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Adenosine

What other names is Adenosine known by?

Acide 5'-adénylique, Adenine Nucleoside, Adénine Nucléoside, Adenine Riboside, Adénine Riboside, Adenosina, Adénosine, Adenosine Phosphate, Adenosine 5'-Triphosphate Disodium, Adenosine; Adenosine Monophosphate (AMP), Adénosine Monophosphate (AMP); Adenosine-5-monophosphate (A5MP), Adénosine-5-monophosphate (A5MP); Adenosine Diphosphate (ADP), Adénosine Diphosphate (ADP); Adenosine Triphosphate (ATP), Phosphate d'Adénosine.

What is Adenosine?

Adenosine is a chemical that is present in all human cells. It readily combines with phosphate to form various chemical compounds including adenosine monophosphate (AMP) and adenosine triphosphate (ATP). People use it for medicine.

AMP is taken by mouth for treating shingles (herpes zoster infection) and a blood disorder called porphyria cutanea tarda.

ATP is used under the tongue to increase physical energy. It is also given intravenously (by IV) for treating acute kidney failure, multiple organ failure, high blood pressure in lung arteries (pulmonary hypertension), cystic fibrosis, lung cancer, weight loss associated with cancer, and controlling blood pressure during anesthesia and surgery. It is also used for cardiac stress tests.

Healthcare providers give adenosine intravenously for treating surgical pain and nerve pain, pulmonary hypertension, and certain types of irregular heartbeat. It is also given for controlling blood pressure during anesthesia and surgery and for heart tests called cardiac stress tests.

Adenosine is injected into the space around the spinal cord to treat nerve pain.

Adenosine phosphate is given by injection into the muscle (intramuscularly) for treating varicose veins, bursitis, pain and swollen tendons (tendonitis), itchiness, multiple sclerosis (MS), neuropathy, shingles (herpes zoster infection), cold sores and genital herpes (herpes simplex infections), and poor blood circulation.

Effective for...

  • Treating certain kinds of irregular heartbeat (as a prescription-only intravenous medicine).

Possibly Effective for...

  • Treating weight loss in people with advanced cancer. Intravenous ATP seems to improve appetite, food intake, and quality of life in people with advanced non-small-cell lung cancer and other tumors.
  • Wounds, usually in the legs, due to poor circulation (venous stasis ulcers). Intramuscular AMP might relieve fluid retention, itchiness, swelling and redness due to venous stasis ulcers.

Insufficient Evidence to Rate Effectiveness for...

  • Shingles (herpes zoster infection). Early research suggests that AMP given by injection into the muscle might be effective for treating herpes zoster (shingles) infection and for preventing nerve pain that follows these infections. Intramuscular AMP might also be effective for treating other kinds of herpes infections, according to limited research.
  • Lung cancer. Developing studies suggest that ATP is not effective for treating non-small-cell lung cancer.
  • Pain.
  • Other conditions.
More evidence is needed to rate the effectiveness of adenosine for these uses.

How does Adenosine work?

Adenosine blocks faulty circuitry in the heart, which causes irregular heart rhythm. Adenosine triphosphate (ATP) might prevent changes in energy metabolism that cause weight loss in people with advanced cancer.

Are there safety concerns?

Adenosine appears to be safe for most people when given by injection by qualified healthcare givers. It can cause breathing problems and chest pain, particularly when given at high doses. Headache, heart pounding, low blood pressure, nausea, sweating, flushing, lightheadedness, sleep problems, coughing, and anxiety can also occur.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Not enough is known about the use of adenosine during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Gout: ATP can raise the level of uric acid in the blood stream and in the urine, and this might trigger a case of gout. Gout causes red, hot, tender, swollen joints. The joint that is most often affected is at the base of the big toe.

Heart disease: ATP can cause reduced blood flow to the heart and chest pain. It might worsen symptoms in patients with heart diseases such as chest pain and heart attack.

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Are there any interactions with medications?


Dipyridamole (Persantine)Interaction Rating: Major Do not take this combination.

The body breaks down adenosine to get rid of it. Dipyridamole (Persantine) can decrease the break down of adenosine. Decreasing the breakdown of adenosine can cause heart problems. Do not take adenosine if you are taking dipyridamole (Persantine).


Carbamazepine (Tegretol)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Adenosine can slow down the heartbeat. Taking carbamazepine (Tegretol) with adenosine might cause the heart to beat too slowly. Do not take adenosine if you are taking carbamazepine (Tegretol).


Medications for gout (Antigout drugs)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Gout is caused by a build-up of uric acid crystals in the joints. Adenosine can increase uric acid in the body and might reduce the effectiveness of medications for gout.

Some medications for gout include allopurinol (Zyloprim), colchicine, probenecid (Benemid), and others.


MethylxanthinesInteraction Rating: Minor Be cautious with this combination.Talk with your health provider.

Methylxanthines might block the effects of adenosine. Adenosine is often used by doctors to do a test on the heart. This test is called a cardiac stress test. Stop drinking black tea or other caffeine containing products at least 24 hours before a cardiac stress test.

Methylxanthines include aminophylline, caffeine, and theophylline.

Dosing considerations for Adenosine.

The following doses have been studied in scientific research:

INTRAVENOUS:

  • For certain types of irregular heartbeat and also for weight loss in people with advanced cancer: Healthcare providers give adenosine as a shot (by injection).
INTRAMUSCULAR:
  • For treating wounds in the legs due to poor blood circulation: Healthcare providers give adenosine intramuscularly (by injection into the muscle).

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Reviewed on 9/17/2019
References

Agteresch HJ, Dagnelie PC, Rietveld T, et al. Pharmacokinetics of intravenous ATP in cancer patients. Eur J Clin Pharmacol 2000;56:49-55.. View abstract.

Agteresch HJ, Dagnelie PC, van den Berg JW, Wilson JH. Adenosine triphosphate: established and potential clinical applications. Drugs 1999;58:211-32.. View abstract.

Agteresch HJ, Dagnelie PC, van der Gaast A, et al. Randomized clinical trial of adenosine 5'-triphosphate in patients with advanced non-small-cell lung cancer. J Natl Cancer Inst 2000;92:321-8.. View abstract.

Agteresch HJ, Rietveld T, Kerkhofs LG, et al. Beneficial effects of adenosine triphosphate on nutritional status in advanced lung cancer patients: a randomized clinical trial. J Clin Oncol 2002;20:371-8.. View abstract.

Aqel RA, Zoghbi GJ, Trimm JR, et al. Effect of caffeine administered intravenously on intracoronary-administered adenosine-induced coronary hemodynamics in patients with coronary artery disease. Am J Cardiol 2004;93:343-6. View abstract.

Eisenach JC, Curry R, Hood DD. Dose response of intrathecal adenosine in experimental pain and allodynia. Anesthesiology 2002;97:938-42.. View abstract.

Haskell CM, Mendoza E, Pisters KM, et al. Phase II study of intravenous adenosine 5'-triphosphate in patients with previously untreated stage IIIB and stage IV non-small cell lung cancer. Invest New Drugs 1998;16:81-5.. View abstract.

Haskell CM, Wong M, Williams A, Lee LY. Phase I trial of extracellular adenosine 5'-triphosphate in patients with advanced cancer. Med Pediatr Oncol 1996;27:165-73.. View abstract.

Jatoi A, Loprinzi CL. Adenosine triphosphate: does it help cancer patients "get bigger and stronger"? J Clin Oncol 2002;20:362-3. View abstract.

Kichenin K, Seman M. Chronic oral administration of ATP modulates nucleoside transport and purine metabolism in rats. J Pharmacol Exp Ther 2000;294:126-33.. View abstract.

Leij-Halfwerk S, Agteresch HJ, Sijens PE, Dagnelie PC. Adenosine triphosphate infusion increases liver energy status in advanced lung cancer patients: an in vivo 31P magnetic resonance spectroscopy study. Hepatology 2002;35:421-4.. View abstract.

Litmann L, Anderson JD, Monroe MH. Adenosine and Aggrenox: A hazardous combination. Ann Intern Med 2002;137:E-76. View abstract.

Sherlock CH, Corey L. Adenosine monophosphate for the treatment of varicella zoster infections: a large dose of caution. JAMA 1985;253:1444-5.

Sklar SH, Alexander EJ, Blue WT, Bodian CA. Herpes zoster: adenosine monophosphate for the prevention of post-neuralgia. JAMA 1985;254:912.

Sklar SH, Blue WT, Alexander EJ, Bodian CA. Herpes zoster. The treatment and prevention of neuralgia with adenosine monophosphate. JAMA 1985;253:1427-30.. View abstract.

Sklar SH, Buimovici-Klein E. Adenosine in the treatment of recurrent herpes labialis. Oral Surg Oral Med Oral Pathol 1979;48:416-7.. View abstract.

Underwood DA. Which medications should be held before a pharmacologic or exercise stress test? Cleve Clin J Med 2002;69:449-50. View abstract.

Williams M, Jarvis MF. Purinergic and pyrimidinergic receptors as potential drug targets. Biochem Pharmacol 2000;59:1173-85.. View abstract.

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