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Procanbid

Generic name: Procainamide hydrochloride
Brand names: Pronestyl Pronestyl-SR, Procanbid

Why is Procanbid prescribed?

Procanbid is used to treat severe irregular heartbeats (arrhythmias). Arrhythmias are generally divided into two main types: heartbeats that are faster than normal (tachycardia), and heartbeats that are slower than normal (bradycardia). Irregular heartbeats are often caused by drugs or disease but can occur in otherwise healthy people with no history of heart disease or other illness.

Most important fact about Procanbid

Procanbid can cause serious blood disorders, especially during the first 3 months of treatment. Be sure to notify your doctor if you notice any of the following: joint or muscle pain, dark urine, yellowing of skin or eyes, muscular weakness, chest or abdominal pain, appetite loss, diarrhea, hallucinations, dizziness, depression, wheezing, cough, easy bruising or bleeding, tremors, palpitations, rash, soreness or ulcers in the mouth, sore throat, nausea, vomiting, fever, and chills.

How should you take Procanbid?

Take only your prescribed doses of Procanbid; never take more.

Procanbid should be swallowed whole. Do not break or chew the tablet. You may see remmants of the tablet in your stool, since it does not disintegrate following release of procainamide.

Try not to miss any doses. Skipping doses, changing the intervals between doses, or "making up" missed doses by doubling up later may cause your condition to worsen and could be dangerous.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature in a tightly closed container, away from heat, light, and moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Procanbid.

• More common side effects may include:
  Abdominal pain, bitter taste, blood disorders, chest pain, chills, diarrhea, dizziness, fever, flushing, giddiness, hallucinations, hives, itching, joint pain or inflammation, loss of appetite, low blood pressure, mental depression, muscle pain, nausea, rash, skin lesions, swelling, vague feeling of illness, vomiting, weakness

Why should Procanbid not be prescribed?

Procanbid should not be taken if you have the heart irregularity known as complete heart block or incomplete heart block without a pacemaker, or if you have ever had an allergic reaction to procaine or similar local anesthetics.

Your doctor will not prescribe Procanbid if you have been diagnosed with the connective-tissue disease lupus erythematosus or the heartbeat irregularity known as torsade de pointes.

Special warnings about Procanbid

To check for the serious blood disorders that can develop during Procanbid therapy, your doctor will do a complete blood count weekly for the first 12 weeks and will continue to monitor your blood count carefully after that.

If you develop a fever, chills, sore throat or mouth, bruising or bleeding, infections, chest or abdominal pain, loss of appetite, weakness, muscle or joint pain, skin rash, nausea, fluttery heartbeat, vomiting, diarrhea, hallucinations, dizziness, depression, wheezing, yellow eyes and skin, or dark urine, contact your doctor immediately. It could indicate a serious illness.

Be sure your doctor knows if you have ever had congestive heart failure or other types of heart disease.

Your doctor will prescribe Procanbid along with other antiarrhythmic drugs, such as quinidine or disopyramide, only if they have been tried and have not worked when used alone.

If you have ever had kidney disease, liver disease, or myasthenia gravis (a disease that causes muscle weakness, especially in the face and neck), your doctor will watch you carefully while you are taking Procanbid.

Make sure your doctor is aware of any drug reactions you have experienced, especially to procaine, other local anesthetics, or aspirin.

Procanbid has been known to trigger a disorder similar to lupus erythematosus. Notify your doctor if you develop any of the following lupus-like symptoms: joint pain or inflammation, abdominal or chest pain, fever, chills, muscle pain, skin lesions.

Doses of Procanbid must be very precise. Different brands of procainamide have different dosing instructions. If your prescription looks different in any way, ask your doctor or pharmacist to check it and make sure it was dispensed correctly.

Possible food and drug interactions when taking Procanbid

If Procanbid is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Procanbid with the following:

Alcohol
Amiodarone (Cordarone)
Antiarrhythmic drugs such as quinidine (Quinidex) and mexiletine (Mexitil)
Cimetidine (Tagamet)
Drugs that ease muscle spasms, such as Cogentin and Artane
Lidocaine
Ranitidine (Zantac)
Trimethoprim (Proloprim)

Special information if you are pregnant or breastfeeding

The effects of Procanbid during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Procanbid appears in breast milk and may affect a nursing infant. If Procanbid is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished.

Recommended dosage

ADULTS

Your dosage will be based on your doctor"s assessment of the degree of underlying heart disease, your age, your weight, and the way your kidneys are functioning. The following is a general guide for determining the dose of Procanbid by body weight. (The dose of other brands will be different.) Your dose may be higher or lower, depending on your individual circumstances. Doses are usually taken every 12 hours.

88-110 pounds--1,000 milligrams
132-154 pounds--1,500 milligrams
176-198 pounds--2,000 milligrams
More than 220 pounds--2,500 milligrams

CHILDREN

The safety and effectiveness of Procanbid have not been established in children.

OLDER ADULTS

Older people, especially those over 50 years of age, or those with reduced kidney, liver, or heart function, get lower doses or wait a longer time between doses.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.

• Symptoms of Procanbid overdose may include:
  Changes in heart function and heartbeat