Mexiletine

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

  1. diabetic neuropathy
  2. neuropathic pain
  3. ventricular tachycardia

For the treatment of life threatening ventricular arrhythmias such as ventricular tachycardia

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. angina
  4. arrhythmia exacerbation
  5. arthralgia
  6. ataxia
  7. AV block
  8. blurred vision
  9. bradycardia
  10. chest pain (unspecified)
  11. confusion
  12. constipation
  13. depression
  14. diaphoresis
  15. diarrhea
  16. dizziness
  17. drowsiness
  18. dyspepsia
  19. dysphagia
  20. dyspnea
  21. edema
  22. elevated hepatic enzymes
  23. esophageal ulceration
  24. exfoliative dermatitis
  25. fatigue
  26. fever
  27. GI bleeding
  28. hallucinations
  29. headache
  30. heart failure
  31. hepatic necrosis
  32. hepatitis
  33. hepatotoxicity
  34. hiccups
  35. hot flashes
  36. hypertension
  37. hypotension
  38. impotence (erectile dysfunction)
  39. leukopenia
  40. libido decrease
  41. lupus-like symptoms
  42. malaise
  43. memory impairment
  44. nausea
  45. nystagmus
  46. palpitations
  47. pancreatitis
  48. paresthesias
  49. peptic ulcer
  50. pharyngitis
  51. premature ventricular contractions (PVCs)
  52. psychosis
  53. pulmonary fibrosis
  54. pyrosis (heartburn)
  55. rash
  56. seizures
  57. Stevens-Johnson syndrome
  58. syncope
  59. thrombocytopenia
  60. tinnitus
  61. tremor
  62. urinary retention
  63. vomiting
  64. weakness
  65. xerosis
  66. 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