procainamide, Pronestyl; Procan-SR; Procanbid (These brands no longer are available in the U.S.) (cont.)

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DOSING: An intravenous dose of 15 to 18 mg/kg may be administered over 25-30 minutes to adults. The initial dose is followed with a maintenance dose of 1-4 mg/min. Dose adjustments (reductions) are recommended in patients with liver and renal problems.

It can also be given by intramuscular (IM) injection. The IM dose is 0.5 to 1 g every 4 to 8 hours.

Dosing in children is based on both their age and weight. Infants usually need a loading dose. Depending on age and weight, a loading dose of the drug may be recommended; in addition, IV or IM dosing may be used. Pediatric specialists, or in an emergency, an Emergency Medicine physician should calculate the dose and route of administration.

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 anti-arrhythmics 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 females unless the physician feels that the potential benefits outweigh the unknown risks.

NURSING MOTHERS: Procainamide is secreted in breast milk. Mothers should discontinue nursing while taking procainamide.

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.

Medically Reviewed by a Doctor on 8/26/2014


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