Procainamide
Procainamide is a Class IA antiarrhythmic medication used to treat various cardiac rhythm disorders. It works by blocking sodium channels in the heart, which slows electrical conduction and stabilizes irregular heartbeats.
Procainamide is an antiarrhythmic drug used to treat and prevent irregular heartbeats by blocking sodium channels in cardiac tissue.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- C01BA02
- RxNorm
- 8700
- Generic
- Procainamide
- Class
- atc-c01
- Brands
- —
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- prefilled syringe, tablet, capsule, solution
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
10 groupspregnancy
first trimesteravoid if possible
use only if benefits outweigh risks to fetus
regular fetal monitoring and uterine activity
Use with caution and monitor for adverse effects.
pregnancy
second trimesteruse lowest effective dose
continue monitoring, consider alternative antiarrhythmics
fetal echocardiography and growth monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid near term if possible
discuss delivery plan, may affect neonatal transition
fetal monitoring, assess for neonatal effects at birth
Use with caution and monitor for adverse effects.
lactation
breastfeedingmonitor infant closely
consider infant side effects including irritability and hypotension
observe infant for symptoms
Use with caution and monitor for adverse effects.
geriatric
elderlyreduce dose, start low
decreased renal clearance, increased sensitivity to side effects
renal function monitoring, ECG, blood pressure
Use with caution and monitor for adverse effects.
pediatric_age
neonates infantsweight-based dosing required
use with caution, monitor ECG and blood pressure closely
continuous cardiac monitoring
Use with caution and monitor for adverse effects.
pediatric_age
children adolescentsweight-based dosing
appropriate for supraventricular and ventricular arrhythmias
regular ECG and vital sign monitoring
renal_impairment
mild renal impairmentreduce dose by 25%
monitor renal function, adjust based on creatinine clearance
renal function tests, ECG, drug levels
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentreduce dose by 50-75%
significant dose reduction required, consider alternative
frequent drug level monitoring, renal function
Use with caution and monitor for adverse effects.
hepatic_impairment
mild hepatic impairmentno major adjustment needed
minor adjustments may be needed
monitor liver function
Use with caution and monitor for adverse effects.
Statistics and clinical data
Drug class
Classification as Class IA antiarrhythmic agent
Common uses
Primary therapeutic indications
First FDA approval
Historical FDA approval information
Available formulations
Available dosage forms
Used to treat and prevent ventricular arrhythmias, including ventricular tachycardia and Wolff-Parkinson-White syndrome, and may be used for certain supraventricular arrhythmias when other treatments are ineffective or contraindicated.
Blocks cardiac sodium channels, which slows the rate of electrical impulse conduction through the heart. It also moderately prolongs the action potential duration and refractoriness, helping to stabilize erratic electrical activity.
Available in IV and oral formulations. Requires careful monitoring due to risks of hypotension, QT prolongation, and potential for drug-induced lupus with prolonged use. May cause blood disorders and should be avoided in patients with complete heart block without a pacemaker. Use requires ECG monitoring and periodic blood level checks.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy