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procainamide Images

Generic Name: procainamide

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.

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