Drug Index

Procainamide

Mechanism :

It is an amide derivative of procaine used in the treatment of atrial and ventricular arrhythmias.


Indication :

  • Ventricular arrhythmias
  • Supraventricular arrhythmias

Contraindications :

Hypersensitivity to drug/class/component, SLE, 2nd or 3rd degree AV block, Torsades de pointes, Congenital long QT syndrome, uncorrected Electrolyte abnormalities.


Dosing :

Use in atrial fibrillation and flutter only after the ventricular rate is stabilized.
IV: Initial loading dose of 3-6 mg/kg over 5 mins; Maximum: 100 mg/dose. May be repeated to maximum of 15 mg/kg/dose every 5-10 mins as and when required; followed by maintenance dose of 0.02-0.08 mg/kg/min IV infusion. Maximum dose: 2 g/day.

Adverse Effect :

GI irritation, drug fever, tachycardia, SLE like syndrome, hepatomegaly, positive Coomb’s test, asystole, myocardial depression, hypotension and AV block.


Interaction :

Cimetidine, Ranitidine, Amiodarone, Beta- Blockers, Trimethoprim: Procainamide adjustments required.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Normal loading dose. Maintenance dose according to response, lower doses or longer dosage intervals may be required

Dose in Patients undergoing Renal Replacement Therapies
CAPDDialysed. Dose as in GFR<10 mL/ min
HDDialysed. Dose as in GFR<10 mL/ min
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDDialysed. Dose as in normal renal function

Hepatic Dose :

Use with caution, monitor serum procainamide and NAPA concentrations closely and adjust dose accordingly.
Moderate hepatic impairment: daily dose reduction by 1/4th is recommended.
Severe hepatic impairment: daily dose reduction by 1/2 is recommended.
03/25/2021 21:06:05 Procainamide
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