Novocainamide prescription 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 by bolus with 20 ml. 0.9% sodium chloride solution.

Prescription form - 107-1/u (Russia)

pharmachologic effect

It 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, AV (atrioventricular) node.

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

It blocks sodium channels in phase 4, prolongs it, thereby suppressing the automatism of the Purkinje fiber, sinus node and ectopic pacemakers, increases the threshold for ventricular myocardial fibrillation.

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

It 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 the widening of the QRS complex and the lengthening of the PQ and QT intervals.

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

Mode of application

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

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

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

Intramuscularly, the drug is administered at 0.5-1 g to maintain the therapeutic effect, however, preference is still given to intravenous administration and ingestion.

Inside the drug is taken in conditions that do not require emergency treatment. In case of ventricular arrhythmias, 50 mg / kg body weight per day is prescribed, evenly dividing the total dose into 8 doses. In case of atrial arrhythmias, 1.25 g is initially prescribed, then 0.75 g every 2 hours. As maintenance therapy, 0.5–1 g every 4–6 hours. After infusion, oral administration is possible no earlier than after 3– 4 hours

For children, the drug is prescribed at 12.5 mg / kg of 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 pacemaker), ventricular flutter or flicker, ventricular arrhythmia against the background of intoxication with cardiac glycosides, leukopenia, arterial hypotension, cardiogenic shock, ventricular tachycardia of the "pirouette" type, prolonged interval QT, under 18 years of age

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 digestive tract: nausea, diarrhea, bitterness in the mouth.

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

With prolonged 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 prolonged use - drug lupus erythematosus (in 30% of patients with a duration of therapy of more than 6 months). Microbial infections, slow healing processes and bleeding gums are likely.

Release form

Tablets of 0.25 mg; ampoules with 10 solution for injections of 5 ml.

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Procainamide (procainamide)

Composition and form of release of the drug

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

pharmachologic effect

Class IA antiarrhythmic agent, has membrane stabilizing activity. It inhibits the incoming fast current of sodium ions, 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 (in the affected myocardium - to a greater extent). The conduction slowdown, which is observed regardless of the resting potential, is more pronounced in the atria and ventricles, less in the AV node. The indirect m-anticholinergic effect, compared with quinidine and disopyramide, is less pronounced, so there is usually no paradoxical improvement in AV conduction. Affects phase 4 depolarization, reduces the automatism of the intact and affected myocardium, inhibits the function of the sinus node and ectopic pacemakers in some patients. The active metabolite, N-acetylprocainamide, has a pronounced activity of class III antiarrhythmic drugs, prolongs the duration of the action potential. It has a weak negative inotropic effect (without a significant effect on the minute volume), vagolytic and vasodilating properties, which causes tachycardia and a decrease in blood pressure, OPSS. Electrophysiological effects are manifested in the widening of the QRS complex and the lengthening 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 / m administration, 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 the indicated metabolite; however, with rapid acetylation or impaired renal function, 40% of the dose is converted.

T 1/2 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 - in the form of a metabolite. In case of impaired renal function or chronic heart failure, the metabolite rapidly accumulates in the blood to toxic concentrations, while the concentration of procainamide remains within acceptable limits.

Indications

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

Contraindications

AV block II and III degree (except when using a pacemaker), flutter or ventricular fibrillation, arrhythmias against the background of intoxication with cardiac glycosides, leukopenia, hypersensitivity 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.

With the / m administration - 50 mg / kg / day in divided doses every 3-6 hours.

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

Maximum doses: adults when taken orally - 4 g / day; in / in the jet with repeated injections, the total dose is 1 g.

Side effects

From the side of the cardiovascular system: arterial hypotension (up to the development of collapse), intraventricular blockade, ventricular tachycardia, tachyarrhythmia; with rapid on / in the introduction - collapse, intraventricular blockade, 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 prolonged 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 prolonged use - drug lupus erythematosus (in 30% of patients with a duration of therapy of more than 6 months); possible microbial infections, slow healing processes and bleeding gums due to the risk of leukopenia and thrombocytopenia.

drug interaction

With simultaneous use with antiarrhythmic drugs, an additive cardiodepressive effect is possible; with antihypertensive agents - the antihypertensive effect is enhanced; with anticholinesterase agents - the effectiveness of anticholinesterase agents decreases.

With simultaneous use with m-anticholinergics, antihistamines, their anticholinergic effect is enhanced.

With simultaneous use, the effect of drugs that block neuromuscular transmission is enhanced; with the simultaneous use of agents that cause oppression of bone marrow hematopoiesis, it is possible to increase leukopenia and thrombocytopenia.

With simultaneous use with increases the QT interval due to the additive effect on its duration and the risk of developing ventricular arrhythmias of the "pirouette" type. The plasma concentration of procainamide and its metabolite N-acetylprocainamide increases, and side effects may increase.

With simultaneous use with captopril, an increased risk of developing leukopenia is possible.

With simultaneous use with ofloxacin, an increase in the concentration of procainamide in the blood is possible; with prenylamine - the negative inotropic effect and the risk of developing ventricular arrhythmias of the "pirouette" type are enhanced.

With simultaneous use with sotalol, quinidine, an additive increase in the QT interval is possible.

With simultaneous use with trimethoprim, the concentration in the blood plasma of procaine and its active metabolite N-acetylprocainamide increases, and there is a risk of developing toxic reactions.

With simultaneous use with cisapride, the duration of the QT interval increases significantly due to the additive action, there is a risk of developing ventricular arrhythmia (including the "pirouette" type).

With simultaneous use with increases the concentration of procainamide in the blood plasma and the risk of increased side effects, 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

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

Use with caution in the blockade of the legs of the bundle of His, arrhythmias against the background of intoxication with cardiac glycosides, myasthenia gravis, hepatic and / or, SLE (including history), bronchial asthma, chronic heart failure in the stage of decompensation, ventricular tachycardia with occlusion of the coronary artery , surgical interventions (including in surgical dentistry), with prolongation of the QT interval, arterial hypotension, atherosclerosis, with myasthenia gravis, in elderly patients.

Use in the elderly

Use with caution in elderly patients.

Novocainamide- an antiarrhythmic drug of class I A, which inhibits the incoming fast flow of Na +, 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 (in the affected myocardium - to a greater extent).
The conduction slowdown, which is observed regardless of the resting potential, is more pronounced in the atria and ventricles, less in the AV node.
The indirect m-anticholinergic effect, compared with quinidine and disopyramide, is less pronounced, so there is usually no paradoxical improvement in AV conduction.
Affects phase 4 depolarization, reduces the automatism of the intact and affected myocardium, inhibits the function of the sinus node and ectopic pacemakers in some patients.
The active metabolite - N-acetylprocainamide (N-APA) has a pronounced activity of class III antiarrhythmic drugs, prolongs the duration of the action potential.
It has a weak negative inotropic effect (without a significant effect on the IOC). It has vagolytic and vasodilating properties, which causes tachycardia and a decrease in blood pressure, total peripheral vascular resistance (OPSS). Electrophysiological effects are manifested in the expansion of the QRS complex and the lengthening of the PQ and QT intervals. The time to achieve the maximum effect with intravenous administration is immediately, with intramuscular injection - 15-60 minutes.

Pharmacokinetics

Penetrates through the blood-brain barrier, secreted in 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 to 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 rapidly accumulates in the blood to toxic concentrations, while the concentration of procainamide remains within acceptable limits.
T1 / 2 - 2.5-4.5 h; with chronic renal failure - 11-20 hours; N-acetylprocainamide - about 6 hours. About 25% of the administered is excreted by the kidneys (50-60% unchanged), with bile.

Indications for use

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

Mode of application

In / in - 100-500 mg at a rate of 25-50 mg / min (under the control of blood pressure and ECG) until the relief of paroxysm (maximum dose - 1 g) or in / in drip - 500-600 mg for 25-30 minutes. The maintenance dose for intravenous drip is 2-6 mg / min, if necessary, 3-4 hours after stopping the infusion, start taking the drug orally.
In heart failure II degree, the dose is reduced by 1/3 or more.
In / m enter 5-10 ml (up to 20-30 ml / day).
When administered intravenously, the drug Novocainamide diluted in 5% glucose solution or sodium chloride solution 0.9%. 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 i / m and / in (drip) administration: single - 1 g (10 ml of the drug), daily - 3 g (30 ml of the drug).
When switching to taking the drug inside, the first dose is administered 3-4 hours after the cessation of the IV infusion.

Side effects

From the side of 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 side of the cardiovascular system: lowering blood pressure, ventricular paroxysmal tachycardia. With rapid on / in the introduction, the development of collapse, a violation of atrial or intraventricular conduction, 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 block II and III degree (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; trembling or flickering of the ventricles; lactation period; age up to 18 years (efficacy and safety have not been established); hypersensitivity to the drug.
In connection with a possible decrease in myocardial contractility and a decrease in blood pressure, the drug should be prescribed with great caution in myocardial infarction. Possible arrhythmogenic effect.
Blockade of the legs of the bundle of His, AV blockade of the 1st degree, myasthenia gravis, bronchial asthma, hepatic and / or renal failure, chronic heart failure, ventricular tachycardia with coronary artery occlusion, surgical interventions (incl.

surgical dentistry), severe atherosclerosis, advanced age.

Pregnancy

Novocainamide use only if 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.
With simultaneous use with antihistamine drugs, atropine-like effects may be enhanced; with pimozode - prolongation of the QT interval.
Reduces the activity of antimyasthenic drugs.
Cimetidine, ranitidine reduce the renal clearance of procainamide and prolong T1 / 2.
In combination therapy with class III antiarrhythmic drugs, the risk of developing an arrhythmogenic effect increases.
Medicines that suppress bone marrow hematopoiesis increase the risk of myelosuppression.

Overdose

A drug Novocainamide has a small therapeutic breadth, therefore, 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 antiarrhythmics. Sodium bicarbonate is able to eliminate the expansion of the QRS complex or arterial hypotension.

Storage conditions

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

Release form

Novocainamide - rr d / in / in and / m injections of 100 mg / 1 ml.
Packing: 10 ampoules of 5 ml.

Compound

1 ml (1 ampoule) of the preparation 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 the elderly. Elderly patients are more likely to develop arterial hypotension.
Before IV use, it is necessary to dilute, inject at a rate of not more than 50 mg / min; should only be used in a hospital setting.
During therapy, it is necessary to constantly monitor blood pressure, ECG, peripheral blood formulas (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 results, including disability and death. Timely medical treatment contributes to overcoming the disease and improving 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.

Instructions for use of the drug indicates that Novocainamide comes in two forms:

• tableted;
• Novocainamide in ampoules.

The main active ingredient is, the content of which is:

• in one tablet is equal to 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 active substance involved in metabolism, N-acetylprocainamide, helps to prolong the duration of antiarrhythmic activity. It has a slight effect of changing the force of contractions of the heart, without significantly affecting the amount of blood ejected into the aorta for 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 fluctuation of the membrane action potential, acts as follows:

• inhibits the conduction of electrical impulses through the atria, AV node and ventricles;
• lengthens the period of time during which the excitability of the membrane decreases and gradually recovers to its original level;
• suppresses the automatism of the sinus node and ectopic pacemakers, increases the threshold for uncoordinated contractions of ventricular muscle groups.

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

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

Indications

Medicines of the antiarrhythmic group should be used only as prescribed by the doctor and instructions. Indications for the use of Novocainamide are severe cardiac arrhythmias:

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

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

Ventricular tachycardia

Contraindications

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

• atrioventricular blockade 1.2 degree;
• cardiac arrhythmia due to an overdose of glycosides, for the treatment of heart failure;
• low 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 the strict supervision of a specialist, according to vital indications. Appointment to children is undesirable. Patients of the older age group - with caution, according to the instructions for the use of Novocainamide.

Instructions for taking tablets

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

Dose of the drug Novocainamide according to the instructions for use in violation of the heart rhythm:

• 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 5% glucose solution or 0.9% saline. 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 with the introduction of Novocainamide directly into the bloodstream is 10 ml of solution.

For seizure localization

Instructions for use indicate that for the relief of a sudden exacerbation of symptoms, the following are effective:

1. Intravenous injection, monitoring blood pressure and electrocardiogram of the heart, 100-500 mg of Novocainamide. The solution is administered slowly, controlling the reaction of the body.
2. Intravenous drip infusion: 500-600 mg of solution for 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 instruction warns that with the intravenous route of administration of the drug Novocainamide, side effects are possible. Third-party actions can be the following:

1. CNS related:
   • muscle fatigue;
   • depressive states;
   • headaches and dizziness;
   • sleep problems;
   • convulsive reactions;
   • loss of coordination.
2. Gastrointestinal related:
   • nausea;
   • vomit;
   • diarrhea.
3. Related to the CCC:
   • fluctuations in blood pressure;
   • increase in cardiac activity.

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

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

• the development of collapse, characterized by a drop in pressure and a deterioration in the blood supply to vital organs;
• asystole and complete circulatory arrest.

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

Recipe in Latin

The Latin name of the drug Novocainamide is Novocainamide.
The international non-proprietary name is Procainamide.
An example of a Novocainamide prescription in Latin for an 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 in atrial flutter.

Analogues

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, like Novocainamide, i.e. analogues.

When switching to analog drugs, it is necessary to consult a doctor, since, despite the same effect, each drug has, according to the instructions, a degree of effectiveness in a particular case of the disease.

The following analogues of Novocainamide are produced:

• Procainamide;
• Novocainamide bufus;
• Novocainamid-Ferein.

In the treatment of the disease, you can use analogues and synonyms of the drug, depending on the course of the disease, the physical and age data 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 drug.

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Conclusion

1. Novocainamide is an effective drug for the treatment of arrhythmias, available in tablets and injectable solution.
2. A huge advantage of the drug is the immediate effect on the relief of acute attacks of atrial fibrillation while maintaining the functions of the left ventricle and a low percentage of adverse reactions.
3. In order to avoid negative consequences for the body and complications, the drug should be taken strictly as directed and under the supervision of a doctor.
4. Before starting treatment, it is necessary to study the instructions for the use of Novocainamide in order to know the indications, contraindications, side effects and follow the method of application.

Last update of the description by the manufacturer 01.06.2011

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Composition and form of release

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

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

pharmachologic effect

pharmachologic effect- antiarrhythmic.

Dosage and administration

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 (in the absence of 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. In / in, in / m. Adults, IV - 100-500 mg at a rate of 25-50 mg / min (with control of blood pressure and ECG) until the relief of paroxysm (maximum dose - 1 g) or IV drip - 500-600 mg over 25-30 minutes . The maintenance dose for intravenous drip is 2-6 mg / min, if necessary, 3-4 hours after stopping the infusion, start taking the drug orally. In heart failure II degree, the dose is reduced (by 1/3 or more).

IM - 50 mg/kg of 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 slowly injected at a rate of not more than 50 mg / min. In this case, it is necessary to constantly monitor the pulse rate, blood pressure and ECG. If necessary, repeat the introduction at the same dose every 5 minutes until the effect or a total dose of 1 g is achieved. To prevent the recurrence of arrhythmia, infusion can be carried out 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), however, it is preferable to / in the route of administration.

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

Storage conditions of 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 Novocainamide

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

250 mg tablets - 3 years.

Do not use after the expiry date stated on the packaging.