Generic name: moricizine hydrochloride
Dosage form: Tablets
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The dosage of Ethmozine® must be individualized on the basis of antiarrhythmic response and tolerance. Clinical, cardiac rhythm monitoring, electrocardiogram intervals, exercise testing, and/or programmed electrical stimulation testing may be used to guide antiarrhythmic response and dosage adjustment. In general, the patients will be at high risk and should be hospitalized for the initiation of therapy (see INDICATIONS AND USAGE).
The usual adult dosage is between 600 and 900 mg per day, given every 8 hours in three equally divided doses. Within this range, the dosage can be adjusted as tolerated, in increments of 150 mg/day at 3-day intervals, until the desired effect is obtained. Patients with life-threatening arrhythmias who exhibit a beneficial response as judged by objective criteria (Holter monitoring, programmed electrical stimulation, exercise testing, etc.) can be maintained on chronic Ethmozine® therapy. As the antiarrhythmic effect of Ethmozine® persists for more than 12 hours, some patients whose arrhythmias are well-controlled on a Q8H regimen may be given the same total daily dose in a Q12H regimen to increase convenience and help assure compliance. When higher doses are used, patients may experience more dizziness and nausea on the Q12 hour regimen.
Patients with Hepatic Impairment
Patients with hepatic disease should be started at 600 mg/day or lower and monitored closely, including measurement of ECG intervals, before dosage adjustment.
Patients with Renal Impairment
Patients with significant renal dysfunction should be started at 600 mg/day or lower and monitored closely, including measurement of ECG intervals, before dosage adjustment.
Transfer to Ethmozine®
Recommendations for transferring patients from another antiarrhythmic to Ethmozine® can be given based on theoretical considerations. Previous antiarrhythmic therapy should be withdrawn for 1-2 plasma half-lives before starting Ethmozine® at the recommended dosages. In patients in whom withdrawal of a previous antiarrhythmic is likely to produce life-threatening arrhythmias, hospitalization is recommended.
|Transferred From||Start Ethmozine®|
|Quinidine, Disopyramide||6-12 hours after last dose|
|Procainamide||3-6 hours after last dose|
|Encainide, Propafenone, Tocainide, or Mexiletine||8-12 hours after last dose|
|Flecainide||12-24 hours after last dose|