Generic Name: procainamide
Brand Names:
Procainamide Hydrochloride SR, Pronestyl, Procanbid, Pronestyl-SR, Procan SR
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.
 | PPP 431 250 mg
bottle, 100 each Procainamide HCl 250mg, Oral tablet, yellow, oblong-shaped, side 1:PPP 431 |
 | PPP 438 500 mg
bottle, 100 each Procainamide HCl 500mg, Oral tablet, red, oblong-shaped, side 1:PPP 438 |
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