Clinical data | |
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Trade names | Tonocard |
AHFS/Drugs.com | Micromedex Detailed Consumer Information |
MedlinePlus | a601248 |
ATC code | |
Pharmacokinetic data | |
Bioavailability | 0.9-1 (oral) |
Protein binding | 10-20% |
Metabolism | glucuronidation (primary) |
Elimination half-life | 9-14 R, 13-20 S |
Excretion | 30-50% urine (unchanged) |
Identifiers | |
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CAS Number | |
PubChem CID | |
IUPHAR/BPS | |
DrugBank | |
ChemSpider | |
UNII | |
KEGG | |
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ChEMBL | |
CompTox Dashboard (EPA) | |
ECHA InfoCard | 100.050.441 |
Chemical and physical data | |
Formula | C11H16N2O |
Molar mass | 192.262 g·mol−1 |
3D model (JSmol) | |
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Tocainide (Tonocard) is a class Ib antiarrhythmic agent. It is no longer sold in the United States.
Tocainide is a lidocaine derivative, that undergoes very less first pass metabolism. It occurs as two enantiomers. The R isomer is three times more potent than the S isomer.[5] Tocainide's oral bioavailability is almost 100%.[6] Plasma half-life generally lasts for 11.5-15.5 hours (13.5 ± 2 hours[7]). In the blood, tocainide is 10-20% protein bound.[8][6] The volume of distribution is 2.8-3.2 L/kg.[8] 31-45% is excreted unchanged in the urine.[8] The more active R-isomer is cleared faster in anephric patients (without kidneys) or those with severe kidney dysfunction. The main metabolite is tocainide carbamoyl ester glucuronlde.[9]
Rifampicin increases conversion of tocainide into its main metabolite, tocainide carbamoyl ester glucuronlde,[9] by inducing the glucuronosyl transferase enzyme that catalyzes glucuronidation of tocainide to produce that metabolite. Rifampicin also increases elimination rate and decreases oral clearance of tocainide.[10] Tocainide decreases plasma clearance of theophylline.[11]