What is Procainamide?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 19 July 2019
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Procainamide is an antiarrhythmic drug that acts to slow the heart by interfering with calcium channels in the muscle cells. A doctor may prescribe this medication for long term management of a heart problem, and it can also be used in an emergency setting to control a severe arrhythmia. Like other drugs capable of changing the heart beat, this drug can be very dangerous for some patients, including people with certain underlying medical issues, along with people who have a normal heart rate.

Injectable forms of procainamide are available for use in hospital settings. Pharmaceutical companies also produce tablets for home use among patients with arrhythmias. Before a doctor prescribes this drug, she will conduct a thorough evaluation of the patient, studying electrocardiograms and interviewing the patient to learn more about the patient's heart problem. Issues like liver or kidney disease, history of heart attack, and problems with a pacemaker can complicate the process of determining whether procainamide is suitable for a patient.

In an emergency where a doctor orders a procainamide injection to stabilize a patient with a dangerously fast heartbeat, a nurse administers the medication slowly and monitors the patient's reaction. Patients taking tablets at home have to time the doses carefully and report side effects to their doctors. Issues like chest pain, fatigue, trouble breathing, and skin rashes can be signs of complications or adverse reactions to the medication.


One potential side effect of procainamide is low blood pressure, caused by the slowing of the heart rate. This medication can also cause autoimmune inflammation like that seen in patients with lupus. Commonly, patients experience dizziness, nausea, and a bitter taste in the mouth, especially when they first start taking procainamide. If these symptoms persist or worsen in severity, the patient should report them to a doctor. The doctor can order testing and discuss alternatives to this medication if the side effects are intolerable.

Administering procainamide to a patient with a normal heart rhythm can be very dangerous. The medication will interrupt the heart's function and can cause a dangerously slow and erratic rhythm to develop. People who take procainamide by accident should call their doctors immediately to get medical advice and this medication should be kept in a safe place to reduce the risks of accidental ingestion. The pharmacist will apply a label indicating what it is, who it is for, how it should be taken, and providing information about the dangers.



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