Mexiletine

What it is used for

• Treating or assisting in treatment of ventricular arrhythmias
• Treating or assisting in treatment of ventricular arrhythmias
• Ventricular arrhythmias in Boxers
• Treating or assisting in treatment of ventricular arrhythmias
• Familial arrhythmic cardiomyopathy of Boxers (ARVC)
• Treating or assisting in treatment of ventricular arrhythmias
• Myotonia congenita or myokymia

How it is given

Possible side effects

• Vomiting (very common)
• Nausea
• Trembling/Tremors
• Unsteadiness/Ataxia
• Dizziness
• Depression/Lethargy
• Shortness of breath
• Proarrhythmia (PVCs)
• Chest pain
• Seizures (rare)
• Agranulocytosis (rare)
• Thrombocytopenia (rare)

Cautions & contraindications

• Pre-existing 2nd or 3rd degree AV block (without a pacemaker)
• Cardiogenic shock
• Known hypersensitivity to mexiletine
• Use with **extreme caution** in patients with severe congestive heart failure, acute myocardial infarction, hepatic function impairment, hypotension, intraventricular conduction abnormalities, sinus node function impairment, or a pre-existing seizure disorder. > **Clinical Note**: Mexiletine is secreted into maternal milk; use of a milk replacer is recommended if the nursing mother is receiving the drug. FDA Pregnancy Category C.

Drug interactions

• Antacids (Aluminum-Magnesium): May slow the absorption of mexiletine.
• Atropine: May reduce the rate of oral absorption.
• Cimetidine: May increase or decrease mexiletine blood levels.
• Griseofulvin: May accelerate the metabolism of mexiletine.
• Lidocaine: May cause additive adverse effects (especially CNS toxicity).
• Metoclopramide: May accelerate the absorption of mexiletine.
• Opiates: May slow the absorption of mexiletine.
• Phenobarbital: May accelerate the metabolism of mexiletine.
• Primidone: May accelerate the metabolism of mexiletine.
• Phenytoin: May accelerate the metabolism of mexiletine.
• Rifampin: May accelerate the metabolism of mexiletine.
• Theophylline: Mexiletine may reduce the metabolism of theophylline, potentially leading to theophylline toxicity.
• Urinary Acidifying Drugs (e.g., methionine, ammonium chloride): May accelerate the renal excretion of mexiletine.
• Urinary Alkalinizing Drugs (e.g., citrates, sodium bicarbonate): May reduce the urinary excretion of mexiletine.

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