This 2-page resource includes information about the attributes of Lexiscan and patient preparation.
Review Lexiscan product attributes, including information about the mechanism of action (MOA), dosing and administration, clinical efficacy and safety profile, adverse events, pharmacodynamics, and pharmacokinetics. Background information on MPI and adenosine receptor-mediated pharmacologic stress is also included. Explore data from the Lexiscan pivotal trials in patients who failed to achieve adequate exercise, in patients with asthma/COPD, and in patients with renal impairment. Aminophylline use in clinical trials is also discussed.
Review the dosing and administration protocol for Lexiscan, including patient preparation considerations before a pharmacologic stress test.
Watch this animated video of the Lexiscan MOA to see the interaction between Lexiscan and adenosine receptors within coronary arteries.
This resource illustrates the steps for administering Lexiscan. It also provides information about the pharmacodynamics and mean time to near-peak coronary blood flow velocity.
Learn more about product attributes for Lexiscan and other pharmacologic stress agents. This piece includes tables listing information on each product, including dosing and administration considerations, administration protocols, preparation and administration steps, mechanism of action, role of pharmacy, diagnostic utility, and more.
Explore institutional and nuclear lab considerations for a pharmacologic stress agent from a clinical, operational, and access and reimbursement perspective. This piece shows how Lexiscan can fit into existing health system workflows.
Discover the market share data of 3 single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) pharmacologic stress agents over time. This piece contains charts displaying market share data beginning in 2007.
Review an illustrated workflow of SPECT MPI process. This piece also lists procedures for patient assessment and preparation, as well as administration protocols for Lexiscan, adenosine, and dipyridamole.
Understand the utility of a standard-dose prefilled syringe with an illustrated administration protocol.
This resource was designed specifically for pharmacy directors and formulary decision-makers. Explore the clinical and operational attributes of Lexiscan with a simple-to-understand diagram.
Explore both institutional and nuclear lab considerations for a pharmacologic stress agent. This piece includes flowcharts that provide a general illustration of how Lexiscan may go from the point of manufacture to the point of patient administration.
Read an overview of Lexiscan efficacy and safety, including data from the ADVANCE MPI pivotal trials and the EXERRT clinical study, which examines conversion to pharmacologic stress for patients unable to achieve adequate exercise stress.
Lexiscan® (regadenoson) injection is a pharmacologic stress agent indicated for radionuclide myocardial perfusion imaging (MPI) in patients unable to undergo adequate exercise stress.
Do not administer Lexiscan to patients with second- or third-degree AV block or sinus node dysfunction unless these patients have a functioning artificial pacemaker.
Fatal and nonfatal myocardial infarction, ventricular arrhythmias, and cardiac arrest have occurred following Lexiscan injection. Avoid use in patients with symptoms or signs of acute myocardial ischemia, for example unstable angina or cardiovascular instability; these patients may be at greater risk of serious cardiovascular reactions to Lexiscan. Cardiac resuscitation equipment and trained staff should be available before administering Lexiscan. Adhere to the recommended duration of injection. As noted in an animal study, longer injection times may increase the duration and magnitude of increase in coronary blood flow. If serious reactions to Lexiscan occur, consider the use of aminophylline, an adenosine antagonist, to shorten the duration of increased coronary blood flow induced by Lexiscan.
Sinoatrial and Atrioventricular Nodal Block
Adenosine receptor agonists, including Lexiscan, can depress the SA and AV nodes and may cause first-, second-, or third-degree AV block, or sinus bradycardia requiring intervention. In postmarketing experience, heart block (including third degree), and asystole within minutes of Lexiscan administration have occurred.
Atrial Fibrillation/Atrial Flutter
New-onset or recurrent atrial fibrillation with rapid ventricular response and atrial flutter have been reported following Lexiscan injection.
Hypersensitivity, Including Anaphylaxis
Anaphylaxis, angioedema, cardiac or respiratory arrest, respiratory distress, decreased oxygen saturation, hypotension, throat tightness, urticaria and rashes have occurred. In clinical trials, hypersensitivity reactions were reported in fewer than 1 percent of patients.
Adenosine receptor agonists, including Lexiscan, induce arterial vasodilation and hypotension. The risk of serious hypotension may be higher in patients with autonomic dysfunction, hypovolemia, left main coronary artery stenosis, stenotic valvular heart disease, pericarditis or pericardial effusions, or stenotic carotid artery disease with cerebrovascular insufficiency. In postmarketing experience, transient ischemic attacks, seizures and syncope have been observed.
Adenosine receptor agonists, including Lexiscan, may result in clinically significant increases in blood pressure in some patients. In postmarketing experience, cases of potentially clinically significant hypertension have been reported, particularly in patients with underlying hypertension and when low-level exercise was included in the MPI.
Adenosine receptor agonists, including Lexiscan, may cause dyspnea, bronchoconstriction and respiratory compromise. Appropriate bronchodilator therapy and resuscitative measures should be available prior to and following Lexiscan administration.
Lexiscan may lower the seizure threshold; obtain a seizure history. New-onset or recurrence of convulsive seizures has occurred following Lexiscan injection. Some seizures are prolonged and require emergent anticonvulsive management. Aminophylline may increase the risk of seizures associated with Lexiscan injection. Methylxanthine use is not recommended in patients who experience a seizure in association with Lexiscan administration.
Cerebrovascular Accident (Stroke)
Hemorrhagic and ischemic cerebrovascular accidents have occurred. Hemodynamic effects of Lexiscan including hypotension or hypertension may be associated with these adverse reactions.
In clinical trials, the most common adverse reactions (≥5%) to Lexiscan were dyspnea, headache, flushing, chest discomfort, angina pectoris or ST-segment depression, dizziness, chest pain, nausea, abdominal discomfort, dysgeusia, and feeling hot. Most adverse reactions began soon after dosing, and generally resolved within approximately 15 minutes, except for headache, which resolved in most patients within 30 minutes. Aminophylline was used as a reversal agent in 3% of patients.
In postmarketing experience, the following additional adverse reactions have occurred: supraventricular tachyarrhythmias, acute coronary syndrome (ACS), tremor, QTc prolongation, abdominal pain in association with nausea, vomiting, or myalgias, diarrhea, fecal incontinence, wheezing and musculoskeletal pain.