{"id":4634,"date":"2025-03-31T18:12:15","date_gmt":"2025-03-31T18:12:15","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/procainamide-hydrochloride-txt\/"},"modified":"2025-03-31T18:12:15","modified_gmt":"2025-03-31T18:12:15","slug":"procainamide-hydrochloride-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/procainamide-hydrochloride-txt\/","title":{"rendered":"procainamide hydrochloride.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nAnti-arrhythmic agent:Treatment of ventricular arrhythmias, especially after myocardial infarctionAtrial tachycardia

DOSE IN NORMAL RENAL FUNCTION <\/H3>Slow IV injection: 50 mg\/min (100 mg with ECG monitoring), repeated at 5-minute intervals until arrhythmia is controlled; max dose 1 gInfusion: 500\u2013600 mg over 25\u201330 minutes with ECG monitoring, then maintenance of 2\u20136 mg\/minute. If required start oral anti-arrhythmics 3\u20134 hours after infusion

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :271.8<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :15\u201320<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 30\u201370<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :1.48\u20134.3<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :2.5\u20135\/9.6\u201311.3

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Normal loading dose. Maintenance dose according to response, lower doses or longer dosage intervals may be required

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Anti-arrhythmics: amiodarone increases procainamide levels, increased risk of ventricular arrhythmias \u2013 avoid concomitant use; increased myocardial depression with other anti-arrhythmics\n
  • Antibacterials: increased risk of ventricular arrhythmias with moxifloxacin \u2013 avoid concomitant use; concentration increased by trimethoprim\n
  • Antidepressants: increased risk of ventricular arrhythmias with tricyclicsAntihistamines: increased risk of ventricular arrhythmias with mizolastine\u2013 avoid concomitant use\n
  • Antimalarials: increased risk of ventricular arrhythmias with artemether\/lumefantrine \u2013 avoid concomitant use\n
  • Antipsychotics: increased risk of ventricular arrhythmias with phenothiazines and any antipsychotics that prolong the QT interval; avoid with amisulpride, pimozide and sertindole\n
  • Atomoxetine: increased risk of ventricular arrhythmias\n
  • Beta-blockers: increased myocardial depression; increased risk of ventricular arrhythmias with sotalol \u2013 avoid concomitant use5HT 3 antagonists: increased risk of ventricular arrhythmias with dolasetron \u2013 avoid concomitant use; avoid with tropisetronMuscle relaxants: enhanced effect of muscle relaxants\n
  • Ulcer-healing drugs: levels increased by cimetidine

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>IV bolus,

    IV infusion <\/H4>, IM

    Rate of Administration <\/H4>Bolus: 50\u2013100 mg\/minute Infusion: 2\u20136 mg\/minute

    Comments<\/H4>Stable in glucose 5% Dilute to a concentration of 2 mg\/mL and give at a rate of 1\u20133 mL\/minute, or to a Procainamide hydrochloride.PROCAINAMIDe HYDROCHLORIDe 607concentration of 4 mg\/mL and give at a rate of 0.5\u20131.5 mL\/minuteStability of solution can be improved by adding sodium bicarbonate to glucose solution

    OTHER INFORMATION <\/H4>For optimum response, plasma concentration should be 3\u201310 mg\/L; severe toxicity has been noted at concentrations above 12 mg\/LActive metabolite is N-acetyl- procainamide (NAPA) which is 80% renally excretedHaemofiltration can be used in cases of procainamide poisoningHalf-life depends on acetylator status of patientCan cause systemic lupus erythematosus in up to 30% of patients with long-term use CAPD removes 19% of procainamide and 24% of NAPA.
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Anti-arrhythmic agent:Treatment of ventricular arrhythmias, especially after myocardial<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4634","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4634","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4634"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4634\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4634"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4634"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4634"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}