J. Iverson Riddle Developmental Center Patient Education ...

J. Iverson Riddle Developmental Center
Patient Education Monograph
IMPORTANT NOTE: THE FOLLOWING INFORMATION IS INTENDED TO SUPPLEMENT, NOT SUBSTITUTE FOR, THE
EXPERTISE AND JUDGEMENT OF YOUR PHYSICIAN, PHARMACIST OR OTHER HEALTHCARE PROFESSIONAL. IT
SHOULD NOT BE CONSTRUED TO INDICATE THAT USE OF THE DRUG IS SAFE, APPROPRIATE, OR EFFECTIVE FOR
YOU. CONSULT YOUR HEALTHCARE PROFESSIONAL BEFORE USING THIS DRUG.
PROCAINAMIDE - ORAL
USES: This medication is used to treat a certain serious (possibly life-threatening), persistent, abnormally fast heartbeat
(sustained ventricular tachycardia). Procainamide belongs to a class of drugs known as antidysrhythmics. It works by
blocking the abnormal electrical activity of an abnormal heartbeat so that the normal heartbeat can occur.
HOW TO USE: This medication may be started at a low dose in the hospital so that your doctor can determine the
best dose, increase it gradually as needed, and monitor you closely for side effects.
• Different kinds of procainamide taken by mouth should be taken in different ways. Each time you get a
refill, make sure you have received the correct kind of procainamide. Do not change kinds of procainamide
unless directed by your doctor. Doing so could increase side effects or decrease the effectiveness of the
medication.
• Take this medication by mouth exactly as prescribed by your doctor. You may take it with or without
food, but it is important to choose one way and take it consistently, either with or without food.
Depending on the kind of procainamide you are prescribed, take it 2-4 times daily as directed.
• If you are taking the extended-release tablet, do not crush or chew them. Doing so can release all of the
drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they
have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet
without crushing or chewing. You may see the empty extended-release tablet shell in your stool. This is
harmless.
• Dosage is based on your medical condition, kidney/liver function, how fast your body gets rid of procainamide,
other medications you may be taking, and response to therapy.
• This medication works best when the amount of drug in your body is kept at a constant level. Therefore,
take this drug at evenly spaced intervals. To help you remember, take it at the same times each day.
It is very important to avoid running out of this medication. Therefore, always order your refills several
days early.
• Do not take more or less of this drug than prescribed or stop taking it (or other heart medicines) even for
a short time unless directed to do so by your doctor. Skipping or changing your dose without approval
from your doctor may cause your abnormal heartbeat to return.
• Contact your doctor immediately and seek emergency medical attention (e.g., call -911, have someone
else drive you to a hospital emergency room) if your condition persists or worsens.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the
missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture.
Do not store in the bathroom. Keep all medicines away from children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly
discard this product when it is expired or no longer needed. Consult your pharmacist or local waste
disposal company for more details about how to safely discard your product.
SIDE EFFECTS: Nausea, vomiting, loss of appetite, diarrhea, and bitter taste in the mouth may occur. If any of
these effects persist or worsen, tell your doctor or pharmacist promptly.
• Remember that your doctor has prescribed this medication because he or she has judged that the benefit
to you is greater than the risk of side effects. Many people using this medication for a longer time may
develop serious side effects, but with frequent visits to your doctor, this risk can be minimized. (See
Warning section.)
• Tell your doctor immediately if any of these unlikely but serious side effects occur: symptoms of liver
problems (e.g., persistent nausea, stomach/abdominal pain, dark urine, yellowing eyes/skin), worsening
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symptoms of heart failure (e.g., ankle/leg swelling, increased tiredness, increased shortness of breath
when lying down).
• Seek immediate medical attention if any of these unlikely but serious side effects occur: severe dizziness,
fainting, sudden change in heartbeat (unusually faster/slower/more irregular), chest pain.
• Tell your doctor immediately if any of these rare but very serious side effects occur: seizures, mental/mood
changes (e.g., depression, confusion, unusual thoughts/behavior, hallucinations), muscle
pain/weakness, dry mouth/eyes.
• A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you
notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the
face/tongue/throat), severe dizziness, trouble breathing.
• This is not a complete list of possible side effects. If you notice other effects not listed above, contact
your doctor or pharmacist.
• In the US -
• Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-
FDA-1088.
• In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health
Canada at 1-866-234-2345.
PRECAUTIONS: Before taking procainamide, tell your doctor or pharmacist if you are allergic to it; or to local
anesthetics (e.g., procaine); or if you have any other allergies. This product may contain inactive ingredients, which
can cause allergic reactions or other problems. Talk to your pharmacist for more details.
• This medication should not be used if you have certain medical conditions. Before using this medicine,
consult your doctor or pharmacist if you have: certain heart problems (second- or third-degree atrioventricular
block or bundle branch block unless you have a heart pacemaker), a certain immune problem
(lupus).
• Before using this medication, tell your doctor or pharmacist your medical history, especially of: firstdegree
atrioventricular block, new or recent heart attack, worsening chest pain (angina), low blood
pressure, kidney problems, liver problems, myasthenia gravis.
• Procainamide may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation
can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as
severe dizziness, fainting) that require immediate medical attention. The risk of QT prolongation may
be increased if you have certain medical conditions or are taking other drugs that may affect the heart
rhythm (see also Drug Interactions section). Before using procainamide, tell your doctor or pharmacist
if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT
prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden
cardiac death).
• Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation.
This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions
such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using procainamide safely.
• Contact your doctor immediately if you develop other illnesses/conditions such as prolonged diarrhea,
large quantities of diarrhea, heavy sweating, vomiting, prolonged loss of appetite, or prolonged loss of
desire to drink water. These conditions could cause you to have serious changes in blood minerals,
leading to increased side effects.
• This drug may rarely make you dizzy or drowsy. Do not drive, use machinery, or do any activity that
requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.
• Caution is advised when using this drug in the elderly because their bodies may not get rid of procainamide
as easily, possibly leading to increased side effects.
• During pregnancy, this medication should be used only when clearly needed. Discuss the risks and
benefits with your doctor.
• This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult
your doctor before breast-feeding.
DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may
be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor
or pharmacist first.
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• This drug should not be used with the following medications because very serious interactions may occur:
ranolazine, disopyramide, ibutilide, propafenone, sertindole, droperidol, ziprasidone, bepridil, dofetilide,
cisapride, mizolastine, pimozide, halofantrine.
• If you are currently using any of these medications listed above, tell your doctor or pharmacist before
starting procainamide.
• Many drugs besides procainamide and those listed above may affect the heart rhythm (QT prolongation),
including amiodarone, quinidine, sotalol, flecainide, haloperidol, amitriptyline, levofloxacin, ciprofloxacin,
macrolide antibiotics (such erythromycin), among others. Therefore, before using procainamide, report
all medications you are currently using to your doctor or pharmacist.
• Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal
products you may use, especially of: cimetidine, ranitidine, alcohol, trimethoprim, succinylcholine.
• Certain drugs may interfere with lab blood tests for procainamide (lidocaine, meprobamate, propranolol).
Tell laboratory personnel and all your doctors if you are taking these medications.
• This document does not contain all possible interactions. Therefore, before using this product, tell your
doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share
the list with your doctor and pharmacist.
NOTES: Do not share this medication with others.
• Laboratory and/or medical tests (e.g., EKG, procainamide blood levels, blood counts, liver/kidney blood
tests, blood antinuclear antibody) should be performed periodically to monitor your progress or check
for side effects. Consult your doctor for more details.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US
residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison
control center. Symptoms of overdose may include: sudden fast/pounding heartbeat, dizziness, fainting, confusion,
nausea, vomiting.
WARNING: Prolonged use of procainamide may frequently cause the body to make certain immune molecules (antinuclear
antibodies) that may make you ill. Contact your doctor immediately if you develop symptoms of this type of
immune illness (e.g., skin sores/hives, muscle/joint aches, fever, chills, painful breathing). Your doctor may be monitoring
you with a blood test for these antibodies, and if you have them, your doctor will decide if continued use of this
medication is right for you.
• Although this medication and others like it are used to treat certain kinds of abnormal heartbeats, they
may rarely cause serious (sometimes fatal) irregular heartbeats. Therefore, procainamide should be
used carefully in selected patients only (see Uses section). Consult your doctor or pharmacist for more
information.
• Procainamide can rarely cause severe changes in blood cell counts, including white cells, red cells, and
blood clotting cells (platelets). Notify your doctor immediately if you develop signs of a serious infection
(e.g., fever, severe chills, persistent sore throat, muscle/joint aches), signs of anemia (e.g., tiredness,
pale skin, faster heartbeat), or easy bruising/bleeding.
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