Monograph Details
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Cardiovascular System
> CHF and arrhythmias
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NORPACE |
| Manufacturer |
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Pfizer Labs |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Class I antiarrhythmic. |
| Generic Name |
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Disopyramide (as phosphate) 100mg, 150mg; caps. |
| Also |
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• NORPACE-CR
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| Indications |
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Documented life-threatening ventricular arrhythmias. |
| Children |
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Initiate in hospital. Give as divided doses every 6 hours: <1 year: 10–30mg/kg per day; 1–4 years: 10–20mg/kg per day. 4–12 years: 10–15mg/kg per day. 12–18 years: 6–15mg/kg per day. |
| Adults |
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400–800mg daily in 4 divided doses every 6 hours. For rapid control of ventricular arrhythmias, consider loading dose of 300mg (200mg if body weight <110 lbs). Renal dysfunction, cardiac decompensation, or body wt <110 lbs: see literature. |
| Contraindications |
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Cardiogenic shock. 2nd- or 3rd- degree AV block, unless paced. Congenital QT prolongation. Severe renal insufficiency (CrCl ≤40mL/min): CR form not recommended. |
| Precautions |
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Correct potassium imbalance before starting. Discontinue if hypotension or CHF worsening occurs; if needed, restart at lower dose after cardiac compensation established. Reduce dose in 1st-degree AV block, consider discontinuing if persistent. Monitor closely or discontinue if QT prolongation or QRS widening occurs. Atrial tachyarrhythmias: digitalize first. Conduction defects. Cardiomyopathy. Renal or hepatic dysfunction. Urinary retention. BPH. Glaucoma. Myasthenia gravis. Chronic malnutrition. Elderly. Labor & delivery. Pregnancy (Cat.C): may stimulate uterine contractions. Nursing mothers: not recommended. |
| Interactions |
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Avoid other antiarrhythmics except in unresponsive, life-threatening arrhythmias. Avoid CYP3A4 inhibitors (eg, erythromycin, clarithromycin); may result in fatal interactions. Hypoglycemia with β-blockers, alcohol. Antagonized by hepatic enzyme inducers (eg, phenytoin). Do not give within 48 hours before or 24 hours after verapamil. |
| Adverse Reactions |
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Anticholinergic effects (eg, dry mouth, urinary retention, constipation, blurred vision), GI upset, dizziness, fatigue, impotence, hypotension, heart failure, AV block, edema, rash, hypoglycemia, hypokalemia, jaundice, blood dyscrasias, lupus-like syndrome, psychosis. |
| How Supplied |
Caps—100
CR—100, 500 |
| Additional Resources |
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• Related Prescribing Note |
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