Sanacore Warnings

Because it has the potential to cause significant hypotension, adenosine should be used with caution in patients with left main coronary stenosis, uncorrected hypovolemia, stenotic valvular heart disease, left to right shunt, pericarditis or pericardial effusion, autonomic dysfunction or stenotic carotid artery disease with cerebrovascular insufficiency.
Adenosine should be used with caution in patients with recent myocardial infarction, heart failure, or in patients with minor conduction defects (first degree AV block, bundle branch block) that could be transiently aggravated during infusion.
Some cases of severe bradycardia have been reported. Some occurred in early post heart transplant patients; in the other cases, occult sino-atrial disease was present. The occurrence of severe bradycardia should be taken as a warning of underlying disease and could potentially favor the occurrence of torsades de pointes. In patients with recent heart transplantation (less than 1 year) an increased sensitivity of the heart to adenosine has been observed.
Due to the possibility of transient cardiac arrhythmias arising during conversion of the supraventricular tachycardia to normal sinus rhythm, administration should be carried out in hospital with electrocardiographic monitoring.
Since neither the kidney nor the liver are involved in the degradation of exogenous adenosine, Adenosine's efficacy should be unaffected by hepatic or renal insufficiency.
As dipyridamole is a known inhibitor of adenosine uptake, it may potentiate the action of Sanacore. It is therefore suggested that Sanacore should not be administered to patients receiving dipyridamole; if use of Sanacore is essential, dipyramidole should be discontinued 24 hours beforehand or the dosage of Sanacore should be reduced.