A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Procan Sr Side Effects, and Drug Interactions - Procainamide
Procan Sr Side Effects, and Drug Interactions - Procainamide
SIDE EFFECTS
Cardiovascular System: Hypotension following oral PA administration
is rare. Hypotension and serious disturbances of cardiorhythm such as
ventricular asystole or fibrillation are more common after intravenous
administration (see OVERDOSAGE,
WARNINGS). Second degree heart
block has been reported in 2 of almost 500 patients taking PA orally.
Multisystem Effects: A lupus erythematosus-like syndrome of arthralgia,
pleural or abdominal pain, and sometimes arthritis, pleural effusion,
pericarditis, fever, chills, myalgia, and possibly related hematologic
or skin lesions (see Below) is fairly common after prolonged PA administration,
perhaps more often in patients who are slow acetylators (see DESCRIPTION
:
Boxed Warning and PRECAUTIONS).
While some series have reported less than 1 in 500, others have reported
the syndrome in up to 30 percent of patients on long-term oral PA therapy.
If discontinuation of PA does not reverse the lupoid symptoms, corticosteroid
treatment may be effective.
Hematologic System: Neutropenia, thrombocytopenia, or hemolytic
anemia may rarely be encountered. Agranulocytosis has occurred after repeated
use of PA, and deaths have been reported. (see WARNINGS
and DESCRIPTION
: Boxed Warning).
Skin: Angioneurotic edema, urticaria pruritus, flushing, and maculopapular
rash have also occurred occasionally.
Gastrointestinal System: Anorexia, nausea, vomiting, abdominal
pain, bitter taste, or diarrhea may occur in 3 to 4 percent of patients
taking oral procainamide. Hepatomegaly with increased serum aminotransferase
activity have been reported after a single oral dose.
Nervous System: Dizziness or giddiness, weakness, mental depression,
and psychosis with hallucinations have been reported occasionally.
DRUG INTERACTIONS
If other antiarrhythmic drugs are being used, additive effects on the
heart may occur with PA administration, and dosage reduction may be necessary
(see WARNINGS).
Anticholinergic drugs administered concurrently with PA may produce additive
antivagal effects on A-V nodal conduction, although this is not as well
documented for PA as for quinidine.
Patients taking PA who require neuromuscular blocking agents such as
succinylcholine may require less than usual doses of the latter, due to
PA effects on reducing acetylcholine release.
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