Procainamide (Intravenous)

Procainamide intravenous injection is used in the treatment or arrhythmia and is also used to slow the rhythm of a heart that is beating too quickly.

Overview

Procainamide is sold in the US under the brand name Pronestyl. The drug is manufactured as a solution, which is administered via intravenous injection, usually in a clinic or hospital setting.

When the heart beats too quickly or irregularly, it cannot work efficiently, placing a strain on the blood vessels and on the heart itself. This medication is used in the treatment of irregular heartbeats. It is also effective in slowing down a heart that is beating too fast.

Procainamide works by acting on the electrical nerve impulses within the heart muscle. It also causes the sensitivity of the tissues within the heart to be reduced.

Conditions treated

  • Irregular or rapid heartbeat

Type of medicine

  • Solution
  • Intravenous injection

Side effects

Many drugs cause a few unwanted side effects, in addition to the effects that are desired. Not all of these side effects may occur, but if they do, you may need to seek further medical assistance.

If you notice any of the effects listed below, you should notify your nurse or treating physician as soon as possible:

  • Unusual tiredness or weakness
  • Unusual bleeding or bruising
  • Skin rash or itching
  • Pains with breathing
  • Joint pain or swelling
  • Hallucinations
  • Fever or sore mouth, gums, or throat
  • Fever and chills
  • Depression
  • Confusion

Some patients may experience the following side effects immediately around the injection site. Tell your nurse or doctor if you notice any of these effects:

  • Warmth around the needle insertion point
  • Tingling
  • Tenderness
  • Swelling
  • Stinging
  • Soreness
  • Skin discoloration
  • Scarring
  • Reddening
  • Rash
  • Pain
  • Numbness
  • Lumps
  • Inflammation
  • Infection
  • Hives
  • Coldness of the skin
  • Blistering
  • Bleeding
  • A feeling of pressure
  • A burning sensation

In the unlikely event that an overdose occurs, you may notice the following side effects. In these circumstances, summon emergency assistance right away:

  • Decrease in urine output
  • Fainting
  • Severe dizziness
  • Drowsiness
  • Irregular or rapid heartbeat
  • Nausea
  • Vomiting

Some of the effects caused by procainamide will go away by themselves, once your body accepts the new drug. Your doctor may be able to give you some advice on how to manage or prevent these effects if they become especially troublesome. If any of the effects prove to be especially persistent or annoying, check with your doctor:

  • Diarrhea
  • Thickening or hardening of the skin around the injection site
  • Poor appetite
  • Feeling dizzy or lightheaded

This list of effects is not necessarily all-inclusive and some patients may note other effects that are not mentioned here. If you experience any other odd effects, you should mention them to your nurse or treating physician.

Dosage

You will only be given procainamide in a clinic or hospital environment by a trained medical professional.

The drug is administered intravenously. A very thin tube called a cannula is placed into your vein, and the medication is infused into your bloodstream via the cannula. Your treating physician will calculate the dose of the drug that you require, depending on your medical condition and how your body responds to the medication. Once your condition has been stabilized, your doctor may discontinue procainamide and use an oral drug that works in a similar way instead.

If you have any questions about how procainamide works or how it is administered, you should have a chat with your doctor or nurse.

Interactions

Some forms of medication should never be used at the same time, as an interaction between them could take place that may be harmful to the patient. In other circumstances, it may be feasible to use two medicines at the same time, providing that the dose or frequency of use of one or both of them is adjusted. Tell your doctor if you are using any other medicines before you are treated with procainamide.

It is not recommended that patients who are using any of the following drugs are also treated with procainamide. Your treating physician may elect to change one or both of the other drugs that you are taking:

  • Zuclopenthixol
  • Zotepine
  • Zolmitriptan
  • Ziprasidone
  • Voriconazole
  • Vinflunine
  • Vernakalant
  • Vemurafenib
  • Vecuronium
  • Vasopressin
  • Vardenafil
  • Vandetanib
  • Tubocurarine
  • Triptorelin
  • Trimipramine
  • Trimethoprim
  • Trifluoperazine
  • Trazodone
  • Toremifene
  • Tizanidine
  • Thioridazine
  • Tetrabenazine
  • Terfenadine
  • Telithromycin
  • Telavancin
  • Tacrolimus
  • Sunitinib
  • Sultopride
  • Sulpiride
  • Sulfamethoxazole
  • Succinylcholine
  • Spiramycin
  • Sparfloxacin
  • Sotalol
  • Sorafenib
  • Solifenacin
  • Sodium Phosphate, Monobasic
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate
  • Sevoflurane
  • Sertindole
  • Salmeterol
  • Rocuronium
  • Risperidone
  • Quinine
  • Quinidine
  • Quetiapine
  • Protriptyline
  • Propafenone
  • Promethazine
  • Procainamide
  • Probucol
  • Prilocaine
  • Posaconazole
  • Pitolisant
  • Pirmenol
  • Piperaquine
  • Pipecuronium
  • Pimozide
  • Pimavanserin
  • Perflutren Lipid Microsphere
  • Pentamidine
  • Pazopanib
  • Pasireotide
  • Pancuronium
  • Paliperidone
  • Ondansetron
  • Ofloxacin
  • Octreotide
  • Nortriptyline
  • Norfloxacin
  • Nilotinib
  • Nalidixic Acid
  • Nafarelin
  • Moxifloxacin
  • Moricizine
  • Mivacurium
  • Mifepristone
  • Metronidazole
  • Metocurine
  • Methadone
  • Mesoridazine
  • Mefloquine
  • Lumefantrine
  • Lorcainide
  • Lopinavir
  • Lidoflazine
  • Lidocaine
  • Levomethadyl
  • Levofloxacin
  • Leuprolide
  • Lapatinib
  • Ketoconazole
  • Ivabradine
  • Isradipine
  • Isoflurane
  • Imipramine
  • Iloperidone
  • Ibutilide
  • Hydroxyzine
  • Hydroxychloroquine
  • Hydroquinidine
  • Histrelin
  • Hexafluorenium
  • Halothane
  • Haloperidol
  • Halofantrine
  • Grepafloxacin
  • Granisetron
  • Goserelin
  • Gonadorelin
  • Gemifloxacin
  • Gatifloxacin
  • Gallamine
  • Foscarnet
  • Fluoxetine
  • Fluconazole
  • Flecainide
  • Fingolimod
  • Escitalopram
  • Erythromycin
  • Enflurane
  • Efavirenz
  • Droperidol
  • Dronedarone
  • Doxepin
  • Doxacurium
  • Donepezil
  • Domperidone
  • Dolasetron
  • Dofetilide
  • Disopyramide
  • Deslorelin
  • Desipramine
  • Delamanid
  • Degarelix
  • Dasatinib
  • Dabrafenib
  • Crizotinib
  • Clozapine
  • Clomipramine
  • Clarithromycin
  • Citalopram
  • Cisatracurium
  • Cisapride
  • Ciprofloxacin
  • Chlorpromazine
  • Chloroquine
  • Chloral Hydrate
  • Buserelin
  • Bupropion
  • Bepridil
  • Azithromycin
  • Atracurium
  • Astemizole
  • Asenapine
  • Artemether
  • Arsenic Trioxide
  • Aripiprazole
  • Aprindine
  • Apomorphine
  • Anagrelide
  • Amoxapine
  • Amitriptyline
  • Amisulpride
  • Amiodarone
  • Alfuzosin
  • Alcuronium
  • Ajmaline
  • Acecainide

Using procainamide with a medication called cimetidine can sometimes present an increased risk of certain adverse effects. However, using both medicines might be the best way to treat your condition. If you are told to use both drugs together, your treating physician may decide to change the frequency of use or the dose of one or both products.

Some drugs must not be taken when you are eating, consuming alcohol, or using tobacco, as doing so could cause an interaction to occur. You should discuss this aspect of your medical treatment with your medical professional.

Medical conditions

If you have any other other medical conditions or a history of certain illnesses, this could affect the suitability of procainamide for your treatment. Be sure to discuss your medical history fully with your doctor before you begin treatment with this drug.

Procainamide should not be used to treat patients who have a history of any of the following medical conditions:

  • Lupus erythematosus
  • Heart rhythm problem (e.g. qt prolongation)
  • Heart block

Using procainamide in patients who have a history of myasthenia gravis or congestive heart failure may make these conditions worse.

Procainamide should be used with caution in patients who have kidney or liver disease. This is because both these conditions may cause the drug to be removed more slowly from the body, potentially increasing the risk of overdose.

Warnings

When you decide to use a medication, you should take into account all the risks of doing so, as well as the benefits that it could bring. Before commencing your treatment with procainamide, you should discuss doing so with your doctor.

You must attend regular updates with your treating physician throughout the course of your treatment with procainamide. This enables your doctor to make sure that the drug is working properly and gives you the opportunity to mention any side effects that you may be experiencing.

If you have ever suffered any allergic reactions or had problems when taking this medicine previously, you should tell your doctor. You should also mention any allergies that you have to any other drugs, including over the counter products, herbal remedies and vitamins. Tell your medical team if you are allergic to food colors, preservatives, animal derivatives, or particular food groups.

Geriatric

Although there is no definitive evidence to suggest that procainamide is unsafe to use in elderly patients, it should be borne in mind that some geriatrics are more prone to kidney diseases. The dose of this medicine should therefore be adjusted accordingly.

One of the most common side effects of procainamide is lightheadedness and dizziness. This particularly affects older patients and those who are given very large doses of the drug. Elderly and infirm patients should take extra care not to fall.

Pregnancy and breastfeeding

Although there is no evidence to suggest that using procainamide could cause a danger to an unborn baby, you should discuss this with your doctor if you think you are pregnant or if you are intending to become pregnant in the immediate future, while you are receiving treatment with this drug.

There is no evidence to suggest that procainamide could present a risk to a nursing infant. However, if you are breastfeeding, you may wish to discuss with your midwife or doctor the pros and cons of continuing to do so, while you are receiving treatment with this medication. It may be advisable to use another form of feeding for your child until you have finished your treatment with procainamide.

Medical complications

Procainamide can make you feel dizzy or lightheaded. If you are affected in this way by the medication, you must not operate machinery, drive, or undertake any other activity that could be potentially dangerous.

Storage

Procainamide is only administered in a hospital setting and should be stored according to the manufacturer's instructions in a suitable on-site facility.

If the solution is seen to have small particulate floating in it or if it is cloudy, it should not be used.

Solution that has passed its recommended use-by date should not be used. All unwanted medication should be disposed of safely and responsibly.

Summary

Procainamide is a drug that is used in a hospital or clinic setting to correct or regulate the heartbeat when it is beating irregularly or too quickly. This is very important, as the heart must beat at the correct rhythm and tempo in order to remain efficient. Following initial treatment with procainamide intravenous solution, your treating physician may decide to switch your medication to an oral form of something similar.

The drug is administered intravenously. Although there are a few recognized general side effects that the drug may sometimes cause, the main problems reported by patients are to do with an adverse skin reaction at or around the injection site.

During and immediately following treatment with procainamide, you should see your doctor to make sure that the drug has worked as desired and to report any side effects that you have noticed.