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| Interactions: | Amiodarone
Adverse Effect: Procainamide toxicity (cardiac arrhythmias) Clinical Management: If these drugs are to be administered concurrently, the dose of procainamide should be decreased by 20% and the patient should be closely monitored for procainamide levels and electrophysiologic evidence of toxicity.
Atenolol
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of Atenolol is not recommended. The Atenolol should be withheld for at least three half-lives prior to dosing.
Atenolol Comb.
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of a class IA antiarrhythmic agent is not recommended. The class IA antiarrhythmic agent should be withheld for at least three half-lives prior to dosing.
Atracurium
Adverse Effect: Excessive neuromuscular blockade Clinical Management: A reduction in the atracurium dose may be necessary when administered with procainamide.
Atropine
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Atropine
Bisoprolol
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of Procainamide is not recommended. The Procainamide should be withheld for at least three half-lives prior to dosing.
Celiprolol
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of Procainamide is not recommended. The Procainamide should be withheld for at least three half-lives prior to dosing.
Cimetidine
Adverse Effect: Procainamide toxicity (cardiac arrhythmias, hypotension, CNS depression) Clinical Management: A reduction in procainamide dose is recommended in patients receiving high-dose cimetidine therapy. If toxicity is suspected, adjust dose according to plasma procainamide concentrations.
Cisapride
Adverse Effect: Cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of cisapride and Procainamide is contraindicated.
Clidinium Br.
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with an anticholinergic medication.
Cotrimoxazole
Adverse Effect: an increased risk of procainamide toxicity (cardiac arrhythmias, hypotension, CNS depression) Clinical Management: Monitor serum procainamide and NAPA serum levels and for signs of procainamide toxicity (cardiac arrhythmias, hypotension, CNS depression). Dosage adjustments needed.
Cyclopentolate
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Cyclopentolate .
Dicyclomine
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Dicyclomine.
Disopyramide
Adverse Effect: excessive prolongation of conduction time or depression of cardiac contractility and hypotension Clinical Management: Monitor blood pressure and ECG in patients receiving procainamide and another class IA antiarrhythmic agent. Procainamide doses may need to be reduced. Closely observe patients for signs of procainamide toxicity, especially in patients with cardiac decompensation.
Glycopyrrolate
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Glycopyrrolate.
Homatropine
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Homatropine .
Hyoscine Butyl Br. - Antispas
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Hyoscine Butyl Br. - Antispas.
Hyoscine Butyl. Br.
Adverse Effect: Additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Hyoscine Butyl. Br.
Ipratropium Br.
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with an anticholinergic medication.
Isopropamide
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Isopropamide .
Metformin
Adverse Effect: An increased risk of lactic acidosis Clinical Management: In patients receiving metformin and Procainamide, closely monitor serum glucose levels and metformin plasma concentrations. Metformin doses may need to be reduced.
Metoprolol
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of Procainamide is not recommended. The Procainamide should be withheld for at least three half-lives prior to dosing.
Metoprolol Comb.
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of a class IA antiarrhythmic agent is not recommended. The class IA antiarrhythmic agent should be withheld for at least three half-lives prior to dosing.
Ofloxacin
Adverse Effect: An increase in procainamide concentrations Clinical Management: In patients receiving procainamide and ofloxacin concomitantly, monitor the procainamide concentration and EKG; adjust the dose accordingly.
Oxprenolol
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of Procainamide is not recommended. The Procainamide should be withheld for at least three half-lives prior to dosing.
Oxybutynin
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Oxybutynin .
Oxyphenonium Br.
Excessive cholinergic blockade occurs with procainamide, TCAs, antihistamines and Phenothiazides
Pancuronium
Adverse Effect: excessive neuromuscular blockade Clinical Management: A reduction in the pancuronium dose may be necessary when administered with procainamide.
Pimozide
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: Pimozide is contraindicated in individuals with congenital QT syndrome, patients with a history of cardiac arrhythmias, or patients taking other drugs which may prolong the QT interval.
Pindolol
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of Procainamide is not recommended. The Procainamide should be withheld for at least three half-lives prior to dosing.
Pipecuronium
Adverse Effect: excessive neuromuscular blockade Clinical Management: A reduction in the pipecuronium dose may be necessary when administered with procainamide.
Procyclidine
Adverse Effect: Additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Procyclidine .
Propantheline Br
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Propantheline Br.
Propantheline Br. - Antispas
Adverse Effect: Additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Propantheline Br. - Antispas.
Propranolol
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of Procainamide is not recommended. The Procainamide should be withheld for at least three half-lives prior to dosing.
Propranolol Comb.
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of a class IA antiarrhythmic agent is not recommended. The class IA antiarrhythmic agent should be withheld for at least three half-lives prior to dosing.
Quinidine
Adverse Effect: excessive prolongation of conduction time or depression of cardiac contractility and hypotension Clinical Management: Monitor blood pressure and ECG in patients receiving procainamide and another class IA antiarrhythmic agent. Procainamide doses may need to be reduced. Closely observe patients for signs of procainamide toxicity, especially in patients with cardiac decompensation.
Sotalol
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Procainamide is not recommended. The Procainamide should be withheld for at least three half-lives prior to dosing
Sparfloxacin
Adverse Effect: prolongation of the QTc interval and/or torsades de pointes Clinical Management: Sparfloxacin is contraindicated in individuals with known QTc prolongation or in patients being treated concurrently with drugs that are known to increase the QTc interval and/or cause torsades de pointes.
Succinyl Choline
Adverse Effect: excessive neuromuscular blockade Clinical Management: A reduction in the succinylcholine dose may be necessary when administered with procainamide.
Trihexiphenidyl
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Trihexiphenidyl
Tropicamide
Adverse Effect: additive antivagal effects on A-V nodal conduction Clinical Management: Monitor heart rate and ECG in patients given procainamide concomitantly with Tropicamide .
Vecuronium
Adverse Effect: excessive neuromuscular blockade Clinical Management: A reduction in the vecuronium dose may be necessary when administered with procainamide |
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