Mexiletine

Mexiletine is an anti-arrhythmic medicine used to treat certain types of arrhythmia (abnormal heart rhythm). It restores normal heart rhythm by blocking abnormal electrical signals in the heart. This helps to maintain a regular and steady heartbeat. Mexiletine should be taken regularly as advised by the doctor. You should take it food and at a fixed time. This medicine should not be stopped abruptly without consulting the doctor as this can worsen your condition. Regular follow-up with your doctor is advised while using this medicine. Side effects like dizziness, blurred vision, headache, weakness, increased heart rate and insomnia may be seen in some patients. Your doctor may advise for regular monitoring of liver and kidney function while you are taking this medicine. This medicine may not be suitable for some people. You must inform doctor if you are suffering from any severe heart, liver or kidney disease. Also let your doctor know about all the other medications that you are using regularly. This medicine is not usually recommended during pregnancy or breastfeeding, so always consult your doctor before taking it. Mexiletine is an anti-arrhythmic medication. It regulates heart beat by blocking abnormal electrical signals in the heart.

• Arrhythmia

Mexiletine is a class Ib antiarrhythmic. It inhibits inward sodium current which decreases the rate of depolarisation of phase 0 of the action potential. It also increases effective refractory period (ERP) relative to the action potential duration (ERP/APD).

Adult Dose: Oral Ventricular Arrhythmias (Life-Threatening) Initial: 200 mg PO q8hr; may load with 400 mg followed by 200 mg PO q8hr if necessary for rapid control of ventricular arrhythmia Dose range: 200-300 mg PO q8hr May increase to 400 mg q8hr; not to exceed 1200 mg/day Take with food or antacid Therapeutic range: 0.5-2 mg/L

Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Mexiletine is to be taken with food.

If you miss a dose of Mexiletine, skip it and continue with your normal schedule. Do not double the dose.

Common: • Abdominal pain • Acne • Blurred vision • Chest pain • Decreased blood pressure • Fatigue • Flushing (sense of warmth in the face, ears, neck and trunk) • Headache • Increased heart rate • Insomnia (difficulty in sleeping) • Nausea • Pain in extremity • Paresthesia (tingling or pricking sensation) • Sleepiness • Tremor • Vertigo • Vomiting • Weakness

[CONSULT YOUR DOCTOR] It is not known whether Mexiletine alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react. It may cause dizziness. Do not drive or perform activities require mental focus until you know how it affects you. Do not start any medicine including prescription or over-the-counter medicines without informing your doctor, as they may alter Mexiletine levels in your body. Your doctor may get blood tests done to check your sodium and potassium levels, kidney function, and lung function before starting treatment with this medicine. Your doctor may regularly monitor blood sugar level while taking this medicine. Inform your doctor if you experience slow or fast heart rate, chest pain, shortness of breath. Inform your doctor if you are pregnant or planning to conceive or breastfeeding. Do not stop taking medication suddenly without talking to your doctor.

Cardiogenic shock, 2nd- or 3rd-degree AV block (unless the patient has a pacemaker).

Levels/effects may be reduced with CYP1A2 inducers (e.g. aminoglutethimide, carbamazepine, phenobarbital, rifampicin). Levels/effects may be increased with CYP1A2 inhibitors (e.g. ciprofloxacin, ketoconazole, norfloxacin, ofloxacin, rofecoxib), CYP2D6 inhibitors (e.g. chlorpromazine, delavirdine, fluoxetine, miconazole, paroxetine, pergolide, quinidine, quinine, ritonavir, ropinirole) and urinary alkalinisers (e.g. antacids, sodium bicarbonate, acetazolamide). May increase the levels/effects of CYP1A2 substrates e.g. aminophylline, fluvoxamine, mirtazapine, ropinirole, theophylline, trifluoperazine. Clearance reduced with fluvoxamine. Delayed absorption with opioid analgesics. Potentially Fatal: Increased risk of arrhythmias with other antiarrhythmics or arrhythmogenic drugs. May precipitate lidocaine toxicity.

[CONSULT YOUR DOCTOR] It is not known whether it is safe to consume alcohol with Mexiletine. Please consult your doctor.

[CONSULT YOUR DOCTOR] Mexiletine may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[SAFE IF PRESCRIBED] Mexiletine is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[CAUTION] Mexiletine should be used with caution in patients with kidney disease. Dose adjustment of Mexiletine may be needed. Please consult your doctor. [CAUTION] Mexiletine should be used with caution in patients with liver disease. Dose adjustment of Mexiletine may be needed. Please consult your doctor.

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