Mexiletine review

Mexiletine is a class IB anti-arrhythmic drug. It is particularly indicated in the treatment of ventricular arrhythmias, also known as irregular heart rhythms. Apart from this, Mexiletine also relieves refractory pain, stiff muscles stemming from a neuromuscular disorder known as myotonia congenita, and nerve damage due to diabetes (diabetic neuropathy).

Mexiletine works by halting the flow of some types of electrical impulses that travel to the heart via the nerves. Once these nerve signals are blocked, the heart tissue becomes less highly sensitized, thus allowing for the establishment of a more stable heart rhythm.

Mexiletine should be administered with caution as improper use may cause aggravated irregular heartbeat. Mexiletine use can increase the risk of death due to myocardial infarction (heart attack), especially if a patient has experienced a heart attack within a period of 2 years. Hence, patients should inform their doctor if they have a personal or family history of heart disease or heart attack. Because of this risk, Mexiletine should only be prescribed for patients who have a potentially serious case of arrhythmia.

Mexiletine may cause lightheadedness, drowsiness and blurry eyesight. Patients under medication should avoid activities requiring a high level of alertness, such as driving a vehicle or operating any type of machinery.

Patients with allergies to Mexiletine or other drugs should appraise their physician of this fact. There are certain medications that may react adversely or even dangerously with Mexiletine, hence patients should supply their doctor with a list of all over-the-counter or prescription medications they are taking, including vitamin, herbal or mineral supplements in order to rule out any drug interactions or to determine whether an adjustment of their Mexiletine dosage is necessary.

Patients should also let their doctor know if they have an existing liver disease or any seizure disorder like epilepsy. These conditions will necessitate a lower dose of Mexiletine and constant medical observation during the course of treatment.

The FDA has classified Mexiletine under Pregnancy Category C, which means that there is still no evidence that taking the medication will cause harm to an unborn child. Although Mexiletine passes into breast milk, it is still not known whether it may adversely affect a nursing infant. Nonetheless, patients who are pregnant or breastfeeding should inform their doctor of their condition before starting Mexiletine therapy.

Patients should avoid smoking while undergoing medication, as tobacco and other tobacco products can lower Mexiletine's effectiveness.

Mexiletine can cause dizziness, nausea, vomiting, heartburn, involuntary trembling, loss of coordination, headaches, numbness and tingling, blurry eyesight, swelling of the hands and feet (edema), anxiety or nervousness, and changes in appetite. Patients should immediately cease taking Mexiletine and call their doctor if they start experiencing serious symptoms of chest pains, extreme fatigue, bleeding or bruising, flu-like symptoms, body malaise, yellowing of the eyes or skin, and upper right abdominal pain.

Mexiletine is available under the brand name Mexitil (mexiletine hydrochloride) and comes in injectable solution, and in 150 mg, 200 mg and 250 mg capsules.

Mexiletine is usually taken twice or thrice a day with food or antacids so as not to cause gastric irritation. While this medication can control a patient's condition, it will not cure it completely. Hence, patients are advised to continuously take Mexiletine even if they start feeling better. Suddenly going off their medication without prior medical consultation may worsen their arrhythmia.

Mexiletine has the following structural formula:

Chemical structure of mexiletine

• Molecular formula of mexiletine is C11H17NO
• Chemical IUPAC Name is 1-(2,6-dimethylphenoxy)propan-2-amine
• Molecular weight is 179.259 g/mol
Mexiletine available : 150mg capsules, 200mg capsules, 250mg capsules

Brand name(s): Mexiletina, Mexiletine HCL, Mexiletinum, Mexitil

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