Tocainide

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.
Excreted Unchanged %
31-45
Half-Life (Normalesrd) Hours
11.2-15.8/18-26
Plasma Protein Binding %
10-20
Volume Of Distribution L/Kg
2.8-3.2
Dose For Normal Renal Function
400 mg q8h
Second Dose
Second Dose: 400-600 mg q8h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis, [A]
Supplement For Dialysis [Recommendation Level]: Pd
PD: None, [A]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [D]
References
Braun J, S&#246; rgel F, Engelmaier F, Gluth WP, Gessler U. Pharmacokinetics of tocainide in patients with severe renal failure. Eur J Clin Pharmacol. 1985; 28: 665-70. [PMID: 3933983] / Raehl CL, Beirne GJ, Moorthy AV, Patel AK. Tocainide pharmacokinetics during continuous ambulatory peritoneal dialysis. Am J Cardiol. 1987; 60: 747-50. [PMID: 3116834] / Roden DM, Woosley RL. Drug therapy. Tocainide. N Engl J Med. 1986; 315: 41-5. [PMID: 3086724] / Wiegers U, Hanrath P, Kuck KH, Pottage A, Graffner C, Augustin J, et al. Pharmacokinetics of tocainide in patients with renal dysfunction and during haemodialysis. Eur J Clin Pharmacol. 1983; 24: 503-7. [PMID: 6407848]
Toxicity Notes
Agranulocytosis, bone marrow depression, leukopenia, neutropenia, aplastic/hypoplastic anemia, thrombocytopenia, pulmonary fibrosis, interstitial pneumonitis, fibrosing alveoliti. Excretion decreased in alkaline urine.