Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: procainamide
BRAND NAME: Pronestyl, Procan-SR, Procanbid (These brands no longer are
available in the U.S.)
DRUG CLASS AND MECHANISM: Procainamide is an injectable drug that is used to
correct disturbances in the heart's rhythm; it is an antiarrhythmic drug. Three
actions are responsible for its ability to correct disturbances of rhythm and
prevent their recurrence. Procainamide decreases the speed of electrical
conduction through the heart muscle, prolongs the electrical phase during which
the heart's muscle cells can be electrically stimulated, and prolongs the
recovery period during which the heart muscle cells cannot be stimulated.
Procainamide was approved for use by the FDA in 1950.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Injection: 100 and 500 mg/ml.
STORAGE: Procainamide may be kept at room temperature. If diluted it is
stable for 24 hours at room temperature or seven days if refrigerated at 2 to 8
C (35 to 46 F).
PRESCRIBED FOR: Procainamide is an antiarrhythmic drug used in the treatment
of abnormal heart rhythms such as:
- early (premature) atrial and ventricular beats;
- intermittent rapid rhythms (tachycardias) involving the atria and
atrio-ventricular (AV) junction as well as abnormal pathways (bypass tracts)
between the atria and ventricles;
- intermittent atrial fibrillation and flutter;
- after conversion from atrial fibrillation or flutter to prevent recurrence;
and
- ventricular tachycardia.
DOSING: An intravenous dose of 500-600 mg over may be administered over 25-30
minutes to adults. The initial dose is followed with a maintenance dose of 1-6
mg/min.
DRUG INTERACTIONS: Amiodarone (Cordarone) increases the blood concentrations
of procainamide by either decreasing the kidneys or the liver's abilities to
remove procainamide. Combining procainamide with thioridazine (Mellaril),
pimozide (Orap), quinolones for example, levofloxacin
(Levaquin), tricyclic
antidepressants for example, amitriptyline
(Endep, Elavil), and ziprasidone (Geodon) may
increase the risk of abnormal heart beats because these drugs may also prolong
the recovery period of the heart. Concurrent administration of procainamide with
other antiarrhythmics can result in additive or antagonistic effects on the
heart.
PREGNANCY: Procainamide crosses the placenta. Adequate studies have not been
performed in humans to determine if there are any effects of procainamide on the
fetus. Therefore, procainamide should be avoided in
pregnant patients unless the
physician feels that the potential benefits outweigh the unknown risks.
NURSING MOTHERS: There are no adequate studies in
nursing mothers. Available
information suggests that there is minimal risk of adverse effects to the
infant.
SIDE EFFECTS: Common reactions include diarrhea, nausea, vomiting, rash,
low
blood pressure, itching, flushing, and slow heart beat. Severe reactions include
abnormal heart beats, seizures,
heart arrest, and blood disorders. A severe
reduction in white blood cell count occurs relatively rarely with procainamide
therapy and is more common with the sustained-release preparations. This side
effect has caused death. For this reason, patients on sustained-release
procainamide get a complete blood count every 2 weeks for the first 3 months of
treatment. A syndrome resembling lupus erythematosus, including fever, chills,
joint pain, chest pain, and/or skin rash can occur with procainamide. The
lupus-like syndrome is reversible after stopping the drug. Rarely, procainamide
can cause confusion, hallucinations, and depression.
Reference: FDA Prescribing Information
Last Editorial Review: 9/10/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Complete Blood Count (CBC) - A complete blood count (CBC) measures the concentration of white blood cells, red blood cells, and platelets in the blood and aids in the diagnosis of conditions and diseases such as anemia, malignancies, and immune disorders.
- Arrhythmia (Irregular Heartbeat) - Arrhythmia (irregular heartbeat or abnormal heart rhythm) symptoms include palpitations, dizziness, fainting, shortness of breath and chest discomfort. Learn how to recognize the warning signs and treatment of arrhythmia on MedicineNet.com.
Latest Medical News
Back to Medications Index
Heart RSS