Tocainide (Oral)

Tocainide is an antiarrhythmics drug, taken orally, used to help heart patients correct an irregular heartbeat. The medication works by returning the heart to a regular rhythm.


Tocainide is an antiarrhythmics drug used to help patients in correcting a severe irregular heartbeat, improving it to a regular rhythm. Tocainide works by decelerating impulses of the heart nerves and reducing the sensitivity of the tissue of the heart.

Otherwise known as the US Brand Name Tonocard, Tocainide is provided to patients through a doctor's prescription in oral tablet form.

Conditions Treated

  • Irregular heartbeat

Type of Medicine

  • Antiarrhythmic

Side Effects

When using Tocainide, a patient may experience unwanted side effects in addition to the intended effects. Side effects may not always occur, but it's important to consult a doctor or seek medical attention if they appear.

The most severe, but rare side effects related to Tocainide include:

Less Common:

  • Abnormal shaking/trembling


  • Skin blisters
  • A shortness of breath or cough
  • Chills, fever
  • Irregular heartbeat
  • Peeling of skin, or additional skin irregularities such as rash or scaling
  • Sores in the mouth
  • Unexplained bleeding or bruising

There are several Tocainide side effects that are less severe and more common, and may not require medical intervention. While your body is adjusting to the medicine, the side effects could appear but then dissipate as time goes on. Consulting with a doctor for any of these side effects is a good option for preparing, preventing, and reducing the symptoms. If you continue to experience any of these side effects as time goes on, check in with your doctor or heathcare provider if you have questions or concerns:


  • Feelings of being lightheaded or dizzy
  • Loss of appetite
  • Nausea

Less Common:

  • Blurred vision
  • Confusion
  • Headache
  • Nervousness
  • Numbness or tingling in extremities such as fingers or toes
  • Skin rash
  • Sweating
  • Vomiting

Additional side effects may be experienced by some patients. If you are taking this drug and notes side effects not listed above, check with your doctor for more information. They should be able to tell you whether or not the side effects are due to this drug or caused by another condition.


Since each patient's needs are different, the dosage of Tocainide will be different for everybody. It's important to always follow your doctor's advice or instructions on the prescription label. Listed below are the are the average dosages for this medication. If your dosage is different, do not alter it unless you have consulted with your doctor and they have told you to do so.

The amount of medicine you take throughout the day will differ depending on the strength of the tablets provided by your doctor and pharmacy. It's also important to note that the dosage number consumed each day, the time between doses, and the period of time you are prescribed the medicine will be different depending on your specific medical problem.

For oral dosage (tablets) (irregular heartbeat):

  • Adults - 400 milligrams (mg) every eight hours, to begin with. Your healthcare professional may increase your dose up to 600 mg three times a day.
  • Children - Dose and use must be determined by your doctor.

Missed Dose

If you happen to miss a dose of Tocainide, take it as soon as you are able. If it is nearly time for the next dose, however, skip the missed dose and return to the regular schedule. Do not double the doses of this medication.


Although there are some medications that should not be used in conjunction with one another, there are other situations where combining this medicine with others could lead to minor interactions. For these situations, your health provider may alter your dose or take other precautions. It is important that you provide your doctor with a full list of the medications in your drug regimen, especially if they are any of the pharmaceuticals shown below. The medications listed below are not all of the interactions that may occur, so it's important to always discuss potential interactions with your doctor.

Combining Tocainide with the below listed medications is not recommended. Your doctor may choose to treat you with a different medicine or change your previous prescriptions:

  • Vernakalant

Using Tocainide with the following medicines is typically not recommended, but in some cases may not be avoided. If you have prescriptions from your doctor both of these medications, your doctor may alter dosages:

  • Amiodarone
  • Lidocaine
  • Prilocaine
  • Sotalol

Combining Tocainide with the following medicines could cause a higher risk of side effects, but may be necessary for your treatment. If you have prescriptions from your doctor both of these medications, your doctor may alter dosages:

  • Cimetidine
  • Rifampin
  • Rifapentine

Interactions with Food, Alcohol, or Tobacco

This drug and other certain medications should never be taken with or around the time of consuming certain varieties of food, drinking alcohol, or using tobacco, as interaction could occur. It's important to always consult your doctor about these possible types of side effects.

Effects on Additional Medical Conditions

Tocainide may be affected by the existence of additional medical problems you are experiencing. It's important to inform your doctor in case you are experiencing any of the following problems, as it may affect their decision to prescribe you this drug:

  • Congestive heart failure - Tocainide could worsen this condition
  • Kidney disease or liver disease - Effects could be increased due to the slower removal of tocainide from your body

Always be sure to inform your doctor of your past medical history, whether it be the aforementioned conditions or otherwise. This knowledge may make your doctor select a different course of treatment for your condition.


It's important to stay in regular contact with your doctor through regular visits to check in on your use of this medicine. It's important they check to make sure that the drug is working properly, and alter the medicine or its dosage depending on your progress.

It may be important that you wear a medical bracelet or carry a medical identification card with states your usage of this medication. Consult your doctor about whether or not this is necessary.

Tocainide may cause some patients dizziness, lightheadedness, or reduce normal alertness levels. It's important to know how this medicine affects you prior to driving a car, using machinery, or doing any dangerous activity where you would need to be fully alert.

If you are scheduled to have any type of surgery, including dental or emergency surgery, be sure to tell the medical professional in charge of your treatment that you are taking this medication.

It's always important to take Tocainide exactly as prescribed by your doctor. Continue to take the drug as prescribed unless instructed differently by your doctor, and do not increase or decrease dosage without consulting your doctor first.

This drug works at its optimum when there is a continuous amount in the bloodstream. The best way to ensure this is to not miss any doses and take the drug at evenly spaced times throughout the day. As an example, if you are prescribed four doses per day, the drug will work best when spaced roughly six hours apart. If this interferes with daily activity, such as sleeping, work, or other tasks, consult with your doctor on how to best schedule your medicine.

If you believe you or someone you know has taken an overdose of this medication, consult a doctor or your local poison control center as soon as you are able. They will guide you on whether or not there is something to be concerned about, and whether or not you should seek emergency medical care.


It's important to let your doctor know if you have ever experienced any allergic reaction any medicine you have taken in the past. Also inform your healthcare provider or doctor if you've experienced or have been diagnosed with any allergies, including food allergies, or allergies to preservatives, dyes, or animals/pets. Allergies could worsen or cause side effects, due to inactive ingredients in the medication.


Studies on animals have shown possible adverse side effects to this medication. However, no studies exist for pregnant women so there is no evidence to show adverse side effects. If you are pregnant, discuss this medication with your doctor.


There have been no studies on breastfeeding women to determine whether or not there is a risk to the infant when consuming this medication during breastfeeding. It's important to consult your doctor about the risks.


This medication should be stored at room temperature in an air-tight container. Avoid keeping it near heat, moisture, or in direct sunlight. Do not freeze. Keep away from children or pets.

If medicine is expired or not needed any longer, always dispose of properly. Do not flush, throw in the trash, or empty down the drain. Your pharmacist should be able to assist you with instructions on how to properly discard unneeded medication.


Tocainide can be a life-saving drug for heart patients experiencing a severe irregular heartbeat. This drug, an antiarrhythmic, improves the irregular rhythm of the patient's heart while decelerating heart impulses and reduces the sensitivity of the tissue of the heart. It is a tablet taken orally, and can only be prescribed by a doctor. Tocainide has a range of both severe and minor side effects, some less common than others. These side effects may be worsened by certain drug interactions, or with the consumption of certain foods, alcohol, or tobacco. It's important for a patient to discuss the other medicines they are taking, as well as any additional medical concerns with their doctor before taking this medicine.

Tocainide can also cause a patient to experience drowsiness, dizziness, and lightheadedness. The patient should always begin taking the drug to see how it will affect them before they begin to drive or operate heavy machinery. The side effects of this drug may get better over time as the patient's body starts to adjust to the medication.

Patients using this medicine should be monitored closely by their physician.

Last Reviewed:
December 25, 2017
Last Updated:
April 26, 2018
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