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Procainamide Hydrochloride Solution for injection

It helps make your heart beat regularly

Generic Name: procainamide  |  Brand Name: Pronestyl-SR

Brand Names: Procainamide Hydrochloride SR, Pronestyl, Procanbid, Pronestyl-SR, Procan SR

There is an FDA Alert for this drug. Click here to view it.

    Positive ANA Titer
  • Prolonged use often results in development of positive antinuclear antibody (ANA) titers.
  • Symptoms of systemic lupus erythematosus (SLE)-like syndrome may or may not accompany ANA titers.
  • Assess benefits versus risks of continued therapy if positive ANA titer develops.

    Mortality
  • Excessive mortality or nonfatal cardiac arrest rate (7.7%) in encainide- or flecainide-treated patients with asymptomatic non-life-threatening ventricular arrhythmias (with MI history >6 days but <2 years) in NHLBI's long-term CAST study relative to placebo.
  • Applicability of CAST findings to other populations (e.g., those without recent MI) uncertain.
  • Because of procainamide's proarrhythmic properties and lack of evidence of improved survival for any antiarrhythmic drug, reserve procainamide for life-threatening ventricular arrhythmias.

    Blood Dyscrasias
  • Agranulocytosis, bone marrow depression, neutropenia, hemoplastic anemia, and thrombocytopenia occur in approximately 0.5% of procainamide-treated patients, usually at recommended dosages.
  • Potentially fatal (e.g., in 20–25% of agranulocytosis cases).
  • Usually noted during the initial 12 weeks of therapy.
  • Perform CBCs, including leukocyte, differential, and platelet counts, at weekly intervals for the first 3 months of therapy and periodically thereafter.
  • Perform CBC promptly if any sign of infection (e.g., fever, chills, sore throat, stomatitis), bruising, or bleeding develops.
  • Discontinue procainamide if any of these hematologic disorders develops.
  • Blood cell counts usually return to normal 1 month after procainamide discontinuance.
  • Exercise caution in preexisting marrow failure or cytopenia of any type.

What is this medicine?

PROCAINAMIDE (proe kane A mide) is an antiarrhythmic drug. It helps make your heart beat regularly. This medicine is used for heartbeat problems that may be life threatening.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
  • anemia or blood disease
  • heart disease or previous heart attack
  • immune system problems, like lupus
  • kidney disease
  • liver disease
  • low blood pressure
  • myasthenia gravis
  • an unusual or allergic reaction to procainamide, procaine, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I use this medicine?

This medicine is for injection into a muscle or into a vein. It is given by a health care professional in a hospital or clinic setting.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

This does not apply.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
  • abarelix
  • amoxapine
  • apomorphine
  • arsenic trioxide
  • certain macrolide antibiotics
  • certain quinolone antibiotics
  • cisapride
  • droperidol
  • haloperidol
  • hawthorn
  • levomethadyl
  • maprotiline
  • medicines for malaria like chloroquine and halofantrine
  • medicines for mental depression such as tricyclic antidepressants
  • methadone
  • other medicines to control heart rhythm
  • pentamidine
  • phenothiazines like chlorpromazine, mesoridazine, and thioridazine
  • pimozide
  • probucol
  • ranolazine
  • sertindole
  • vardenafil
  • ziprasidone

This medicine may also interact with the following medications:

  • cimetidine
  • ranitidine
  • succinylcholine
  • trimethoprim

What should I watch for while using this medicine?

Your condition will be monitored carefully while you are receiving this medicine.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more dizzy, increase flushing and rapid heartbeats. Avoid alcoholic drinks.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • breathing problems
  • changes in behavior, mood, or mental ability including mental depression
  • chest pain, palpitations
  • confusion
  • dark yellow or brown urine
  • feeling faint or lightheaded
  • fever, chills, or sore throat
  • hallucinations
  • irregular or fast heartbeat
  • joint or muscle pain
  • swelling of feet or legs
  • tingling or numbness in the hands or feet
  • unusual bruising, bleeding, or pinpoint red spots on the skin
  • unusually weak or tired
  • vomiting
  • yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • diarrhea
  • loss of appetite
  • nausea
  • stomach pain

Where should I keep my medicine?

This drug is given in a hospital or clinic and will not be stored at home.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.


Last Updated: July 20, 2009
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