N-Acetyl procainamide

N-Acetylprocainamide (NAPA) (or acecainide) is the N-acetylated metabolite of procainamide. It is a Class III antiarrhythmic agent.

It can be given either intravenously or orally, and is eliminated primarily by renal excretion. Comparative studies with other antiarrhythmic drugs have not been undertaken apart from a small study in atrial flutter where acecainide was better than quinidine plus digoxin. Thus, although further clinical experience is required before the relative place of acecainide in therapy can be determined, the drug nevertheless appears to offer advantages over procainamide, particularly with respect to the reduced formation of antinuclear antibodies.