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|Tonocard

TOCAINIDE (Systemic)*

Some commonly used brand names are:

In the U.S.—

• Not commercially available

In Canada—

• Tonocard

* Not commercially available in the U.S.

Category

• Antiarrhythmic

Description

Tocainide (toe-KAY-nide) belongs to the group of medicines known as antiarrhythmics. It is used to correct irregular heartbeats to a normal rhythm.

Tocainide produces its helpful effects by slowing nerve impulses in the heart and making the heart tissue less sensitive.

Tocainide is available only with your doctor"s prescription, in the following dosage form:

• Oral
• Tablets (Canada)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For tocainide, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to tocainide or anesthetics. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Tocainide has not been shown to cause birth defects or other problems in humans. Studies in animals have shown that high doses of tocainide may increase the possibility of death in the animal fetus.

Breast-feeding—Tocainide may pass into breast milk. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Studies on this medicine have been done only in adult patients and there is no specific information comparing use of tocainide in children with use in other age groups.

Older adults—Dizziness or lightheadedness may be more likely to occur in the elderly, who are usually more sensitive to the effects of tocainide.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of tocainide. Make sure you tell your doctor if you have any other medical problems, especially:

• Congestive heart failure—Tocainide may make this condition worse

• Kidney disease or
• Liver disease—Effects may be increased because of slower removal of tocainide from the body

Proper Use of This Medicine

Take tocainide exactly as directed by your doctor , even though you may feel well. Do not take more medicine than ordered.

If tocainide upsets your stomach, your doctor may advise you to take it with food or milk.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at evenly spaced times day and night . For example, if you are to take 3 doses a day, the doses should be spaced about 8 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your health care professional.

Dosing—The dose of tocainide will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of tocainide. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine.

• For oral dosage form (tablets):
  • For irregular heartbeat:
    • Adults—At first, 400 milligrams (mg) every eight hours. Then, your doctor may increase your dose up to 600 mg three times a day.
    • Children—Use and dose must be determined by your doctor.

Missed dose—If you miss a dose of tocainide and remember within 4 hours, take it as soon as possible. Then go back to your regular dosing schedule. However, if you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

It is important that your doctor check your progress at regular visits to make sure the medicine is working properly. This will allow changes to be made in the amount of medicine you are taking, if necessary.

Your doctor may want you to carry a medical identification card or bracelet stating that you are using this medicine.

Tocainide may cause some people to become dizzy, lightheaded, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert .

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine .

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 06/13/2003

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