Mexiletine Brand Name– Mexitil
What is Mexiletine
Mexiletine is an oral, local anesthetic-type antiarrhythmic agent similar to lidocaine and tocainide.
Mexiletine is a class Ib antiarrhythmic according to the Vaughan-Williams classification and is used to treat life-threatening ventricular arrhythmias.
It also has been used successfully in the treatment of pain associated with diabetic neuropathy.
Mexiletine was approved by the FDA in December 1985, and the patent expired in June 1994.
Indications
- diabetic neuropathy
- neuropathic pain
- ventricular tachycardia
For the treatment of life threatening ventricular arrhythmias such as ventricular tachycardia
Side Effects
- abdominal pain
- agranulocytosis
- angina
- arrhythmia exacerbation
- arthralgia
- ataxia
- AV block
- blurred vision
- bradycardia
- chest pain (unspecified)
- confusion
- constipation
- depression
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dyspepsia
- dysphagia
- dyspnea
- edema
- elevated hepatic enzymes
- esophageal ulceration
- exfoliative dermatitis
- fatigue
- fever
- GI bleeding
- hallucinations
- headache
- heart failure
- hepatic necrosis
- hepatitis
- hepatotoxicity
- hiccups
- hot flashes
- hypertension
- hypotension
- impotence (erectile dysfunction)
- leukopenia
- libido decrease
- lupus-like symptoms
- malaise
- memory impairment
- nausea
- nystagmus
- palpitations
- pancreatitis
- paresthesias
- peptic ulcer
- pharyngitis
- premature ventricular contractions (PVCs)
- psychosis
- pulmonary fibrosis
- pyrosis (heartburn)
- rash
- seizures
- Stevens-Johnson syndrome
- syncope
- thrombocytopenia
- tinnitus
- tremor
- urinary retention
- vomiting
- weakness
- xerosis
- xerostomia
Monitoring Parameters
- ECG
- LFTs
- serum mexiletine concentrations
Contraindications
- acute myocardial infarction
- agranulocytosis
- AV block
- bradycardia
- breast-feeding
- cardiac arrhythmias
- cardiogenic shock
- geriatric
- heart failure
- hepatic disease
- hepatotoxicity
- hypotension
- leukopenia
- mortality
- myocardial infarction
- Parkinson’s disease
- pregnancy
- renal disease
- renal failure
- renal impairment
- seizure disorder
- serious rash
- tobacco smoking
- ventricular dysfunction
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Propoxyphene
- Acetazolamide
- Albendazole
- Alosetron
- Amiodarone
- Amlodipine; Celecoxib
- Ammonium Chloride
- Anagrelide
- Artemether; Lumefantrine
- Ascorbic Acid, Vitamin C
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Atazanavir; Cobicistat
- Barbiturates
- Bendamustine
- Bupivacaine; Lidocaine
- Bupropion
- Bupropion; Naltrexone
- Caffeine
- Caffeine; Ergotamine
- Capmatinib
- Carbamazepine
- Carbonic anhydrase inhibitors
- Celecoxib
- Chlorpromazine
- Cimetidine
- Cinacalcet
- Ciprofloxacin
- Citalopram
- Clobazam
- Clozapine
- Cobicistat
- Colesevelam
- Dacomitinib
- Darifenacin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Desvenlafaxine
- Dextromethorphan; Quinidine
- Dofetilide
- Eliglustat
- Eltrombopag
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Escitalopram
- Ethotoin
- Etravirine
- Fedratinib
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluvoxamine
- Fosphenytoin
- Ginger, Zingiber officinale
- Green Tea
- Haloperidol
- Hydantoins
- Hydrochlorothiazide, HCTZ; Propranolol
- Imatinib
- Lacosamide
- Lidocaine
- Lidocaine; Prilocaine
- Lopinavir; Ritonavir
- Melatonin
- Methazolamide
- Mirabegron
- Moricizine
- Obeticholic Acid
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Sodium Bicarbonate
- Oritavancin
- Osilodrostat
- Panobinostat
- Paroxetine
- Peginterferon Alfa-2b
- Perphenazine
- Perphenazine; Amitriptyline
- Phenytoin
- Pimozide
- Pirfenidone
- Pomalidomide
- Propafenone
- Propoxyphene
- Propranolol
- Quinidine
- Quinine
- Ramelteon
- Ranolazine
- Rasagiline
- Rifamycins
- Riluzole
- Ritonavir
- Rolapitant
- Ropinirole
- Rucaparib
- Sertraline
- Simeprevir
- Sodium Bicarbonate
- Tacrine
- Tasimelteon
- Terbinafine
- Teriflunomide
- Theophylline, Aminophylline
- Thiabendazole
- Thioridazine
- Tizanidine
- tobacco
- Vemurafenib
- Zileuton
