Procainamide is useful for treating heart rhythm disturbances (arrhythmias) , especially in the chambers of the heart . This drug is usually used to stabilize a heartbeat that is too fast and irregular.

The heart can beat by receiving electrical signals sent through the nerves. When the electrical activity in the cardiac nerves is excessive, the heartbeat will be irregular. This will reduce the effectiveness of the heart in pumping blood throughout the body.

Procainamide works by slowing the conduction of electrical signals in the heart and reducing the sensitivity of the heart muscle to these signals. That way, the heart can beat normally and is more stable in pumping blood.

Procainamide trademarks : - 

What is Procainamide

class Prescription drug
Category Antiarrhythmic
Benefit Treating heart rhythm disturbances ( arrhythmias ) and ventricular arrhythmias
Used by Adults and children
Procainamide for Pregnant and Breastfeeding Mothers Category C:  Animal studies have shown an adverse effect on the fetus, but there have been no controlled studies in pregnant women.

Drugs should only be used if the expected benefit outweighs the risk to the fetus.

Procainamide can be absorbed into breast milk. If you are pregnant or breastfeeding, consult your doctor before using this medicine.

Drug form Tablets, capsules and infusions

Warning Before Using  Procainamide:

Procainamide is a hard drug. Note the following points before using it:

  • Do not use procainamide if you have an allergy to this drug.
  • Tell your doctor if you have any allergies, especially to aspirin, anesthetics, or sulfites.
  • Tell your doctor if you have had or have ever had  lupus , heart failure, heart block (AV block), heart attack , torsades de pointes, cardiac QT prolongation, circulatory disorders, weakened immune system, asthma, hypertension , stroke, disease kidney , liver disease, or myasthenia gravis .
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy.
  • Tell your doctor if you are taking procainamide before having any medical procedures, laboratory tests, or surgery.
  • As much as possible avoid smoking, consuming alcohol, consuming caffeinated drinks, such as coffee, tea, or chocolate drinks, because they can interfere with the work of procainamide.
  • Do not immediately engage in activities that require alertness, such as driving a vehicle after taking procainamide, because these drugs can cause dizziness or a feeling of lightheadedness and increase the risk of falling.
  • Immediately see a doctor if an allergic reaction  or drug overdose occurs.

Dosage and Rules for Using Procainamide

The following are the short-term doses of procainamide for adults and children for the management of severe or symptomatic arrhythmias and ventricular arrhythmias:

1. Procainamide drink (oral)

  • Adults : 50 mg/kgBB per day which is divided into several consumption schedules every 3-6 hours.
  • Children : 15–50 mg/kgBB per day which is divided into 4 consumption schedules.

2. Procainamide Infusion

Adult :

  • 100 mg every 5 minutes at a maximum infusion rate of 50 mg/minute until the arrhythmia improves or until the dose reaches 1,000 mg.
  • Alternate doses of 500–600 mg over 25–30 minutes, followed by infusion at a rate of 2–6 mg/minute.

Children : 10–12 mg/kg in 1 injection, followed by an infusion of 0.02–0.075 mg/kg per minute.

How to Use Procainamide Properly

Infusion form of procainamide will be given by a doctor or medical officer according to the doctor's directions. The doctor will replace the procainamide infusion with procainamide in oral form after the patient's condition improves.

Make sure you follow the doctor's instructions and the directions for use on the packaging when taking oral procainamide. Procainamide tablets or capsules need to be taken on an empty stomach, which is about 1 hour before eating or 2 hours after eating. This medicine can be taken with food to prevent stomach upset.

Swallow the procainamide tablets or capsules whole, do not chew or crush the medication before swallowing. Even if you feel your condition has improved, don't stop your medication without a doctor's recommendation.

If you forget to take procainamide, take this drug immediately if the break with the next dose is not close. If it's close, ignore it and don't double the dose.

Store procainamide tablets or capsules in a cool, dry place. Keep this drug out of reach of children.

Interactions of Procainamide with Other Drugs

Interaction effects that can occur if procainamide is used together with certain drugs are:

  • Increased risk of developing life-threatening arrhythmias when used with terfenadine and antipsychotic drugs  that prolong the cardiac QT interval, such as haloperidol and chlorpromazine
  • Enhanced effect of antihypertensive , antiarrhythmic, antimuscarinic, muscle relaxant  and acetylcholinesterase inhibitor drugs.
  • Increased risk of side effects from procainamide when used with trimethoprim .

Procainamide Side Effects and Dangers

Side effects that may arise after using procainamide are:

  • Skin rash or itching
  • Dizziness  or feeling lightheaded
  • Loss of appetite
  • Stomach ache
  • Nausea and vomiting
  • Bitter taste in mouth
  • Diarrhea

Contact your doctor if these side effects do not improve immediately or get worse. Immediately see a doctor if you experience more serious side effects, such as:

  • Sudden fever, chills, sore throat , mouth ulcers, or feeling weak
  • Joint pain, muscle pain, chest pain , or wheezing
  • The body bruises easily, the skin is pale or yellowish, or the urine is cloudy
  • Hallucinations
  • Depression
  • Lupus - like symptoms  which can include joint pain, swollen joints, chest pain, abdominal pain, shortness of breath , and a red rash on the cheeks
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