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Drug Interactions between Choledyl SA and Mexitil

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

mexiletine oxtriphylline

Applies to: Mexitil (mexiletine) and Choledyl SA (oxtriphylline)

MONITOR CLOSELY: Coadministration with mexiletine may increase the serum concentrations of theophylline. The proposed mechanism is inhibition of the CYP450 1A2-mediated metabolism of theophylline by mexiletine. Pharmacokinetic studies have shown that mexiletine increases theophylline concentrations by approximately 50% to 100%, although greater increases of up to 3-fold accompanied by symptoms of toxicity have been described in a few case reports. Discontinuation of mexiletine or dosage reductions of theophylline by one-half to two-thirds were required in some cases.

MANAGEMENT: Caution is advised when theophylline is used with mexiletine. Close monitoring of serum theophylline levels is recommended, particularly following the addition, discontinuation or change of dosage of mexiletine, and the theophylline dosage adjusted accordingly. Patients should be advised to notify their physician if they experience signs of theophylline toxicity such as nausea, vomiting, diarrhea, headache, restlessness, insomnia, seizures, palpitations, and cardiac arrhythmia.

References

  1. Upton RA (1991) "Pharmacokinetic interactions between theophylline and other medication (Part II)." Clin Pharmacokinet, 20, p. 135-50
  2. Loi CM, Wei X, Vestal RE (1991) "Inhibition of theophylline metabolism by mexiletine in young male and female nonsmokers." Clin Pharmacol Ther, 49, p. 571-80
  3. Katz A, Buskila D, Sukenik S (1987) "Oral mexiletine-theophylline interaction." Int J Cardiol, 17, p. 227-8
  4. Stoysich AM, Mohiuddin SM, Destache CJ, et al. (1991) "Influence of mexiletine on the pharmacokinetics of theophylline in healthy volunteers." J Clin Pharmacol, 31, p. 354-7
  5. Kessler KM, Interian A, Cox M, et al. (1989) "Proarrhythmia related to a kinetic and dynamic interaction of mexiletine and theophylline." Am Heart J, 117, p. 964-6
  6. Stanley R, Comer T, Taylor JL, Saliba D (1989) "Mexiletine-theophylline interaction." Am J Med, 86, p. 733-4
  7. Ueno K, Miyai K, Seki T, Kawaguchi Y (1990) "Interaction between theophylline and mexiletine." DICP, 24, p. 471-2
  8. Ueno K, Miyai K, Kato M, et al. (1991) "Mechanism of interaction between theophylline and mexiletine." DICP, 25, p. 727-30
  9. Hurwitz A, Vacek JL, Botteron GW, et al. (1991) "Mexiletine effects on theophylline disposition." Clin Pharmacol Ther, 50, p. 299-307
View all 9 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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

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