TOCAINIDE

Brand & Generic Names

Tonocard

Basic Information

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

Uses

Stabilizes irregular heartbeat, particularly irregular contractions of the ventricles of the heart or a too rapid heart rate.

Dosage & Usage Information

How to take:
Tablet--Swallow with food, water or milk. Dosage may need to be changed according to individual response.

When to take:
Take at regular times each day. For example, instructions to take 3 times a day means every 8 hours.

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

What drug does:
Decreases excitability of cells of heart muscle.

Time lapse before drug works:
30 minutes to 2 hours.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.
Wear identification information that states that you take this medicine so during an emergency a physician will know to avoid additional medicines that might be harmful or dangerous.

Overdose

SYMPTOMS:
Convulsions, depressed breathing, 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:

In case of overdose, see Overdose section.

Common:

• Nausea, vomiting, lightheadedness, dizziness.
• Appetite loss.

Infrequent:

• Trembling, headache.
• Numbness or tingling in hands or feet.

Rare:

• Sore throat, unexplained bleeding or bruising, fever, chills, blurred vision, accelerated heart rate or more irregular heartbeat, cough, difficult breathing, wheezing, double vision, disorientation, shakiness, seizures, blisters.
• Rash, swollen feet and ankles, unusual sweating.

Warnings & Precautions

Don't take if:

• You are allergic to tocainide or anesthetics whose names end in "caine."
• You have myasthenia gravis.

Before you start, consult your doctor:

• If you have congestive heart failure.
• If you are pregnant or plan to become pregnant.
• If you take anticancer drugs, trimethoprim, pyrimethamine, primaquine, phenylbutazone, penicillamine or oxyphenbutazone. These may affect blood-cell production in bone marrow.
• If you take any other heart medicine such as digitalis, flucystosine, colchicine, chloramphenicol, beta-adrenergic blockers or azathioprine. These can worsen heartbeat irregularity.
• If you will have surgery within 2 months, including dental surgery, requiring general, local or spinal anesthesia.
• If you have liver or kidney disease.

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

Pregnancy:
Studies inconclusive on harm to unborn child. Decide with you doctor whether drug benefits justify risk to unborn child.

Breast-feeding:
Avoid if possible. Consult doctor.

Infants & children:
Not recommended. Safety and dosage have not been established.

Prolonged use:
Request periodic lab studies on blood, liver function, potassium levels, X-ray, ECG*.

Skin & sunlight:
No problems expected.

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

Discontinuing:
Don't discontinue without consulting doctor, even though symptoms diminish or disappear.

Others:
No problems expected.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Antiarrhythmics*,	Increased possibility of adverse
others	reactions from either drug.
Beta-adrenergic blockers*	Irregular heartbeat. May worsen
	congestive heart failure.
Bone marrow depressants*	Decreased production of blood cells
	in bone marrow.
Cimetidine	May increase tocainide effect and
	toxicity.
Clozapine	Toxic effect on bone marrow.
Encainide	Increased effect of toxicity on
	heart muscle.
Guanfacine	Increased effect of both medicines.
Nicardipine	Increased effect and toxicity of
	each drug.
Nimodipine	Increased likelihood of adverse
	effect from either drug.
Propafenone	Increased effect of both drugs and
	increased risk of toxicity.
Tiopronin	Increased risk of toxicity to bone
	marrow.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Possible irregular heartbeat.
	Avoid.
Caffeine drinks,	Possible irregular
iced drinks.	heartbeat.
Cocaine:	Possible lightheadedness,
	dizziness, quivering, convulsions.
Foods:	None expected.
Marijuana:	None expected.
Tobacco:	Possible irregular heartbeat.