Drug interactions - summary-

+ Regadenoson

Dipyridamole -

dipyradamole may change the effects of regadenson. With hold dipyradamole  for
at least  2 days prior to regadenson administration

Mexthylxanthines  eg caffeine, theophylline

 methylxanthines are nonspecific adenosine receptor  antagonist and interfere with the
vasodilation activity. Avoid methylxanthine for at least 12 hours before regadenoson
administration

Radionuclide myocardial perfusion imaging ( MPI )

Most common adverse reactions resolved in within 15 minutes, except headache which is
resolved in 30 minutes in majority of patients

Cardiovascular -    angina pectoris   10%

CNS -  dizziness    7%     flushing   14%    headache   24%

GI -         abdomnal discomfort   4%     dysgesia    4%     nausea    5%

Miscellaneous -    chest discomfort    12%    cheast pain   6%   dyspnea  26%
                               feeling hot   4%

Second and third degree atrio-ventricular AV block or sinus node sysfunction

Special Precautions/Warnings -

Myocardial ischemia - fatal cardiac arrest, life threatening ventricular arrhythmias and
myocardial infarction may result in from  the ischemia induced pharmacological stress
agents.
If serious reactions with regadenoson occur, consider use of aminophylline  an adenosine
antagonist  to shorten the duration of increased CHF induced by rendenoson

Hypotension-  adenosine receptor agonists inculding regadenoson induce arterial vasodilation  and hypotension. Decreased systolic pressure was observed.

Bronchoconstriction-  adenosine receptor may cause bronchoconstriction  and respiratory compromise. Appropiate bronchodilator therapy and resuscitative  measures should be available prior to regadenoson administration

Pregnancy -use  regadenoson in pregnant women only if  needed.

Lactation- breast feeding women may consider interrupting breast-feeding for 10 minutes after administration

Children - safety and effectiveness in children  younger than 18 years have not been
 established

Elderly- older patients ( over 75 years )  had a similar adverse had similar  reaction profile as compared with younger patients

Indication

Radionuclide myocardial perfusion imaging ( MPI )

Dosage-
5ml ( regadenoson 0.4mg ) intervenously ( IV )

Administer regadenson as a rapid ( approx 10 seconds ) injection into a peripheral vein using a
22-guage or larger catheter or needle. Administer a 5ml saline flush immediately after the
injection of regadenson.

Storage-  store at 25 C ( 77F 0

1. Instruct patients to avoid  consumption of any products containing methylxanthines,
 including caffeinated coffee, tea, or other caffeinated beverages for at least 12 hours
before a scheduled redindonuclide

2. Before regadenoson admin inform patients the most common  reactions eg shortness
of breath,headache, and flushing that has been reported in association with regadenoson
 during MPI.

3. Instruct patients with COPD  or asthma to discuss their respiratory history and administration
of pre-and post study therapy with their doctor before scheduling an MPI study with regadenoson

Pregnancy -
Use  regadenoson in pregnant women only if  needed.

Lactation-
Breast feeding women may consider interrupting breast-feeding for 10 minutes after
administration

Children -
Safety and effectiveness in children  younger than 18 years have not been
 established

Elderly-
Older patients ( over 75 years )  had a similar adverse had similar  reaction profile as
compared with younger patients