Drug Interaction:
Diuretics/cardiovascular drugs- because of possible additive pharmacologic effects, use
caution when encainide is used with other drugs that affects cardiac function.
Cimitedine- increases plasma concentrations of encainide and its metabolites.
Indication:
Antiarrhythmic agents include-
Group I - Moricizine, Qunidine, Procainamide, Disopyramide, Lidocaine, Phenytoin, Tocainide,
Mexiletine, Flecanide, Encainide, Propafenone
Group II- Propranolol, Esmolol, Acebutol
Group III- Bretylium, Amiodarone, Solatol
Group IV- Verapramil, Digoxin, Adenosine
Adverse Reaction:
Adverse events caused dciscontinuation in about 7% of patients in clinical trials
Only 0.4% of patients discontinued therapy due toCHF or related causes
Second- degree or third- degree AV block developed in 0.5% and 0.2% respy.
BODY AS A WHOLE- Chest pain 5% Asthenia 4% Headache 3%
Parethesia 1%
Upper/lower extremity pain, Pain < 1%
CARDIOVASCULAR - Palpitations 4%, Ventricular tachycardia 3%
Congestive heart failure,QRS interval prolongation,
Syncope < 1%
GI - Abdominal pain, Nausea 2%,
Constipation,Diarrhea , Dyspepsia < 1%
CNS - Dizziness 6%, Tremor < 1%
RESPIRATORY - Dyspnea 2% Increased cough < 1%
SKIN Rash < 1%
SPECIAL SENSES - Abnormal vision 4%, Taste pervertion 1%
Contra-Indications:
Symptoms nonsustained ventricular arrhythmias and frequent premature ventricular complexes.
Patients with pre-existing second or third degree AV block. Cardiogenic shock.
Hypersens to the drug
Special precautions:
Pregnancy, lactation.
Dosages/ Overdosage Etc:
Indications:
Documented life threatening arrhythmias viz. sustained ventricular tachycardia
Dosage:
Adults- 25mg every 8 hours. After 3 to 5 days, increase the dosage to 35mg 3 times a day if necessary.
Patient Information:
ENCAINIDE HCL
1. Allergy- tell your doctor if you ever had any allergic reaction to encainde or any other substances such as food, preservatives or dyes.
2. Pregnancy- not studied in pregnant women. However this medicine has shown to cause birth defects or other problems in animal studies. Before taking encainide make sure your doctor knows if you are pregnant or if you may become pregnant
3. Breast feeding- encainide passes into the milk of some animals and may also pass into the milk of humans.
However this medicine has not been reported to cause problems in nursing babies
4. Children- studies on this medicine has been done only on adult patients, therfore be sure to discuss with your doctor the use of this medicine
5. Older adults- no specific informaton about teuse of ecainde in the elderly
6. Other medical problems- tell your doctor if you any other medical problems especially-
Diabetes mellitus-eacainde may raise blood sugar levels.
Kidney disease - effects of encainde may be increased because of slower removal from the body.
Liver disease -effects of encaidema be chnaged.
Recent heart attack- risk of irregular heart beats may be increased
If you have a pace maker -encainide may interfere with the pacemaker and require careful following up
by the doctor.
7.. Dosing- dose of tocainide may be different for different patients. Follow yourdoctors advice
8. Missed dose -
If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time for the next dose, skip the missed dose. Do not double doses.
9. Storage -
Keep out of reach of children. Store away from heat or direct sunlight. Do not store
the capsule in bathroom, near the kitchen sink, or in other damp places.
10. Outdated medicines -
Do not keep outdated medicine or medicine no longer needed. Be sure that any
discarded medicine is out of reach of children.
Pharmacology/ Pharmacokinetics:
Pharmacology:
Mechanism of action of the antiarrhythmic effects are unknown but probably are the result of
encainide's ability to slow conduction, reduce membrane responsiveness, inhibit automaticity
and increase the ratio of the effective refractory period to action potential duration.
Pharmacokinetics:
Absorption after oral administration is nearly complete with peak plasma levels present 30 to 90 minutes after dosing. Absorption is delayed by food but overal bioavialability is not altered.
Interaction with Food:
Absorption delayed by food, but overal bioavailability is not altered.
Pregnancy and lactation:
Pregnancy:
Use during pregnancy only if needed.
Lactation:
Use with caution, weighing the benefits against the potential for serious adverse reactions to the nursing infant.