Procainamide hydrochloride

By Medically reviewed by hellodoktor

Generic Name: Procainamide hydrochloride Brand Name(s): Generics only. No brands available.


What is procainamide hydrochloride used for?

Procainamide hydrochloride is an antiarrhythmic. It works by stabilizing the heart rhythm in conditions in which the heart beats too fast or is in an irregular rhythm (antiarrhythmic effect).

Procainamide hydrochloride is commonly used for treating certain abnormal heart rhythms.

How should I take procainamide hydrochloride?

Procainamide hydrochloride is usually administered as an injection at your doctor’s office, hospital, or clinic. If you are using procainamide hydrochloride at home, carefully follow the injection procedures taught to you by your health care provider.

If procainamide hydrochloride contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.

Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.

Take procainamide hydrochloride regularly to receive the most benefit from it. Continue to use procainamide hydrochloride even if you feel well. Do not miss any doses.

Ask your health care provider any questions you may have about how to use procainamide hydrochloride.

How do I store procainamide hydrochloride?

Procainamide hydrochloride is usually handled and stored by a health care provider. If you are using procainamide hydrochloride at home, store procainamide hydrochloride as directed by your pharmacist or health care provider. Keep procainamide hydrochloride out of the reach of children and away from pets.

Precautions & warnings

What should I know before using procainamide hydrochloride?

Before using this drug, tell your doctor if:

  • You are pregnant, planning to become pregnant, or are breastfeeding.
  • You are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.
  • You have allergies to medicines, foods, or other substances.
  • You have had a severe allergic reaction (e.g., severe rash, hives, difficulty breathing, dizziness) to a local anesthetic (e.g., procaine).

Procainamide hydrochloride may cause dizziness or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to procainamide hydrochloride.

Drinking alcohol may decrease the effectiveness of procainamide hydrochloride. Check with your doctor before drinking alcohol.

Do not exceed the recommended dose or use procainamide hydrochloride for longer than prescribed without checking with your doctor.

Do not suddenly stop taking procainamide hydrochloride without checking with your doctor.

Procainamide hydrochloride may reduce the number of clot-forming cells (platelets) in your blood. To prevent bleeding, avoid situations in which bruising or injury may occur. Report any unusual bleeding, bruising, blood in stools, or dark, tarry stools to your doctor.

Procainamide hydrochloride may lower your body’s ability to fight infection. Prevent infection by avoiding contact with people with colds or other infections. Notify your doctor of any signs of infection, including fever, sore throat, rash, or chills.

Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using procainamide hydrochloride.

Procainamide hydrochloride may interfere with certain lab tests. Make sure your doctor and laboratory personnel know you are using procainamide hydrochloride.

Some of these products contain sulfites, which can cause allergic reactions in certain individuals (e.g., asthma patients). If you have previously had allergic reactions to sulfites, contact your pharmacist to determine if the product you are taking contains sulfites.

Lab tests, including heart function tests, complete blood cell counts, and serum ANA titers, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.

Use procainamide hydrochloride with caution in the elderly because they may be more sensitive to its effects.

Use procainamide hydrochloride with extreme caution in children. Safety and effectiveness have not been confirmed.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using procainamide hydrochloride during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking procainamide hydrochloride. Procainamide hydrochloride is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Lactation: crosses into breast milk, discontinue drug or do not nurse.

Side effects

What side effects can occur from procainamide hydrochloride?

Check with your doctor if any of these most common side effects persist or become bothersome:

  • Pain, swelling, or redness at the injection site

Seek medical attention right away if any of these severe side effects occur:

  • Rash
  • Hives
  • Itching
  • Difficulty breathing
  • Tightness in the chest
  • Swelling of the mouth, face, lips, or tongue
  • Butterfly-shaped rash on the face
  • Chest pain
  • Dark urine
  • Depression
  • Diarrhea
  • Dizziness or lightheadedness
  • Fainting
  • Fast, slow, or irregular heartbeat
  • Fever, chills, or sore throat
  • Hallucinations
  • Loss of appetite
  • Mood or mental changes
  • Mouth sores or irritation
  • Muscle pain or weakness
  • Nausea
  • Pale stools
  • Seizures
  • Stomach pain
  • Severe or persistent tiredness
  • Shortness of breath
  • Swollen or tender joints
  • Unusual bruising or bleeding
  • Unusual tiredness or weakness
  • Vomiting
  • Wheezing
  • Yellowing of the skin or eyes

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.


What drugs may interact with procainamide hydrochloride?

Procainamide hydrochloride may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products may interact with this drug, including:

  • Antiarrhythmics (e.g., amiodarone, quinidine), anticholinergics (e.g., hyoscyamine), arsenic, astemizole, cisapride, dofetilide, droperidol, H2¬†antagonists (e.g., cimetidine), ketolide antibiotics (e.g., telithromycin), macrolide antibiotics (e.g., erythromycin), phenothiazines (e.g., chlorpromazine), phosphodiesterase type 5 inhibitors (e.g., sildenafil), pimozide, quinolone antibiotics (e.g., ciprofloxacin), serotonin receptor antagonists (e.g., dolasetron, terfenadine), trimethoprim, or ziprasidone because the risk of side effects, including irregular heartbeat, may be increased.
  • Neuromuscular blockers (e.g., succinylcholine) because actions or side effects may be increased by procainamide hydrochloride.

Does food or alcohol interact with procainamide hydrochloride?

Procainamide hydrochloride e may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with procainamide hydrochloride?

Procainamide hydrochloride may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Especially if you have:

  • A history of liver or kidney disease
  • Congestive heart failure, heart block, QT prolongation, or other heart problems
  • Bone marrow problems
  • Blood problems (e.g., low blood platelet or white blood cell levels)
  • Myasthenia gravis
  • Digitalis (digoxin) toxicity


The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using procainamide hydrochloride.

What is the dose of procainamide hydrochloride for an adult?


IM Administration

  • The recommended dose is 0.5-1 g IM q4-8hr.

IV Administration

  • Loading dose is 100-200 mg/dose or 15-18 mg/kg; infuse slowly over 25-30 min not to exceed 50 mg/min; may repeat q5min PRN not to exceed 1 g.
  • The maintenance dose is 1-4 mg/min by continuous IV infusion.

Renal Impairment

Reduce loading dose to 12 mg/kg.

Reduce infusion to one third in moderate renal or cardiac impairment and two thirds in severe renal or cardiac impairment.

Hepatic Impairment

Reduce dose by 50%.

What is the dose of procainamide hydrochloride for a child?


IM Administration

  • The recommended dose is 20-30 mg/kg/day IM divided q4-6hr; not to exceed 4 g/day.

IV Administration

  • Loading dose is 3-6 mg/kg IV over 5 minutes, not to exceed 100 mg/dose; may repeat q5-10min PRN not to exceed 15 mg/kg/dose.
  • The maintenance dose is 0.02-0.08 mg/kg/min IV infusion; not to exceed 2 g/24 hours.

How is procainamide hydrochloride available?

Procainamide hydrochloride is available in the following dosage forms and strengths:

  • Injection solution: 100 mg/mL 500mg/mL

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of procainamide hydrochloride, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Review Date: April 14, 2017 | Last Modified: September 13, 2019

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