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tocainide (Oral route)

TOE-ka-nide

Oral route(Tablet)

Blood dyscrasias and pulmonary disorders have been reported with therapy. Some of these reactions have been fatal. Complete blood counts should be monitored during therapy. The use of tocainide as well as other antiarrhythmic agents should be reserved for patients with life-threatening ventricular arrhythmias due the lack of evidence of improved survival for any antiarrhythmic drug in patients without life-threatening arrhythmias .

Commonly used brand name(s)

In the U.S.

  • Tonocard

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antiarrhythmic, Group IB

Chemical Class: Amino Amide

Uses For tocainide

Tocainide belongs to the group of medicines known as antiarrhythmics. It is used to correct irregular heartbeats to a normal rhythm.

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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.

Before Using tocainide

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 any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on tocainide 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.

Geriatric

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

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with 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. When you are taking tocainide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using tocainide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Lidocaine
  • Prilocaine

Using tocainide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cimetidine
  • Lidocaine
  • Rifampin
  • Rifapentine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

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 tocainide

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.

tocainide 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 amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using 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, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using tocainide

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 tocainide.

Tocainide may cause some people to become dizzy, lightheaded, or less alert than they are normally. Make sure you know how you react to tocainide 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 tocainide.

tocainide Side Effects

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:

Less common
  • Trembling or shaking
Rare
  • Blisters on skin
  • cough or shortness of breath
  • fever or chills
  • irregular heartbeats
  • peeling or scaling of skin
  • skin rash (severe)
  • sores in mouth
  • unusual bleeding or bruising

Some 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. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Dizziness or lightheadedness
  • loss of appetite
  • nausea
Less common
  • Blurred vision
  • confusion
  • headache
  • nervousness
  • numbness or tingling of fingers and toes
  • skin rash
  • sweating
  • vomiting

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

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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