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tocainide (Tonocard, Taquidil)
Tradename: Tonocard. (tocainide hydrochloride) Class-IB antiarrhythmic agent.
Indications:
1) ventricular arrhythmias
-> alone or in combination with class Ia agent
2) not effective in treatment of supraventricular arrhythmias
3) not proven effective in preventing recurrence of sustained life-threatening ventricular arrhythmias
Dosage: 400-600 mg PO TID
Tabs: 400, 600 mg.
Adverse effects:
1) neurologic (may occur with therapeutic levels)
- dizziness
- confusion
- tremors
- paresthesias
2) gastrointestinal
- nausea & vomiting
- may be reduced by administering tocainide with food
3) pulmonary (0.1%)
- pulmonary fibrosis
- interstitial pneumonitis
- fibrosing alveolitis
4) hematologic (0.1-0.2%)
- agranulocytosis
- leukopenia
- hypoplastic anemia
- thrombocytopenia
- CBC should be monitored with long term tocainide therapy
5) lupus-like reaction
Drug interactions:
-> tocainide may attenuate theophylline metabolism
Laboratory:
1) specimen: serum, plasma (EDTA, heparin)
2) methods: GLC, HPLC
Therapeutic range: 4-10 ug/mL
Interactions
drug interactions
General
antiarrhythmic agent, Group IB
Properties
MISC-INFO: elimination route LIVER 60%
KIDNEY 20-40%
1/2life 11-16 HOURS
therapeutic-range 4-10 UG/ML
toxic-range >10 UG/ML
protein-binding 10-50%
elimination by hemodialysis +
pregnancy-category C
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (ed), Companion Handbook, McGraw
Hill, NY, 1994
- Manual of Medical Therapeutics, 28th ed, Ewald &
McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 156
- Clinical Guide to Laboratory Tests, NW Tietz (ed) 3rd ed,
WB Saunders, Philadelpha 1995