General Toxicity Notes
Blood levels most often the best guide to therapy. Half-life may be prolonged in heart failure or with reduced hepatic blood flow.
Half-Life (Normalesrd) Hours
6-8/42-70
Plasma Protein Binding %
10-20
Volume Of Distribution L/Kg
1.5-1.7
Dose For Normal Renal Function
500 mg q6-8h
Adjustment For Renal Failure Method
D,I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% q6-8h [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
50% q8-12h [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
25% q12-18h [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None
Supplement For Dialysis [Recommendation Level]: Pd
PD: None
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, monitor serum concentration, [D]
References
Connolly SJ, Kates RE. Clinical pharmacokinetics of N-acetylprocainamide. Clin Pharmacokinet. 1982; 7: 206-20. [PMID: 6178545] / Domoto DT, Brown WW, Bruggensmith P. Removal of toxic levels of N-acetylprocainamide with continuous arteriovenous hemofiltration or continuous arteriovenous hemodiafiltration. Ann Intern Med. 1987; 106: 550-2. [PMID: 2435200] / Vlasses PH, Ferguson RK, Rocci ML Jr, Raja RM, Porter RS, Greenspan AM. Lethal accumulation of procainamide metabolite in severe renal insufficiency. Am J Nephrol. 1986; 6: 112-6. [PMID: 2422935]
Toxicity Notes
Hemofiltration useful in poisoning.