Procainamide
Information about Procainamide[edit source]
Procainamide is an oral antiarrhythmic agent that has been in wide use for more than 60 years.
Liver safety of Procainamide[edit source]
Long term procainamide therapy is known to induce hypersensitivity reactions, autoantibody formation and a lupus-like syndrome but is a rare cause of clinically apparent acute liver injury.
Mechanism of action of Procainamide[edit source]
Procainamide (proe kane' a mide) is an analogue of the local anesthetic procaine and has electrophysiological effects that resemble quinidine. Procainamide appears to act by blocking open sodium channels and outward potassium channels. As a consequence, it decreases cardiac automaticity, increases refractory periods and slows conduction.
FDA approval information for Procainamide[edit source]
Procainamide was approved for use in the United States in 1950, and current indications include suppression of symptomatic premature ventricular contractions and life threatening ventricular tachycardia, as well as maintenance of normal sinus rhythm after conversion of atrial fibrillation or flutter. Because of its safety profile, procainamide is now rare used.
Dosage and administration for Procainamide[edit source]
Procainamide is available in capsules and tablets of 250, 375 and 500 mg generically as well as under the brand name Pronestyl; it is also available as extended release forms of 250, 500, 750 and 1,000 mg under the brand name Procanbid. The usual maintenance dose in adults is 500 to 1000 mg every 4 to 6 hours.
Side effects of Procainamide[edit source]
The most common side effects include headache, nervousness, anxiety, nausea, decreased appetite, palpitations and disturbed sleep.
List of antiarrhythmic agents:
- Amiodarone
- Disopyramide
- Dofetilide
- Dronedarone
- Flecainide
- Ivabradine
- Mexiletine
- Procainamide
- Propafenone
- Quinidine
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Contributors: Prab R. Tumpati, MD