Procainamide
- Atc Codes:C01BA02
- CAS Codes:614-39-1#51-06-9
- PHARMGKB ID:614-39-1#51-06-9
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Luxembourg: Pronestyl; Poland: Procainamidum; Spain: Biocoryl.
North America
Canada: Procainamide, Procan; USA: Procainamide.
Latin America
Brazil: Procamide.
Asia
Japan: Amisalin.
Drug combinations
Chemistry
Procainamide Hydrochloride: C~13~H~21~N~3~O HCl. Mw: 271.79. (1) Benzamide, 4-amino-N-[2-(diethylamino)ethyl]-, monohydrochloride; (2) p-Amino-N-[2-(diethylamino)ethyl]benzamide monohydrochloride. CAS-614-39-1; CAS-51-06-9 [procainamide].
Pharmacologic Category
Class Ia Antiarrhythmics. (ATC-Code: C01BA02).
Mechanism of action
Decreases myocardial excitability and conduction velocity and may depress myocardial contractility, by increasing electrical stimulation threshold of ventricle, His-Purkinje system and through direct cardiac effects.
Therapeutic use
Treatment of ventricular tachycardia, premature ventricular contractions, paroxysmal atrial tachycardia, and atrial fibrillation. Prevention of recurrence of ventricular tachycardia, paroxysmal supraventricular tachycardia, atrial fibrillation or flutter.
Pregnancy and lactiation implications
Use caution during pregnancy or lactation.
Unlabeled use
Stable monomorphic VT. Stable wide complex tachycardia, probable VT. Atrial fibrillation or flutter, including pre-excitation syndrome. AV reentrant, narrow complex tachycardia (e.g. reentrant SVT)(preserved ventricular function). Tachycardia with pulses and poor perfusion (possible VT).
Contraindications
Hypersensitivity to procaine, other ester-type local anesthetics, or any component of the formulation. Complete heart block (except in patients with functioning artificial pacemaker). Second-degree AV block (without functional pacemaker). Various types of hemiblock (without functional pacemaker). SLE. Torsade de pointes. Concurrent cisapride use. QT prolongation.
Warnings and precautions
Potentially fatal blood dyscrasias occurred with therapeutic doses. First-degree heart block might occur. Drug-induced lupus erythematosus-like syndrome may result. Hypersensitivity reactions can occur. Proarrhythmic effects might occur (QTc prolongation). May increase ventricular response rate in atrial fibrillation or flutter. Electrolyte disturbances, especially hypokalemia or hypomagnesemia, should be corrected prior to use and throughout therapy. Use with caution in heart failure (may precipitate or exacerbate condition). Avoid use in myasthenia gravis (may worsen condition). Use with caution in renal impairment. Use caution with concurrent use of other antiarrhythmics. Injection may contain bisulfite (allergens). Some tablets contain tartrazine. Antiarrhythmic agents should be reserved for life-threatening ventricular arrhythmias.