophylline reverses it.
FDA-approved for
- myocardial perfusion imaging (stress agent) (2008)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Pharmacologic stress agent for myocardial perfusion imaging | Adults | 0.4 mg (5 mL) IV once | 0.4 mg IV once | 0.4 mg IV once |
Renal No adjustment needed
Hepatic Undefined
Instructions
- Give as IV injection within 10 sec into a peripheral vein (22 G or larger)
- Follow immediately with 5 mL saline flush
- Inject radionuclide 10-20 sec after the flush
- Avoid methylxanthines (caffeine, tea, aminophylline, theophylline) for >=12 h before
Available strengths
- inj 0.08 mg/mL
Contraindications
- Second- or third-degree AV block without a functioning pacemaker
- Sinus node dysfunction without a functioning pacemaker
Cautions
- Myocardial ischemia (fatal cardiac events); have resuscitation equipment ready
- SA/AV nodal block
- Atrial fibrillation/flutter
- Hypersensitivity/anaphylaxis
- Hypotension
- Hypertension
- Bronchoconstriction
- Seizure
- Stroke
Adverse reactions
- Dyspnea
- Headache
- Flushing
- Chest discomfort
- Dizziness
- Angina
- Chest pain
- Nausea
Pregnancy No human data; adverse fetal outcomes only at maternally toxic doses in animals
Lactation No human data; pump and discard milk for 10 h after administration
Cost
Regadenoson (LEXISCAN)
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 0.08 mg/mL | inj | per unit | not offered |
NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Regadenoson is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.
NO BOXED WARNINGS
Principal riskSeizures and, rarely, infarction