Abstract

Sustained-Release Procainamide Use of Serum Concentrations to Determine Dosage

Authors: WILLIAM E. REED JR., M. WAYNE COOPER MD, Pharm D

Abstract

ABSTRACTThe utility of the antiarrhythmic drug procainamide (PA) is limited by the required dosage schedule (every three to four hours). A commercially available, slow release procainamide (P-SR) is recommended to be given every six hours. We compared procainamide capsules (P-Caps) given every four hours with P-SR given every six hours in a crossover study of 12 patients. Doses of P-Caps were chosen to produce a therapeutic result and serum drug concentrations within the therapeutic range. Doses of P-SR were adjusted until serum PA concentrations were similar to those when P-Caps were used. The dosage for P-Caps was 58 mg/kg/day ± 24.6; P-SR dosage was 53 mg/kg/day ± 15.18 (mean ± SD) (P not statistically significant). The PA peak to trough variation for P-Caps was 2.2 μg/ml ± 2.3 and for P-SR 1.5 μg/ml ± 1.4 (P not significant). We conclude that P-SR given every six hours in the same daily dose as PA capsules given every four hours will provide similar therapeutic concentrations with no greater peak to trough variation.

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