Safety evaluation of tocainide in the American emergency use program

Confusion and paranoia associated with oral tocainide

“…It was noted that adverse experiences with tocainide were primarily neurological and gastrointestinal in nature and were transient and reversible (Horn et al, 1980). In a study of 30 patients with refractory ventricular arrhythmias treated with oral tocainide, one patient experienced delusions and thought impairment (Ryan et al, 1979).…”

Neurologic complications of arrhythmia treatment

“…These symptoms are dose-related and resolve with stopping the medication (Horn et al, 1980;Meschia and Biller, 1998). Seizures and coma have also been rarely reported, usually in the setting of overdose (Clark and El-Mahdi, 1984;Forrence et al, 1986;Sperry et al, 1987;Meschia and Biller, 1998).…”

A Seizure Induced by Concurrent Lidocaine-Tocainide Therapy-is it Just a Case of Additive Toxicity?

“…Tocainide-induced seizures, however, have only been reported twice in the literature, once in a patient with a toxic serum tocainide concentration of 20 ltg/mI. 3 Limited data are available describing the pharmacokinetics of intravenous lidocaine and oral tocainide when administered concurrently,4.5 a situation commonly occurring when converting patients from intravenous to oral antiarrhythmics. This report describes a potential complication associated with the conversion from intravenous lidocaine to oral tocainide.…”