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Novocainamide recipe in Latin. The drug Novocainamide: a cure for heart pathologies

Recipe (international)

Rp.:Sol. Procainamidum 10% - 5ml.

D.t. d. No. 1 in ampull.

S. Administer intravenously with 20 ml. 0.9% sodium chloride solution.

Prescription form - 107-1/у (Russia)

pharmachologic effect

Belongs to class IA antiarrhythmic drugs. Blocks sodium channels, inhibits the incoming fast current of sodium ions, reduces the rate of depolarization in phase 0.

Reduces the conductivity and excitability of Purkinje fibers, inhibits the conduction of impulses through the atria and the AV (atrioventricular) node.

Blocks potassium channels and thereby prolongs phase 3, lengthens the effective refractory period of the Purkinje fiber.

Blocks sodium channels in phase 4, prolongs it, thereby suppresses the automaticity of Purkinje fibers, sinus node and ectopic pacemakers, increases the threshold of ventricular myocardial fibrillation.

The indirect m-anticholinergic effect, compared to quinidine and disopyramide, is less pronounced, so a paradoxical improvement in AV conduction is usually not observed.

Has a weak negative inotropic effect. It has vasodilating properties, which causes a decrease in blood pressure and reflex tachycardia. Electrophysiological effects are manifested in widening of the QRS complex and prolongation of the PQ and QT intervals.

The active metabolite N-acetylprocainamide has pronounced activity as class III antiarrhythmic drugs and prolongs the duration of the action potential.

Mode of application

For adults: Intravenously; the drug is administered to quickly relieve attacks of arrhythmia, for which 100 mg of the drug is diluted in saline or 5-fold dextrose solution to a concentration of 2-5 mg per 1 ml.

It should be administered slowly, at a rate of 50 mg/min, and blood pressure monitoring is mandatory.

The drug can be re-administered in the same dose every 5 minutes, but not exceed the total dose of 1 g.

The drug is administered intramuscularly in doses of 0.5-1 g to maintain the therapeutic effect, however, preference is still given to intravenous administration and oral administration.

The drug is taken orally for conditions that do not require emergency treatment. For ventricular cardiac arrhythmias, 50 mg/kg body weight per day is prescribed, evenly dividing the total dose into 8 doses. For atrial rhythm disturbances, initially 1.25 g is prescribed, then 0.75 g every 2 hours. As maintenance therapy - 0.5-1 g every 4-6 hours. After infusions, oral administration is possible no earlier than 3- 4 hours

For children, the drug is prescribed at a dose of 12.5 mg/kg body weight 4 times a day.

Indications

Ventricular arrhythmias: extrasystole, paroxysmal ventricular tachycardia. Supraventricular arrhythmias. Paroxysm of atrial fibrillation or atrial flutter. Supraventricular tachycardia (including WPW syndrome).

Contraindications

Hypersensitivity, sinoatrial and AV block II-III degree (in the absence of an artificial cardiac pacemaker), ventricular flutter or fibrillation, ventricular arrhythmia due to intoxication with cardiac glycosides, leukopenia, arterial hypotension, cardiogenic shock, ventricular tachycardia of the "pirouette" type, prolonged interval QT, age up to 18 years

Side effects

From the nervous system and sensory organs: hallucinations, depression, myasthenia gravis, dizziness, headache, convulsions, psychotic reactions with productive symptoms, ataxia, taste disturbance.

From the gastrointestinal tract: nausea, diarrhea, bitterness in the mouth.

From the cardiovascular system and blood (hematopoiesis, hemostasis): decreased blood pressure, decreased myocardial contractility, ventricular paroxysmal tachycardia, heart failure. With rapid intravenous administration, collapse, disruption of atrial or intraventricular conduction, and asystole are possible.

With long-term use - inhibition of bone marrow hematopoiesis (leukopenia, thrombocytopenia, neutropenia, agranulocytosis, hypoplastic anemia), hemolytic anemia with a positive Coombs test.

Other: fever, allergic reactions (skin rash); with long-term use - drug-induced lupus erythematosus (in 30% of patients with a duration of therapy of more than 6 months). Microbial infections, slower healing processes and bleeding gums are likely.

Release form

Tablets 0.25 mg; ampoules with 10th solution for injection, 5 ml.

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Procainamide

Composition and release form of the drug

20 pcs. - dark glass jars (1) - cardboard packs.

pharmachologic effect

Antiarrhythmic drug of class IA, has membrane-stabilizing activity. Inhibits the incoming fast current of sodium ions, reduces the rate of depolarization in phase 0. Inhibits conductivity, slows down repolarization. Reduces the excitability of the myocardium of the atria and ventricles. Increases the duration of the effective refractory period of the action potential (to a greater extent in the affected myocardium). The conduction slowdown, which is observed regardless of the value of the resting potential, is more pronounced in the atria and ventricles, and less in the AV node. The indirect m-anticholinergic effect, compared to quinidine and disopyramide, is less pronounced, so a paradoxical improvement in AV conduction is usually not observed. Affects phase 4 of depolarization, reduces the automaticity of intact and damaged myocardium, inhibits the function of the sinus node and ectopic pacemakers in some patients. The active metabolite, N-acetylprocainamide, has pronounced activity as class III antiarrhythmic drugs and prolongs the duration of the action potential. It has a weak negative inotropic effect (without a significant effect on minute volume), vagolytic and vasodilating properties, which causes tachycardia and a decrease in blood pressure and peripheral vascular resistance. Electrophysiological effects are manifested in widening of the QRS complex and prolongation of the PQ and QT intervals. The time to achieve the maximum effect when taken orally is 60-90 minutes, when administered intravenously - immediately, when administered intramuscularly - 15-60 minutes.

Pharmacokinetics

When taken orally and intramuscularly, absorption is rapid. Protein binding is 15-20%. Metabolized in the liver to form the active metabolite N-acetylprocainamide. Typically, about 25% of the administered procainamide is converted to this metabolite; however, with rapid acetylation or impaired renal function, 40% of the dose is converted.

T1/2 of procainamide is 2.5-4.5 hours, and in case of impaired renal function - 11-20 hours; N-acetylprocainamide - about 6 hours. Excreted by the kidneys, 50-60% unchanged, the rest as a metabolite. In case of impaired renal function or chronic heart failure, the metabolite quickly accumulates in the blood to toxic concentrations, while the concentration of procainamide remains within acceptable limits.

Indications

Contraindications

AV blockade of the II and III degrees (except in cases of use of a pacemaker), ventricular flutter or fibrillation, arrhythmias due to intoxication with cardiac glycosides, leukopenia, increased sensitivity to procainamide.

Dosage

Individual. When taken orally, the initial dose ranges from 250 mg to 1 g, then, if necessary and taking into account tolerance, 250-500 mg every 3-6 hours.

For intramuscular administration - 50 mg/kg/day in divided doses every 3-6 hours.

For IV jet administration, a single dose is 100 mg; if necessary, repeated administrations are possible until the arrhythmia stops. For intravenous infusion, the dose is 500-600 mg.

Maximum doses: adults when taken orally - 4 g/day; intravenous bolus with repeated administrations, the total dose is 1 g.

Side effects

From the cardiovascular system: arterial hypotension (up to the development of collapse), intraventricular blockade, ventricular tachycardia, tachyarrhythmia; with rapid intravenous administration - collapse, intraventricular block, asystole.

From the side of the central nervous system: hallucinations, depression, myasthenia gravis, dizziness, convulsions, psychotic reactions with productive symptoms, ataxia.

From the hematopoietic system: with long-term use - inhibition of bone marrow hematopoiesis (leukopenia, thrombocytopenia, neutropenia, agranulocytosis, hypoplastic anemia), hemolytic anemia with a positive Coombs test.

Allergic reactions:, itching.

Others: bitterness in the mouth, with long-term use - drug-induced lupus erythematosus (in 30% of patients with a duration of therapy of more than 6 months); microbial infections, slower healing processes and bleeding gums are possible due to the risk of leukopenia and thrombocytopenia.

Drug interactions

When used concomitantly with antiarrhythmic drugs, additive cardiodepressive effects are possible; with antihypertensive drugs - the antihypertensive effect is enhanced; with anticholinesterase drugs - the effectiveness of anticholinesterase drugs decreases.

When used simultaneously with m-anticholinergic blockers and antihistamines, their anticholinergic effect is enhanced.

With simultaneous use, the effect of drugs that block neuromuscular transmission is enhanced; with the simultaneous use of drugs that cause inhibition of bone marrow hematopoiesis, leukopenia and thrombocytopenia may increase.

When used concomitantly, the QT interval increases due to an additive effect on its duration and the risk of developing torsade de pointes (TdP). The plasma concentration of procainamide and its metabolite N-acetylprocainamide increases, and side effects may increase.

When used simultaneously with captopril, the risk of developing leukopenia may increase.

When used simultaneously with ofloxacin, it is possible to increase the concentration of procainamide in the blood; with prenylamine - the negative inotropic effect and the risk of developing ventricular arrhythmia of the “pirouette” type are increased.

When used simultaneously with sotalol and quinidine, an additive increase in the QT interval is possible.

When used simultaneously with trimethoprim, the plasma concentration of procaine and its active metabolite N-acetylprocainamide increases, and there is a risk of developing toxic reactions.

When used simultaneously with cisapride, the duration of the QT interval significantly increases due to an additive effect, and there is a risk of developing ventricular arrhythmia (including pirouette type).

When used simultaneously, the concentration of procainamide in the blood plasma increases and the risk of increased side effects increases, especially in elderly patients and with impaired renal function, which is due to a decrease in the excretion of procainamide by the kidneys under the influence of cimetidine by almost 1/3 or more.

special instructions

The arrhythmogenic effect of procainamide was noted in 5-9% of cases. Due to the possible inhibition of myocardial contractility and a decrease in blood pressure, it should be used with great caution. In cases of severe atherosclerosis, procainamide is not recommended.

Use with caution in case of bundle branch block, arrhythmia due to intoxication with cardiac glycosides, myasthenia gravis, hepatic and/or SLE (including history), bronchial asthma, chronic heart failure in the stage of decompensation, ventricular tachycardia due to occlusion of the coronary artery , surgical interventions (including dental surgery), with prolongation of the QT interval, arterial hypotension, atherosclerosis, myasthenia gravis, in elderly patients.

Use in old age

Use with caution in elderly patients.

Novocainamide- class I A antiarrhythmic drug, which inhibits the incoming fast Na+ current, reduces the rate of depolarization in phase 0. Inhibits conduction, slows down repolarization.
Reduces the excitability of the myocardium of the atria and ventricles. Increases the duration of the effective refractory period of the action potential (to a greater extent in the affected myocardium).
The conduction slowdown, which is observed regardless of the value of the resting potential, is more pronounced in the atria and ventricles, less in the AV node.
The indirect m-anticholinergic effect, compared to quinidine and disopyramide, is less pronounced, so a paradoxical improvement in AV conduction is usually not observed.
Affects phase 4 of depolarization, reduces the automaticity of intact and damaged myocardium, inhibits the function of the sinus node and ectopic pacemakers in some patients.
The active metabolite, N-acetylprocainamide (N-APA), has pronounced activity as class III antiarrhythmic drugs and prolongs the duration of the action potential.
It has a weak negative inotropic effect (without a significant effect on IOC). It has vagolytic and vasodilating properties, which causes tachycardia and a decrease in blood pressure and total peripheral vascular resistance (TPVR). Electrophysiological effects are manifested in the expansion of the QRS complex and prolongation of the PQ and QT intervals. The time to achieve the maximum effect with intravenous administration is immediate, with intramuscular administration it takes 15-60 minutes.

Pharmacokinetics

Penetrates the blood-brain barrier and is secreted into breast milk. Metabolized in the liver to form an active metabolite - N-acetyl-procainamide, has a first-pass effect. About 25% of the administered procainamide is converted into the indicated metabolite, however, with rapid acetylation or chronic renal failure (CRF), 40% of the dose is converted. In chronic renal failure or chronic heart failure, the metabolite quickly accumulates in the blood to toxic concentrations, while the concentration of procainamide remains within acceptable limits.
T1/2 - 2.5-4.5 hours; for chronic renal failure - 11-20 hours; N-acetylprocainamide - about 6 hours. About 25% of the administered dose is excreted by the kidneys (50-60% unchanged) with bile.

Indications for use

Indications for use of the drug Novocainamide are: ventricular arrhythmias; ventricular tachycardia; ventricular extrasystole; atrial tachycardia; atrial fibrillation and/or flutter.

Mode of application

IV - 100-500 mg at a rate of 25-50 mg/min (under the control of blood pressure and ECG) until relief of paroxysm (maximum dose - 1 g) or IV drip - 500-600 mg for 25-30 minutes. The maintenance dose for intravenous drip administration is 2-6 mg/min; if necessary, 3-4 hours after stopping the infusion, start taking the drug orally.
In case of heart failure of the second degree, the dose is reduced by 1/3 or more.
5-10 ml are administered intramuscularly (up to 20-30 ml/day).
When administered intravenously, the drug Novocainamide diluted in 5% glucose solution or 0.9% sodium chloride solution. The rate of administration should not exceed 50 mg/min. This requires constant monitoring of heart rate, blood pressure and ECG.
The highest dose for adults with intramuscular and intravenous (drip) administration: single dose - 1 g (10 ml of the drug), daily - 3 g (30 ml of the drug).
When switching to taking the drug orally, the first dose is prescribed 3-4 hours after stopping the IV infusion.

Side effects

From the central nervous system: general weakness, hallucinations, depression, myasthenia gravis, dizziness, headache, insomnia, convulsions, psychotic reactions with productive symptoms, ataxia.
From the digestive system: bitterness in the mouth, diarrhea, nausea, vomiting.
From the cardiovascular system: decreased blood pressure, ventricular paroxysmal tachycardia. With rapid intravenous administration, the development of collapse, disruption of atrial or intraventricular conduction, and asystole is possible.
Allergic reactions: skin rash.

Contraindications

Contraindications to the use of the drug Novocainamide are: ventricular arrhythmia caused by intoxication with cardiac glycosides; sinoatrial and AV blockade of II and III degrees (in the absence of an implanted pacemaker); chronic heart failure in the stage of decompensation; arterial hypotension; cardiogenic shock; systemic lupus erythematosus (including history); ventricular tachycardia of the "pirouette" type; prolonged QT interval; leukopenia; ventricular flutter or fibrillation; lactation period; age under 18 years (efficacy and safety have not been established); hypersensitivity to the drug.
Due to a possible decrease in myocardial contractility and a decrease in blood pressure, the drug should be prescribed with great caution during myocardial infarction. Possible arrhythmogenic effect.
Bundle branch block, AV block of the first degree, myasthenia gravis, bronchial asthma, liver and/or renal failure, chronic heart failure, ventricular tachycardia due to coronary artery occlusion, surgical interventions (incl.

surgical dentistry), severe atherosclerosis, old age.

Pregnancy

Novocainamide use only when the benefit to the mother outweighs the potential risk to the fetus/child.
When prescribed during pregnancy, there is a potential risk of developing arterial hypotension in the mother, which can lead to uteroplacental insufficiency.

Interaction with other drugs

Novocainamide enhances the effect of antiarrhythmic, hypotensive, anticholinergic and cytostatic drugs, muscle relaxants, side effects of bretylium tosylate.
When used simultaneously with antihistamines, atropine-like effects may increase; with pimozod - prolongation of the QT interval.
Reduces the activity of antimyasthenic drugs.
Cimetidine and ranitidine reduce the renal clearance of procainamide and prolong T1/2.
When combined with class III antiarrhythmic drugs, the risk of developing an arrhythmogenic effect increases.
Medicines that inhibit bone marrow hematopoiesis increase the risk of myelosuppression.

Overdose

A drug Novocainamide has a small therapeutic breadth, so severe intoxication can easily occur (especially with the simultaneous use of other antiarrhythmic drugs): bradycardia, sinoatrial and AV blockade, asystole, prolongation of the QT interval, paroxysms of polymorphic ventricular tachycardia, decreased myocardial contractility, persistent arterial hypotension, edema lungs, convulsions, coma, respiratory arrest.
Treatment: symptomatic. For the treatment of ventricular tachycardia, do not use class I A or class 1 C antiarrhythmic drugs. Sodium bicarbonate can eliminate widening of the QRS complex or arterial hypotension.

Storage conditions

List B. Store out of reach of children, protected from light at a temperature of 0 to 25°C. Shelf life - 5 years.

Release form

Novocainamide - solution for intravenous and intramuscular administration of 100 mg/1 ml.
Packaging: 10 ampoules of 5 ml.

Compound

1 ml (1 ampoule) of the drug Novocainamide contains: procainamide hydrochloride 100 mg 500 mg.
Excipients: sodium disulfite, water for injection.

Additionally

With caution: liver failure, renal failure.
Contraindicated in children under 18 years of age.
With caution in old age. Elderly patients are more likely to develop arterial hypotension.
Before intravenous use, it must be diluted and administered at a rate of no more than 50 mg/min; should only be used in a hospital setting.
During therapy, it is necessary to constantly monitor blood pressure, ECG, and peripheral blood count (at the end of therapy).
Elderly patients are more likely to develop arterial hypotension.

Main settings

Name:	NOVOCAINAMIDE
ATX code:	C01BA02 -

Diseases of the heart and blood vessels can lead to serious consequences, including disability and death. Timely drug treatment helps to overcome the disease and improve the quality of life.

Novocainamide, the instructions for use of which will help you get acquainted with the drug, is included in the list of highly effective drugs that help with emergency care and prevention.

The instructions for use of the medicine indicate that Novocainamide comes in two forms:

tableted;
Novocainamide in ampoules.

The main active ingredient is , the contents of which are:

one tablet equals 250 grams;
in injection solution 100 milligrams.

Pharmacological group

According to the instructions for use, Novocainamide belongs to the pharmacological group of class IA, restoring the failure of the sequence and frequency of heart contractions.

The active substance involved in metabolism, N-acetylprocainamide, helps to prolong the duration of antiarrhythmic activity. It has a slight effect on changing the force of heart contractions without significantly affecting the amount of blood ejected into the aorta within 60 seconds. It has a blocking effect on the activity of the autonomic nervous system, affects the decrease in the tone of the venous walls of blood vessels.

Mechanism of action

The drug Novocainamide, the mechanism of action of which is realized by reducing the magnitude of the incoming sodium current, aligning its speed with the increased outgoing current and stopping the oscillation of the membrane action potential, acts as follows:

suppresses the conduction of electrical impulses through the atria, AV node and ventricles;
extends the period of time during which the excitability of the membrane decreases and gradually restores to its original level;
suppresses the automatism of the sinus node and ectopic rhythm drivers, increases the threshold of uncoordinated contractions of ventricular muscle groups.

Electrophysiological effects in the heart are manifested by broadening of the ventricular complex, which is recorded during excitation of the ventricles of the heart.

The time period for obtaining the highest effect with intravenous administration of Novocainamide is immediately, with intramuscular administration - within an hour, as evidenced by the instructions for use.

Indications

Antiarrhythmic drugs should be used exclusively as prescribed by a doctor and instructions. Indications for the use of Novocainamide are severe cardiac arrhythmias:

- increased ventricular contractions up to 100 beats per minute while maintaining normal heart rhythm;
ventricular extrasystole - a violation of the heart rhythm associated with extraordinary, premature ventricular contractions;
- caused by disturbances in the conductivity of electrical impulses and the regularity of heart contractions;
atrial fibrillation and;
a congenital anomaly of the structure of the heart associated with frequent premature excitation of the ventricles.

Treatment should be preceded by diagnosis and examination of the patient using high-tech techniques.

Ventricular tachycardia

Contraindications

The use of the drug Novocainamide in any form, according to the instructions for use, is contraindicated in the following cases:

atrioventricular block 1.2 degrees;
cardiac arrhythmia due to overdose of glycosides, for the treatment of heart failure;
decreased level of leukocytes in the blood;
diffuse connective tissue disease;
bronchial asthma;
low blood pressure;
extreme degree of left ventricular failure;
hypersensitivity to the composition of the drug.

Use during pregnancy and lactation - under strict supervision of a specialist, according to health indications. Administration to children is undesirable. For patients in the older age group, use caution according to the instructions for using Novocainamide.

Instructions for taking pills

The drug Novocainamide in tablet form should be administered orally as a whole. For effective therapy, take Novocainamide tablets, the instructions for use advise, on an empty stomach, with water.

Dose of the drug Novocainamide according to the instructions for use for cardiac arrhythmias:

first dose from 0.25 to 1 gram;
subsequent doses with a break of 6 hours, 0.25–0.5 grams.

Application of solution for injection in ampoules

When administered intravenously, Novocainamide, an injection solution in an ampoule, is diluted in a 5% glucose solution or 0.9% saline solution. The rate of administration should correspond to 50 mg/min, with mandatory monitoring of indicators: pressure and heart rate, electrocardiogram data - before and after the procedure.

The maximum single dose for a person when Novocainamide is administered directly into the bloodstream is 10 ml of solution.

To localize an attack

The instructions for use indicate that to relieve a sudden exacerbation of symptoms, the following are effective:

Intravenous injection, monitoring blood pressure and cardiac electrocardiogram, 100–500 mg of Novocainamide. The solution is administered slowly, monitoring the body's reaction.
Intravenous drip infusion: 500–600 mg of solution over half an hour.

In case of heart failure of the 2nd degree, intravenous administration of 10–30 ml of the drug solution per day is advisable.

Side effects

The instructions warn that with the intravenous route of administration of the drug Novocainamide, side effects are possible. Third-party actions may be the following:

CNS related:
- muscle fatigue;
- depressive states;
- headaches and dizziness;
- sleep problems;
- convulsive reactions;
- loss of coordination.
Related to the gastrointestinal tract:
- nausea;
- vomit;
- diarrhea.
Related to SSS:
- fluctuations in blood pressure;
- increase in cardiac activity.

Allergic reactions are possible in the form of skin rash, redness and itching.

With rapid intravenous administration of Novocainamide, serious reactions are possible:

development of collapse, characterized by a drop in pressure and deterioration of blood supply to vital organs;
asystole and complete cessation of blood circulation.

Intravenous injections of Nocainamide must be performed in the manipulation room of a clinic or in a hospital, strictly following the instructions for use.

Recipe in Latin

The Latin name of the drug Novocainamide is Novocainamide.
International nonproprietary name - Procainamide.
An example of a recipe for Novocainamide in Latin for intravenous injection:
RP: Solutionis Procainamidi 10% - 5 ml.
D.t. d. No. 10 in ampullis
S. Inject slowly 5 ml in 20 ml of 5% glucose solution intravenously for atrial flutter.

Analogs

When, for objective reasons, it is not possible to purchase the original drug, you can use drugs that have a similar therapeutic effect on the body as Novocainamide, i.e. analogues.

When switching to analogue medications, you must consult a doctor, since, despite the same effect, each drug has, according to the instructions, a degree of effectiveness in a specific case of the disease.

The following analogues of Novocainamide are produced:

Procainamide;
Novocainamide bufus;
Novocainamide-Ferein.

When treating a disease, you can use analogues and synonyms of the medicine, depending on the course of the disease, the physical and age characteristics of the patient. It is important that they are prescribed by the attending physician. Because each drug has a similar main effect, but side effects and combinations may vary. The cost of the drug is not the main indicator in choosing a medicine.

Useful video

From the following video you can learn useful information about:

Conclusion

Novocainamide is an effective drug for the treatment of arrhythmia, available in tablets and injection solution.
The huge advantage of the drug is its immediate effect on relieving acute attacks of atrial fibrillation while maintaining left ventricular function and a low percentage of adverse reactions.
To avoid negative consequences for the body and complications, the drug should be taken strictly as prescribed and under the supervision of a doctor.
Before starting treatment, it is necessary to study the instructions for use of Novocainamide in order to know the indications, contraindications, side effects and follow the method of application.

Latest update of the description by the manufacturer 01.06.2011

Filterable list

Active substance:

ATX

Pharmacological group

3D images

Composition and release form

in a blister pack 10 pcs.; in a cardboard pack 2 packs; or in dark glass jars of 20 pcs.; in a cardboard pack 1 jar.

in neutral glass ampoules of 5 ml, complete with an ampoule knife or scarifier; There are 10 ampoules in a cardboard box.

pharmachologic effect

pharmachologic effect- antiarrhythmic.

Directions for use and doses

Pills. Inside, regardless of food intake.

Ventricular extrasystole: 0.25-1 g, then 0.25-0.5 g every 3-6 hours (if necessary, the daily dose can be increased to 3-4 g).

Paroxysms of atrial fibrillation: 1-1.5 g once. After 1 hour (if there is no effect), another 0.5 g and then every 2 hours, 0.5-1 g (until the paroxysm stops). The highest daily dose is 3 g.

Solution for intravenous and intramuscular administration. IV, IM. Adults, IV - 100-500 mg at a rate of 25-50 mg/min (with blood pressure and ECG monitoring) until the paroxysm is relieved (maximum dose - 1 g) or IV drip - 500-600 mg for 25-30 minutes . The maintenance dose for intravenous drip administration is 2-6 mg/min; if necessary, 3-4 hours after stopping the infusion, start taking the drug orally. In case of heart failure of the second degree, the dose is reduced (by 1/3 or more).

IM - 50 mg/kg body weight per day in divided doses.

When administered intravenously, the drug is diluted in 0.9% sodium chloride solution or 5% dextrose solution to a concentration of 2-5 mg/ml and administered slowly at a rate of no more than 50 mg/min. In this case, it is necessary to constantly monitor pulse rate, blood pressure and ECG. If necessary, repeat the administration at the same dose every 5 minutes until an effect or a total dose of 1 g is achieved. To prevent re-development of arrhythmia, infusion can be performed at a rate of 2-6 mg/min.

After stopping the arrhythmia, to maintain the effect, intramuscular administration is possible - 0.5-1 g (up to 2-3 g / day), but the intravenous route of administration is preferable.

The highest dose for adults for intramuscular and intravenous (drip) administration: single dose - 1 g (10 ml), daily - 3 g (30 ml).

Storage conditions for the drug Novocainamide

In a place protected from light, at a temperature not exceeding 30 °C.

Keep out of the reach of children.

Shelf life of the drug Novocainamide

solution for intravenous and intramuscular administration 100 mg/ml - 2 years.

tablets 250 mg - 3 years.

Do not use after the expiration date stated on the package.