MEXILETINE

Brand & Generic Names

Mexitil

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? No
• Drug class: Antiarrhythmic

Uses

Stabilizes irregular heartbeat.

Dosage & Usage Information

How to take:
Capsules--Swallow whole with food, milk or antacid to lessen stomach irritation.

When to take:
At the same times each day as directed by your doctor.

If you forget a dose:
Take as soon as you remember up to 4 hours late. If more than 4 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Blocks the fast sodium channel in heart tissue.

Time lapse before drug works:
30 minutes to 2 hours.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Nausea, vomiting, seizures, convulsions, cardiac arrest.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Chest pain, shortness Discontinue. Seek of breath, irregular or emergency treatment. fast heartbeat.

Common:

Dizziness, anxiety, shakiness, unsteadiness when walking, heartburn, nausea, vomiting.

Infrequent:

• Sore throat, fever, mouth sores; blurred vision; confusion; constipation; diarrhea; headache; numbness or tingling in hands or feet; ringing in ears; unexplained bleeding or bruising; rash; slurred speech; insomnia; weakness; difficult swallowing.
• Loss of taste.

Rare:

• Seizures.
• Hallucinations, psychosis, memory loss, difficult breathing, swollen feet and ankles, hiccups, jaundice.
• Hair loss, impotence.

Warnings & Precautions

Don't take if:

• If you are allergic to mexiletine, lidocaine or tocainide.

Before you start, consult your doctor:

• If you have had liver or kidney disease or impaired kidney function.
• If you have had lupus.
• If you have a history of seizures.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.
• If you have heart disease or low blood pressure.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons. Ask doctor about smaller doses.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Use only under close medical supervision.

Prolonged use:

• May cause lupus*-like illness.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check ECG*, liver function.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Use caution if you feel dizzy or weak. Otherwise, no problems expected.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:
No problems expected.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Cimetidine	Increased mexiletine effect and
	toxicity.
Encainide	Increased effect of toxicity on the
	heart muscle.
Nicardipine	Possible increased effect and
	toxicity of each drug.
Phenobarbital	Decreased mexiletine effect.
Phenytoin	Decreased mexiletine effect.
Propafenone	Increased effect of both drugs and
	increased risk of toxicity.
Rifampin	Decreased mexiletine effect.
Urinary acidifiers*	May decrease
(ammonium chloride,	effectiveness
ascorbic acid,	of medicine.
Urinary alkalizers*	May slow
(acetazolamide,	elimination of
antacids with	mexiletine and
calcium or magnesium,	cause need to
citric acid,	adjust dosage.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Causes irregular effectiveness of
	mexiletine. Avoid.
Caffeine drinks,	Irregular heartbeat.
Cocaine:	Decreased mexiletine effect.
Foods:	None expected.
Marijuana:	Irregular heartbeat. Avoid.
Tobacco:	Dangerous combination. May lead to
	liver problems and reduce excretion
	of mexiletine.