tocainide (Tonocard, Taquidil)

Introduction

Tradename: Tonocard. (tocainide hydrochloride) Class-IB antiarrhythmic agent.

Indications

• ventricular arrhythmias
  • alone or in combination with class Ia agent
• not effective in treatment of supraventricular arrhythmias
• not proven effective in preventing recurrence of sustained life-threatening ventricular arrhythmias

Dosage

400-600 mg PO TID

Tabs: 400, 600 mg.

Adverse effects

• neurologic (may occur with therapeutic levels)
  • dizziness
  • confusion
  • tremors
  • paresthesias
• gastrointestinal
  • nausea & vomiting
  • may be reduced by administering tocainide with food
• pulmonary (0.1%)
  • pulmonary fibrosis
  • interstitial pneumonitis
  • fibrosing alveolitis
• hematologic (0.1-0.2%)
  • agranulocytosis
  • leukopenia
  • hypoplastic anemia
  • thrombocytopenia
  • CBC should be monitored with long term tocainide therapy
• lupus-like reaction

Drug interactions

• tocainide may attenuate theophylline metabolism

• drug interaction(s) of antiarrhythmic agents in combination with diuretics

Laboratory

• specimen: serum, plasma (EDTA, heparin)
• methods: GLC, HPLC

Therapeutic range: 4-10 ug/mL

More general terms

• antiarrhythmic agent, Group IB

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=38945
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=108173