Norpace

— THERAPEUTIC CATEGORIES —
  • CHF and arrhythmias

Norpace Generic Name & Formulations

General Description

Disopyramide (as phosphate) 100mg, 150mg; caps.

Pharmacological Class

Class I antiarrhythmic.

See Also

How Supplied

Caps—100; CR—100, 500

Manufacturer

Norpace Indications

Indications

Documented life-threatening ventricular arrhythmias.

Norpace Dosage and Administration

Adult

400–800mg daily in 4 divided doses every 6hrs. 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 full labeling.

Children

Initiate in hospital. Give as divided doses every 6hrs: <1yr: 10–30mg/kg per day; 1–4yrs: 10–20mg/kg per day. 4–12yrs: 10–15mg/kg per day. 12–18yrs: 6–15mg/kg per day.

Norpace Contraindications

Contraindications

Cardiogenic shock. 2nd- or 3rd- degree AV block, unless paced. Congenital QT prolongation. Severe renal insufficiency (CrCl ≤40mL/min): CR form not recommended.

Norpace Boxed Warnings

Boxed Warning

Mortality.

Norpace Warnings/Precautions

Warnings/Precautions

Excessive mortality or non-fatal cardiac arrest rate was seen in CAST trial. 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.

Norpace Pharmacokinetics

See Literature

Norpace Interactions

Interactions

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 48hrs before or 24hrs after verapamil.

Norpace Adverse Reactions

Adverse Reactions

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.

Norpace Clinical Trials

See Literature

Norpace Note

Not Applicable

Norpace Patient Counseling

See Literature