Neonatal Drug Therapy Manual


Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Antiarrhythmic Agent, class 1-A
Original Date: 
April 1996
Revised Date: 
May 2014
  • Ventricular arrhythmias, atrial fibrillation or flutter
  • Paroxysmal atrial fibrillation
  • IV intermittent infusion
    • Loading dose: over 60 minutes
  • IV continuous infusion
    • Load:   7 - 10 mg/kg over 1 hour followed by a continuous infusion
    • Continuous infusion: 20 - 80 mcg/kg/min; titrate dose to effect
Side Effects: 
  • CVS: hypotension, tachycardia, arrhythmias, increase or decrease AV block, QT prolongation, widening of QRS complex
  • GI: nausea, vomiting
  • Hematologic: neutropenia, thrombocytopenia, agranulocytosis
Parameters to Monitor: 
  • ECG, (attention to QRS & QT duration), BP
  • CBC with differential, platelet count
Reconstitution and Stability: 
  • Procainamide 100 mg/mL
    • Take 1 mL (100 mg) and add to 49 mL 0.9% NaCl
    • Final concentration: 2 mg/mL
  • Procainamide 100 mg/mL
    • Take 2 mL (200 mg) and add to 48 mL of 0.9% NaCl
    • Final concentration: 4 mg/mL

- Solution Compatible: 0.9% NaCl


- Chang PM, Silka MJ, Moromisato DY, et al.  Amiodarone Versus Procainamide for the Acute Treatment of Recurrent Supraventricular Tachycardia in Pediatric Patients. Circ Arrhythm Electrophysiol. 2010;3: 134-40

- Moffett BS, Cannon BC, Friedman RA, et al. Therapeutic Levels of Intravenous Procainamide in Neonates: A Retrospective Assessment. Pharmacotherapy, 2006; 26 (12): 1687-93

- Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 20th Edition. Hudson: Lexi-Comp Inc; 2013

- Trissel LA. Handbook on Injectable Drugs. 16th Edition: Bethesda: American Society of Health-System Pharmacists: 2011

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