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Adenosine and Panlor-SS

Determining the interaction of Adenosine and Panlor-SS and the possibility of their joint administration.

Check result:
Adenosine <> Panlor-SS
Relevance: 18.10.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Ask your doctor before using adenosine together with caffeine. Using these medications together can decrease the effects of adenosine. It is recommended that caffeine including caffeine be avoided for 12 to 24 hours before adenosine administration. You may need a dose adjustment or special test if you use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSING INTERVAL: Methylxanthines (e.g., caffeine, theophylline) are nonspecific, competitive antagonists of adenosine receptors. As such, they may interfere with the pharmacologic effects of adenosine and other adenosine receptor agonists such as dipyridamole and regadenoson. There have been case reports of patients receiving theophylline who required higher than normal dosages of adenosine for the treatment of paroxysmal supraventricular tachycardia. In studies of healthy volunteers, caffeine and theophylline have been shown to reduce the cardiovascular response to adenosine infusions (i.e., heart rate increases, vasodilation, blood pressure changes), and theophylline has also been shown to attenuate adenosine-induced respiratory effects and chest pain/discomfort. Similarly, caffeine has been found to reduce the hemodynamic response to dipyridamole, and both caffeine and theophylline have been reported to cause false-negative results in myocardial scintigraphy tests using dipyridamole. In a placebo-controlled study that assessed the effects of oral caffeine on regadenoson-induced increase in coronary flow reserve (CFR), healthy subjects who took caffeine 200 mg orally two hours prior to regadenoson administration exhibited a median CFR that was 92% that of subjects who took placebo. The study was done using positron emission tomography with radiolabeled water.

MANAGEMENT: Clinicians should be aware that adenosine and other adenosine receptor agonists may be less effective in the presence of methylxanthines. Methylxanthines including caffeine should be withheld for 12 to 24 hours (or five half-lives) prior to administration of adenosine receptor agonists for myocardial perfusion imaging. However, parenteral aminophylline should be readily available for treating severe or persistent adverse reactions to adenosine receptor agonists such as bronchospasm or chest pain.

References
  • Ranhosky A, Kempthorne-Rawson J, the Intravenous Dipyridamole Thallium Imaging Study Group "The safety of intravenous dipyridamole thallium myocardial perfusion imaging." Circulation 81 (1990): 1205-9
  • Minton NA, Henry JA "Pharmacodynamic interactions between infused adenosine and oral theophylline." Hum Exp Toxicol 10 (1991): 411-8
  • "Product Information. Persantine (dipyridamole)." Boehringer-Ingelheim, Ridgefield, CT.
  • "Product Information. Lexiscan (regadenoson)." Astellas Pharma US, Inc, Deerfield, IL.
  • Smits P, Aengevaeren WR, Corstens FH, Thien T "Caffeine reduces dipyridamole-induced myocardial ischemia." J Nucl Med 30 (1989): 1723-6
  • "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  • Smits P, Schouten J, Thien T "Respiratory stimulant effects of adenosine in man after caffeine and enprofylline." Br J Clin Pharmacol 24 (1987): 816-9
  • Conti CR "Adenosine: clinical pharmacology and applications." Clin Cardiol 14 (1991): 91-3
  • "Product Information. Adenoscan (adenosine)." Fujisawa, Deerfield, IL.
Adenosine

Generic Name: adenosine

Brand name: Adenocard, Adenoscan, Adeno-jec, My-O-Den, Myoden

Synonyms: n.a.

Panlor-SS

Generic Name: acetaminophen / caffeine / dihydrocodeine

Brand name: Dvorah, Panlor Tablet, Trezix, Panlor DC, Panlor SS, Zerlor

Synonyms: Panlor-SS (Oral)

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction