PROCAINAMIDE

Brand & Generic Names

Procan SR
Promine
Pronestyl
Pronestyl SR

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antiarrhythmic

Uses

Stabilizes irregular heartbeat.

Dosage & Usage Information

How to take:
Tablet or capsule--Swallow with liquid.
Extended-release tablets--Swallow each dose whole. Do not crush them.

When to take:
Best taken on empty stomach, 1 hour before or 2 hours after meals. If necessary, may be taken with food or milk to lessen stomach upset.

If you forget a dose:
Take as soon as you remember up to 2 hours late (4 hours for extended-release tablets). If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Slows activity of pacemaker (rhythm-control center of heart) and delays transmission of electrical impulses.

Time lapse before drug works:
30 to 60 minutes.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Fast and irregular heartbeat, confusion, stupor, decreased blood pressure, fainting, cardiac arrest.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Hives, rash, intense Seek emergency itching, faintness treatment soon after dose immediately. (anaphylaxis); convulsions.

Common:

Diarrhea, appetite loss, nausea, vomiting, bitter taste.

Infrequent:

• Joint pain, painful breathing.
• Dizziness.

Rare:

• Hallucinations, depression, confusion, psychosis, itchy skin, rash, sore throat, fever, jaundice, unusual bleeding or bruising.
• Headache, fatigue

Warnings & Precautions

Don't take if:

• You are allergic to procainamide.
• You have myasthenia gravis.

Before you start, consult your doctor:

• If you are allergic to local anesthetics that end in "caine."
• If you have had liver or kidney disease or impaired kidney function.
• If you have had lupus.
• If you take digitalis preparations*.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Safety not established. Decide with your doctor whether drug benefits justify risk to unborn child.

Breast-feeding:
No proven problems. Consult doctor.

Infants & children:
Not recommended.

Prolonged use:

• May cause lupus*-like illness.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check ANA titers*, blood pressure, complete blood counts (white blood cell count, platelet count, red blood cell count, hemoglobin, hematocrit).

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Use caution if you feel dizzy or weak. Otherwise, no problems expected.

Discontinuing:
Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:

• Some products contain tartrazine dye. Avoid, especially if you are allergic to aspirin.
• May affect results of some medical tests.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Acetazolamide	Increased procainamide effect.
Ambenonium	Decreased ambenonium effect.
Aminoglycosides*	Possible severe muscle weakness,
	impaired breathing.
Antiarrhythmics*,	Increased likelihood of adverse
other	reactions with either drug.
	Possible increased effect of
	both drugs.
Antihypertensives*	Increased antihypertensive effect.
Antimyasthenics*	Decreased antimyasthenic effect.
Anticholinergics*	Increased anticholinergic effect.
Cimetidine	Increased procainamide effect.
Cisapride	Decreased procainamide effect.
Dapsone	Increased risk of adverse effect
	on blood cells.
Encainide	Increased effect of toxicity on
	heart muscle.
Guanfacine	Increased effect of both medicines.
Kanamycin	Possible severe muscle weakness,
	impaired breathing.
Neomycin	Possible severe muscle weakness,
	impaired breathing.
Nicardipine	Possible increased effect and
	toxicity of each drug.
Nizatidine	Increased effect and toxicity of
	procainamide.
Pimozide	Increased risk of heartbeat
	irregularities.
Propafenone	Increased effect of both drugs and
	increased risk of toxicity.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	None expected.
Caffeine drinks,	Irregular heartbeat.
Cocaine:	Decreased procainamide effect.
Foods:	None expected.
Marijuana:	None expected.
Tobacco:	Decreased procainamide effect.