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Can you take Mexiletine with Tremfya?

1 drug interaction and 10 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

mexiletine guselkumab

Applies to: mexiletine and Tremfya (guselkumab)

Guselkumab may alter the blood levels and effects of mexiletine. Your doctor may need to monitor you more closely and/or adjust the dosing of your medication(s). For example, a dose adjustment may be needed if you have been receiving mexiletine and are starting treatment with guselkumab. Likewise, if you have been receiving both medications, the dose of mexiletine may need to be adjusted when guselkumab is discontinued. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

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

Disease interactions

10 potential interactions Applies to: 10 conditions, including Heart Failure, Seizures, Hypotension, Liver Disease, and Infection.

Heart Block

Major:

mexiletine

Mexiletine has a major potential interaction with 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.

Heart Failure

Major:

mexiletine

Mexiletine has a major potential interaction with 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.

History, Tuberculosis

Moderate:

Tremfya

The guselkumab in Tremfya has a moderate potential interaction with History, Tuberculosis.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

Hypotension

Major:

mexiletine

Mexiletine has a major potential interaction with Hypotension.

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.

Infection

Moderate:

Tremfya

The guselkumab in Tremfya has a moderate potential interaction with Infection.

There have been reports of serious infections, including infections with opportunistic pathogens, and reactivation of latent infections in patients receiving interleukin inhibitors. Treatment with these agents should not be initiated in patients with an active infection until the infection resolves or is adequately treated. Caution is recommended when considering the use of interleukin inhibitors in patients with a history of recurrent infections, underlying conditions which may predispose them to infections, or chronic, latent, or localized infections.

Liver Disease

Moderate:

mexiletine

Mexiletine has a moderate potential interaction with Liver Disease.

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.

Renal Dysfunction

Moderate:

mexiletine

Mexiletine has a moderate potential interaction with Renal Dysfunction.

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.

Seizures

Moderate:

mexiletine

Mexiletine has a moderate potential interaction with Seizures.

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.

Tuberculosis, Active

Moderate:

Tremfya

The guselkumab in Tremfya has a moderate potential interaction with Tuberculosis, Active.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

Tuberculosis, Latent

Moderate:

Tremfya

The guselkumab in Tremfya has a moderate potential interaction with Tuberculosis, Latent.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

More resources

mexiletine

A total of 165 drugs are known to interact with mexiletine.

Tremfya

A total of 331 drugs are known to interact with Tremfya.

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.