Tonocard (Oral)

Tocainide belongs to the group of medicines known as antiarrhythmics. It is used to correct irregular heartbeats to a normal rhythm.

Tocainide produces its helpful effects by slowing nerve impulses in the heart and making the heart tissue less sensitive.

Tocainide is available only with your 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 them 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 cause some people to feel dizzy, lightheaded, or less alert than usual. Make sure you know how this medicine affects you before driving, using machines, or doing anything else that could be dangerous if you are dizzy or 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, the risks of taking the medicine must be weighed against the benefits it will provide. This is a decision you and your doctor will make together. For this medicine, consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, inform your health care professional if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription 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 about using tocainide in children compared to other age groups.

Geriatric

Dizziness or lightheadedness may be more likely in older adults, who are generally 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 happen. In these situations, your doctor may want to adjust the dose or take other precautions. When you are taking this medicine, it is especially important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been selected based on their potential importance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or 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 take 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 take one or both of the medicines.

• Cimetidine
• Rifampin
• Rifapentine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used around the time of eating food or specific types of food due to potential interactions. Using alcohol or tobacco with certain medicines may also lead to 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 the use of this medicine. Make sure you 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 increased due to slower removal of tocainide from the body

Along with its intended effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they might 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
• Severe skin rash
• Sores in mouth
• Unusual bleeding or bruising

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body gets used to the medicine. Also, your health care professional may be able to tell you how to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, 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.