Tocainide (Oral)

Tocainide is part of a group of medicines called antiarrhythmics. It is used to restore irregular heartbeats to a normal rhythm.

Tocainide works by slowing down nerve signals in the heart and reducing the sensitivity of heart tissue.

Tocainide is available only with a doctor's prescription.

It is important for your doctor to check your progress at regular visits to ensure the medicine is working properly. This will help make changes to the amount of medicine you are taking if needed.

Your doctor may ask you to carry a medical identification card or bracelet that states you are using this medicine.

Tocainide may make some people feel dizzy, lightheaded, or less alert than usual. Make sure you know how this medicine affects you before you drive, operate machines, or do anything else that could be dangerous if you feel dizzy or are not alert.

Before having any type of surgery (including dental surgery) or emergency treatment, inform the medical doctor or dentist in charge that you are taking this medicine.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine against the benefits it may provide. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For over-the-counter products, read the label or package ingredients carefully.

Pediatric

Studies on this medicine have only been conducted in adult patients, and there is no specific information comparing the use of tocainide in children to its use in other age groups.

Geriatric

Elderly patients may be more likely to experience dizziness or lightheadedness, as they are usually more sensitive to the effects of tocainide.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might occur. In such cases, your doctor may want to adjust the dose or take other precautions. It is very important that your healthcare professional knows if you are taking any of the medicines listed below when you are using this medicine. The following interactions have been chosen based on their potential significance and are not necessarily a complete list.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to prescribe you this medication or may change some of the other medicines you take.

• Vernakalant

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both of the medicines.

• Amiodarone
• Cobicistat
• Darunavir
• Lacosamide
• Lidocaine
• Prilocaine
• Sotalol

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or how often you use one or both of the medicines.

• Cimetidine
• Rifampin
• Rifapentine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be taken around mealtimes or with specific types of food due to possible interactions. Using alcohol or tobacco with certain medicines may also result in interactions. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may affect how you can use this medicine. Make sure to tell your doctor if you have any other medical issues, especially:

• Congestive heart failure—Tocainide may worsen this condition

• Kidney disease or
• Liver disease—Effects may be stronger due to slower removal of tocainide from the body.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common

• Trembling or shaking

Rare

• Blisters on skin
• cough or shortness of breath
• fever or chills
• irregular heartbeats
• peeling or scaling of skin
• skin rash (severe)
• sores in mouth
• unusual bleeding or bruising

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Dizziness or lightheadedness
• loss of appetite
• nausea

Less common

• Blurred vision
• confusion
• headache
• nervousness
• numbness or tingling of fingers and toes
• skin rash
• sweating
• vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Tonocard

Chemical Class: Amino Amide

Take tocainide exactly as directed by your doctor, even though you may feel well. Do not take more medicine than ordered.

If tocainide upsets your stomach, your doctor may advise you to take it with food or milk.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at evenly spaced times day and night. For example, if you are to take 3 doses a day, the doses should be spaced about 8 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your health care professional.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets): For irregular heartbeat: Adults—At first, 400 milligrams (mg) every eight hours. Then, your doctor may increase your dose up to 600 mg three times a day. Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.