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Disopyramide

    Brands

    DEA Class; Rx

    Common Brand Names; Norpace, Norpace CR

    • Antidysrhythmics, Ia

    Oral class IA antiarrhythmic; similar pharmacology to procainamide and quinidine
    Used only for life-threatening ventricular arrhythmia
    Significant proarrhythmic, anticholinergic, and negative inotropic properties limit its use

    Indicated for the treatment of documented, life-threatening arrhythmias such as sustained ventricular tachycardia.
    For maintenance of sinus rhythm in patients with atrial fibrillation or atrial flutter.

    Hypersensitivity

    Cardiogenic shock, preexisting second or third degree heart block, congenital QT syndrome, sick sinus syndrome

    • Xerostomia (32%)
    • Urinary hesitancy (23%)
    • Constipation (11%)
    • Impotence
    • Urinary urgency
    • Urinary retention
    • Dry throat
    • Weight gain
    • Abdominal distension
    • Flatulence
    • Anorexia
    • Vomiting
    • Nausea
    • Dermatoses
    • Pruritus
    • Generalized rash
    • Increased triglycerides and cholesterol
    • Hypokalemia
    • Muscle weakness
    • Muscular pain
    • Dyspnea
    • Blurred vision
    • Dry eyes
    • Fatigue
    • Malaise
    • Headache
    • Dizziness
    • Nervousness
    • Syncope
    • Hypotension
    • Chest pain
    • Edema

    CHF, ECG abnormalities, electrolyte abnormalities (hypo/hyper K), glaucoma, hypoglycemia, myasthenia gravis, sick sinus syndrome, BPH/urinary retention, need normal potassium prior to use, hypotension, cardiac myopathies, heart failure, prostatic enlargement, Wolff-Parkinson-White syndrome, bundle branch block, hepatic/renal impairment

    Hypotension may occur

    May cause QTc prolongation and subsequent torsade de pointes

    Can both precipitate and exacerbate HF due to marked myocardial depressant effects in HF

    Pregnancy Category: C

    Lactation: crosses into breast milk, discontinue drug or do not nurse

    Adults

    800 mg/day PO; however, up to 1600 mg/day PO has been used in the hospital setting to treat severe refractory ventricular tachycardia.

    Elderly

    800 mg/day PO; however, up to 1600 mg/day PO has been used in the hospital setting to treat severe refractory ventricular tachycardia.

    Adolescents

    15 mg/kg/day PO.

    Children

    5—12 years: 15 mg/kg/day PO.
    1—4 years: 20 mg/kg/day PO.

    Infants

    30 mg/kg/day PO.

    Disopyramide phosphate

    capsule

    • 100mg
    • 150mg

    capsule, controlled-release

    • 100mg
    • 150mg