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Mexiletine Disease Interactions

There are 5 disease interactions with mexiletine.

Major

Antiarrhythmics (applies to mexiletine) cardiovascular dysfunction

Major Potential Hazard, Low plausibility. Applicable conditions: Hypotension, Congestive Heart Failure

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

References

  1. Halkin H, Meffin P, Melmon KL, Rowland M (1975) "Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite." Clin Pharmacol Ther, 17, p. 669-76
  2. Crouthamel WG (1975) "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J, 90, p. 335-9
  3. Ravid S, Podrid PJ, Lampert S, Lown B (1989) "Congestive heart failure induced by six of the newer antiarrhythmic drugs." J Am Coll Cardiol, 14, p. 1326-30
  4. Swiryn S, Kim SS (1983) "Quinidine-induced syncope." Arch Intern Med, 143, p. 314-6
  5. Gottlieb SS, Packer M (1989) "Deleterious hemodynamic effects of lidocaine in severe congestive heart failure." Am Heart J, 118, p. 611-2
  6. Ochs HR, Grube E, Greenblatt DJ, Arendt R (1981) "Intravenous quinidine in congestive cardiomyopathy." Eur J Clin Pharmacol, 19, p. 173-6
  7. Prescott LF, Adjepon-Yamoah KK, Talbot RG (1976) "Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure." Br Med J, 1, p. 939-41
  8. (2002) "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories
  9. (2002) "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals
  10. "Product Information. Quinidex Extentabs (quiNIDine)." Wyeth-Ayerst Laboratories
  11. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
  12. (2001) "Product Information. Adenocard (adenosine)." Fujisawa
  13. (2001) "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim
  14. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M (1973) "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med, 78, p. 499-508
  15. Singh SN, Fletcher RD, Fisher SG, et al. (1995) "Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia." N Engl J Med, 333, p. 77-82
  16. (2022) "Product Information. Cordarone (amiodarone)." Apothecon Inc
  17. (2001) "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn
View all 17 references
Major

Mexiletine (applies to mexiletine) sinus (applies to mexiletine) AV node dysfunction

Major Potential Hazard, High plausibility. Applicable conditions: Heart Block

The use of mexiletine is contraindicated in patients with cardiogenic shock, second- or third-degree AV block in the absence of a functional artificial pacemaker.

References

  1. (2001) "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim
Moderate

Mexiletine (applies to mexiletine) liver disease

Moderate Potential Hazard, High plausibility.

Mexiletine is extensively metabolized by the liver to minimally active and inactive forms. The serum concentration of mexiletine is increased and the half-life prolonged in patients with liver impairment. Elevation of liver enzymes have been reported during the first few weeks of therapy, primarily in patients with congestive heart failure (CHF) or ischemia. Hepatic necrosis, resulting in death, has occurred. Therapy with mexiletine should be administered cautiously in patients with compromised liver function, CHF or ischemia. Clinical monitoring of cardiac function (ECG) and liver function is recommended.

References

  1. Pentikainen PJ, Hietakorpi S, Halinen MO, Lampinen LM (1986) "Cirrhosis of the liver markedly impairs the elimination of mexiletine." Eur J Clin Pharmacol, 30, p. 83-8
  2. Nitsch J, Steinbeck G, Luderitz B (1983) "Increase of mexiletine plasma levels due to delayed hepatic metabolism in patients with chronic liver disease." Eur Heart J, 4, p. 810-4
  3. (2001) "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim
Moderate

Mexiletine (applies to mexiletine) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Mexiletine is primarily eliminated by the kidney. Approximately 10% of mexiletine is excreted in the urine unchanged. Marked changes in urinary pH alter the rate of mexiletine excretion. Elimination is accelerated with an acidic urinary pH and slowed with an alkaline urinary pH. Therapy with mexiletine should be administered cautiously in patients with significant renal impairment. Clinical monitoring of cardiac function (ECG) and renal function is recommended.

References

  1. Wang T, Wuellner D, Woosley RL, Stone WJ (1985) "Pharmacokinetics and nondialyzability of mexiletine in renal failure." Clin Pharmacol Ther, 37, p. 649-53
  2. El Allaf D, Henrard L, Crochelet L, Delapierre D, Carlier J, Dresse A (1982) "Pharmacokinetics of mexiletine in renal insufficiency." Br J Clin Pharmacol, 14, p. 431-5
  3. Guay DR, Meatherall RC, Ferguson I, Smith H, Light B (1985) "Mexiletine clearance during peritoneal dialysis ." Br J Clin Pharmacol, 19, p. 857-8
  4. Jones TE, Reece PA, Fisher GC (1983) "Mexiletine removal by peritoneal dialysis." Eur J Clin Pharmacol, 25, p. 839-40
  5. (2001) "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim
View all 5 references
Moderate

Mexiletine (applies to mexiletine) seizures

Moderate Potential Hazard, Low plausibility.

Seizures have been reported rarely during mexiletine therapy in patients with and without a history of seizures. Therapy with mexiletine should be administered cautiously in patients with or predisposition to seizure disorders.

References

  1. (2001) "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim

Mexiletine drug interactions

There are 147 drug interactions with mexiletine.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.