Recainam dose titration and pharmacokinetics in patients with resistant arrhythmias.
Recainam, a new antiarrhythmic drug, was evaluated in 20 patients with drug-resistant stable ventricular arrhythmias. Dosage was increased stepwise every 48 to 72 hours until arrhythmia suppression, side effects, or a predetermined maximal dosage occurred. After a pharmacokinetic evaluation, efficacy was confirmed in a double-blind, crossover protocol. One patient had unusable ambulatory ECG data. There were 14 of 19 patients who responded during dose titration; efficacy was confirmed in 11 of 14. The mean effective dosage and trough plasma concentration were 427 mg every 8 hours and 1.83 micrograms/ml, respectively. One patient withdrew because of nausea. Slowing of intraventricular conduction necessitated dosage reduction in two patients. Plasma half-life was 9.4 +/- 4.1 hours, with renal elimination accounting for 62% of oral clearance. However, 66% of the variability in oral drug clearance was the result of nonrenal elimination. Oral recainam at dosages of 300 to 600 mg every 8 hours is effective in some drug-resistant ventricular arrhythmias and is well tolerated.
Davies
R F
RF
Department of Medicine, Vanderbilt University, Nashville, Tenn.
Lineberry
M D
MD
Funck-Brentano
C
C
Echt
D S
DS
Lee
J T
JT
Capuzzi
D M
DM
Roden
D M
DM
Woosley
R L
RL
D000284:Administration, Oral; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy; D004311:Double-Blind Method; D004361:Drug Tolerance; D004562:Electrocardiography; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D010671:Phenylurea Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D011897:Random Allocation
D000889:Anti-Arrhythmia Agents; D010671:Phenylurea Compounds; C039524:recainam