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$Title{TOCAINIDE}
$Subject{Tonocard (Merck Sharp & Dohme)}
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Copyright (C) 1991 Publications International, Ltd.


TOCAINIDE
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BRAND NAME (Manufacturer):
     Tonocard (Merck Sharp & Dohme)
TYPE OF DRUG:
     Antiarrhythmic
INGREDIENT:
     tocainide
DOSAGE FORM:
     Tablets (400 mg and 600 mg)
STORAGE:
     Store at room temperature in a tightly closed container.

USES

     Tocainide is used to treat heart arrhythmias.  It suppresses irregular
heartbeats and helps to achieve a more normal rhythm.

TREATMENT

     To decrease stomach irritation, you can take tocainide with a glass of
milk or with food (unless your doctor directs you to do otherwise).
     Try to take the drug at the same time(s) every day.  Tocainide works best
when the amount of drug in your bloodstream is kept constant.  This medication
should, therefore, be taken at evenly spaced intervals day and night.  For
example, if you are to take tocainide three times per day, the doses should be
spaced eight hours apart.
     Try not to miss any doses of tocainide.  If you do miss a dose, take the
missed dose as soon as possible.  However, if the next scheduled dose is
within four hours (if you are taking tocainide three times daily) or within
six hours (if you are taking it twice daily), do not take the missed dose at
all; just return to your regular dosing schedule.  Do not double the next
dose.

SIDE EFFECTS

     Minor.

     Abdominal pain, altered taste, anxiety, constipation, diarrhea,
difficulty in swallowing, dizziness, drowsiness, dry mouth, fatigue, headache,
heartburn, hot or cold feelings, increased thirst, light-headedness, loss of
appetite, nausea, restlessness, sweating, or vomiting.  These side effects
should disappear as your body adjusts to this medication.
     If you feel dizzy or light-headed, sit or lie down for a while; get up
slowly from a sitting or reclining position, and be careful on stairs.
     If you experience mouth dryness, you might try chewing sugarless gum or
sucking on ice chips or a piece of hard candy.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
chest pain, chills, confusion, coughing, depression, disorientation, earache,
fever, hair loss, hallucinations, hearing loss, incoordination, itching, leg
cramps, mental changes, mood changes, mouth sores, muscle or joint pain, neck
pain, palpitations, rash, ringing in the ears, seizures, shakiness, shortness
of breath, sleep disorders, slurred speech, sore throat, tingling in the
fingers or toes, unsteadiness, unusual bleeding or bruising, urination
problems, visual disturbances, weakness, wheezing, or yellowing of the skin or
eyes.

INTERACTIONS

     The concurrent use of tocainide and metoprolol can have additive negative
effects on the heart.
     Before taking tocainide, BE SURE TO TELL YOUR DOCTOR about any
medications you are currently taking, especially metoprolol.

WARNINGS

     * Be sure to tell your doctor about any unusual or allergic reactions you
have had to any medications, especially to tocainide or any other chemically
related local anesthetic or antiarrhythmic, such as bupivacaine, dibucaine,
etidocaine, lidocaine, mepivacaine, or prilocaine.
     * Before starting tocainide, be sure to tell your doctor if you now have
or if you have ever had blood disorders, bone marrow disease, heart block,
heart failure, kidney disease, or liver disease.
     * Before surgery or other medical or dental treatment, tell your doctor
or dentist you are taking this drug.
     * If this drug makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * During the first three months of tocainide therapy, your doctor may
schedule periodic blood counts.  It is important for you to have these blood
tests done to monitor for possible side effects on the bone marrow.
     * Tell your doctor if you are pregnant.  Studies in pregnant women have
not been conducted.  However, adverse effects have occurred in the offspring
of animals that were given large doses of tocainide.  Also, tell your doctor
if you are breast-feeding an infant.  It is not yet known if tocainide passes
into human breast milk.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
