Mexiletine
Mexiletine (meks IL e teen) is a generic medication prescribed for certain heart rhythm problems in adults. Mexiletine belongs to a group of drugs called antiarrhythmics.
Mexiletine (meks IL e teen) is a generic medication prescribed for certain heart rhythm problems in adults. Mexiletine belongs to a group of drugs called antiarrhythmics.
- Generic
- • Capsule
- • 150mg
- • 90 Capsules
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Intro
Introduction
Written by Sarah Lewis, PharmD
Medically reviewed by Elizabeth Scheffel, PharmD
Updated on October 25, 2023
Mexiletine (meks IL e teen) is a generic medication prescribed for certain heart rhythm problems in adults. Mexiletine belongs to a group of drugs called antiarrhythmics.
Boxed warnings
Mexiletine has boxed warnings about the risks of death or nonfatal cardiac arrest (when your heart suddenly stops beating) and liver damage. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).
For details, see the “Interactions and warnings for mexiletine” section.
Side effects
Side effects of mexiletine
Mexiletine may cause mild or serious side effects. More common mild side effects of mexiletine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.
To learn more about mexiletine’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for mexiletine listed in the “Resources” section.
Mild side effects
More common mild side effects reported with mexiletine are listed below.
This article doesn’t include all possible mild side effects of the drug. To learn more about mexiletine’s side effects, refer to the prescribing information for mexiletine listed in the “Resources” section.
With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.
Mexiletine oral capsule’s mild side effects include:
- dizziness or lightheadedness
- nausea, vomiting, or heartburn
- nervousness
- tremor
- mild allergic reaction*
* For details about this side effect, see the “Interactions and warnings for mexiletine” section.
Serious side effects
Serious side effects of mexiletine are listed below.
This article doesn’t include all possible serious side effects of the drug. To learn more about mexiletine’s side effects, refer to the prescribing information for mexiletine listed in the “Resources” section.
With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.
In general, mexiletine’s serious side effects include:
- chest pain
- confusion
- difficulty in coordination
- low blood cell counts, which can become severe
- seizures
- very slow heart rate
- worsening heart rhythm problems
- boxed warning(s): risk of death or nonfatal cardiac arrest (when your heart suddenly stops beating) and liver damage*
- severe allergic reaction*
* For details about these side effects, see the “Interactions and warnings for mexiletine” section.
FAQ
Common questions about mexiletine
Below you’ll find answers to a few commonly asked questions about mexiletine.
What brand names are available for mexiletine?
Currently, there isn’t a brand-name drug available for mexiletine. Mexiletine oral capsule is a generic version of the brand-name drug Mexitil. But this drug is no longer on the market.
A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less compared to brand-name drugs.
You can learn more about this by talking with your doctor or pharmacist.
How does mexiletine work? And how long does it take to start working?
Mexiletine’s mechanism of action (how it works) is to slow certain electrical signals in the heart. This steadies the heart rhythm.
Mexiletine will start working within 30 minutes to 2 hours. You’ll need to be in the hospital when you start taking it.
If you’d like to know more about this, talk with your doctor or pharmacist.
Does mexiletine cause long-term side effects?
No, long-term side effects aren’t expected with mexiletine. In studies, specific side effects weren’t seen in people who had taken the drug for a long time. Long lasting side effects after treatment ended also weren’t reported.
Talk with your doctor if you have questions about possible long-term side effects with mexiletine.
Are there alternatives to mexiletine?
Yes, there are alternatives to mexiletine. Mexiletine is an antiarrhythmic drug. There are several other drugs in this class or group of drugs.
There are many factors that doctors consider when choosing an antiarrhythmic drug. Talk with your doctor if you’d like to know more about alternatives to mexiletine. Ask them to explain why one drug might be better for you than another.
Does mexiletine cause weight loss?
Weight loss was not reported as a side effect of mexiletine in studies. Edema (or swelling), which was seen as a side effect, can result in weight gain.
If you are concerned about weight changes while taking mexiletine, talk with your doctor or pharmacist.
Uses
Uses of mexiletine
The Food and Drug Administration (FDA) approves prescription drugs such as mexiletine for certain conditions. The approved use for mexiletine is described below.
Use for certain abnormal heart rhythms
Doctors may prescribe mexiletine oral capsule for treating certain life threatening heart rhythm problems. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.
With heart rhythm problems, the heart may beat too fast, too slow, or with an atypical rhythm. Rhythm problems can occur in the upper or lower chambers of the heart. Mexiletine treats rhythm problems that affect the lower chambers. These are called ventricular arrhythmias.
Symptoms may include dizziness, shortness of breath, or heart palpitations (feelings of fluttering or pounding in the chest).
Doctors may not prescribe mexiletine oral capsule in certain situations, such as for heart rhythm problems that aren’t life threatening.
Interactions and warnings
Interactions and warnings for mexiletine
Below, you’ll find information about mexiletine’s possible interactions and warnings.
Interactions of mexiletine
Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.
Before you take mexiletine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:
- prescription or over-the-counter drugs
- vitamins, herbs, or supplements
To learn about drug-condition interactions, see the “Warnings for mexiletine” section below.
Warnings for mexiletine
Some people should not take mexiletine, and others should take it cautiously.
Boxed warnings
Mexiletine has boxed warnings about the risk of death or nonfatal cardiac arrest (when the heart suddenly stops beating) and liver damage. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).
To learn more about these warnings, read below. You can also talk with your doctor or pharmacist.
Risk of death or nonfatal cardiac arrest. With cardiac arrest, you have a sudden problem with electrical activity in the heart that causes it to stop beating. This side effect wasn’t reported in studies of mexiletine. But it was commonly reported in a study of two drugs that are like mexiletine, encainide, and flecainide. These drugs are also antiarrhythmics. In the study, all of the people had a heart attack within the last 2 years. They were given one of the two drugs or a placebo to treat ventricular arrhythmias that weren’t life threatening. Cardiac arrest as a side effect was more common in the people who received one of the drugs (encainide or flecainide) rather than the placebo.
Symptoms of cardiac arrest may include suddenly passing out, no pulse, and no breaths.
If you have concerns about cardiac arrest, given your medical history, tell your doctor. They may be able to recommend another treatment.
Risk of liver damage. With liver damage, you have increased levels of certain liver function tests (LFTs) that are part of your lab tests. Sometimes, this happens in the first few weeks of mexiletine treatment. This problem often occurs in people who have congestive heart failure or ischemia (reduced flow of oxygenated blood to tissue or an organ of the body).
Most of the time, the increase in LFTs is temporary, doesn’t cause symptoms, and doesn’t cause people to stop taking mexiletine. In rare cases, severe liver damage can occur.
Symptoms of liver problems may include:
- dark urine
- fatigue
- pain in the upper right part of the abdomen
- yellowing of the skin or whites of the eyes
If you experience any of these symptoms, seek immediate medical care.
To learn more, talk with your doctor or pharmacist.
Other warnings
Mexiletine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether mexiletine is a safe option for you.
Ask your doctor about specific warnings for mexiletine, and be sure to tell your doctor about your:
- current health, including any allergies to medications
- past health conditions or surgeries
Allergic reaction
Mexiletine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.
If you’ve had an allergic reaction to mexiletine or any of its ingredients, your doctor will likely not prescribe mexiletine. They can tell you about medications that are safer options for you.
A mild allergic reaction may cause the following symptoms:
A severe allergic reaction may cause the following symptoms:
- severe skin rashes that may blister and peel
- swelling under your skin, usually in your hands, feet, eyelids, or lips
- swelling of your mouth, throat, or tongue, which can cause breathing problems
If you have an allergic reaction to mexiletine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.
Overdose of mexiletine
You should not take more mexiletine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.
If you think you’ve taken too much mexiletine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.
Pregnancy or breastfeeding and mexiletine
Information about mexiletine and pregnancy and breastfeeding is described below.
Mexiletine and pregnancy
It’s not known whether mexiletine should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.
Mexiletine and breastfeeding
Mexiletine should not be taken while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with mexiletine.
Ask your doctor
What to ask your doctor
Let your doctor know if you have questions about mexiletine or would like more details about it.
Here’s a list of some possible questions you may want to ask your doctor:
- Are there any alternatives to mexiletine that I can take for my condition?
- How long will I be in the hospital when I start mexiletine?
- How should I take mexiletine?
- Am I at higher risk of side effects than other people?
Resources
Resources
- Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
- Mexiletine hydrochloride capsules USP, 150 mg, 200 mg, and 250 mg. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/c4a60f9e-fed1-4172-adc4-0be84ac65db9/spl-doc
- van der Ree MH, et al. (2022). Effectiveness and safety of mexiletine in patients at risk for (recurrent) ventricular arrhythmias: A systematic review. https://academic.oup.com/europace/article/24/11/1809/6678481
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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