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CARDIOVASCULAR SYSTEM › CARDIAC THERAPY › ANTIARRHYTHMICS, CLASS I AND III › Antiarrhythmics, class Ia
procainamide
C01BA02
Forms & Strengths
- Tablets: 250mg, 500mg, 750mg
- Injectable: 500mg/mL, 100mg/mL
Adult Dosing
- Loading dose: 1g IV or 500-1000mg PO
- Maintenance dose: 2-6g/day PO divided q4-6h
- IV maintenance: 1-4mg/min
Pediatric Dosing
- Loading dose: 2-6mg/kg IV or 15-30mg/kg PO
- Maintenance dose: 30-60mg/kg/day PO divided q4-6h
- IV maintenance: 20-80mcg/kg/min
Indications
- Ventricular arrhythmias
- Supraventricular arrhythmias
- Atrial fibrillation/flutter
- Paroxysmal supraventricular tachycardia
Mechanism of Action
- Class IA antiarrhythmic
- Sodium channel blockade
- Prolongs repolarization, increases refractoriness
Contraindications
- Complete heart block
- Second or third degree AV block
- Sickle cell disease
- Myasthenia gravis
Adverse Reactions
- GI upset, nausea, vomiting
- Fevers, lupus-like syndrome
- Agranulocytosis, thrombocytopenia
- Cardiac effects: widened QRS, QT interval prolongation
Drug Interactions
- Concomitant use with other antiarrhythmics
- Interactions with quinidine, beta blockers
- Increased procainamide levels with cimetidine, ranitidine
- Decreased procainamide levels with rifampin
Curated Content: Needs Vetting Before Put to Clinical Use