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New Message Board Archives >> Medications, Treatments, Therapies 2005 >> Mexiletene
(Message started by: Lizzie2 on Jan 19th, 2005, 9:18am)

Title: Mexiletene
Post by Lizzie2 on Jan 19th, 2005, 9:18am
I am not sure if I spelled that correctly and the pill bottle is out of my reach.  Has anyone tried this?  I think it is new? but not sure....doc told me it is a pill form of lidocaine, and in the hospital I was on lidocaine infusion for 12 days.  However, last night I thought I was dead on the mexiletene.  I was shaking, face was red, BP normal, HR 104, nauseous, jittery, dizzy, lightheaded, tingling in my face and throat.  It was pretty awful.  Plus I wasn't clear-minded about what was going on.  My parents dropped me off in Philadelphia, and I wasn't sure if I should go to the ER or not, but I had no idea how to decide in my mind.

I called my neuro's emergency page line, but nobody ever called me back.  Talk about sucky.  I'm going to the nurse practitioner today.  Guess they will see the reaction if it happens again....  <sigh>

Title: Re: Mexiletene
Post by floridian on Jan 19th, 2005, 11:02am
From what I can tell, it is a drug that is similiar to lidocaine, not sure it is identical.  It has anti-arrythmic properties and is a calcium channel blocker (relatively weak).  Digging for more.

Not identical to lidocaine/xylocaine but in the same class.  Considered a sodium channel blocker.  

Spelling: Mexitil (generic: mexiletene)
http://www.healthsquare.com/newrx/mex1261.htm

Title: Re: Mexiletene
Post by Lizzie2 on Jan 19th, 2005, 11:05am
I found sodium-channel blocker...that would indicate a cocaine-like property or also lidocaine.  Depends which side of the "caine" fence it is traveling down.  Here's the info from micromedex....


Quote:
DrugPoints(R) System:  MEXILETINE HYDROCHLORIDE  


Common Tradenames (See Complete Tradename Listing)
MEXITIL
Class
antiarrhythmic
antiarrhythmic, group ib
Dosage, Adult (usual)
Ventricular arrhythmias (ARR) (rapid control): loading dose, 400 mg ORALLY then 200 mg ORALLY in 8 hr
Ventricular ARR: initial, 200 mg ORALLY every 8 hr
Ventricular ARR: titration, increase in 50-100 mg increments at 2-3 day intervals or longer
Ventricular ARR: maintenance, 200-300 mg ORALLY every 8 hr; MAX 1200 mg/day
Ventricular ARR: initial, 150-250 mg IV bolus over 10 min, then 250 mg IV infusion over 30-60 min, then 250 mg IV infusion over 2.5 hr, then 500 mg IV infusion over 8 hr
Ventricular ARR: maintenance, 250-500 mg IV infusion every 12 hr
Dosage, Pediatric, (usual)
not FDA approved in children
Arrhythmias: 2.5-5 mg/kg/dose ORALLY every 8 hr
Dose Adjustments:
liver disease: dosage adjustments may be required (specific guidelines unavailable)
hemodialysis: supplemental doses may be required following hemodialysis sessions
renal impairment: dosage adjustments may be required with CrCL less than 10 mL/min; however, specific guidelines are unavailable
Administration
administer mexiletine with food or antacids
patients whose arrhythmias are well controlled at 300 mg or less orally every 8 hr may be converted to 12 hr dosing intervals at the same dose given with the 8 hr interval dosing
Monitoring
mexiletine should be initiated in the hospital setting, with continuous ECG monitoring
monitor CBC and liver function
usual therapeutic level of mexiletine in adults is 0.5-2 mcg/mL
How Supplied
150 MG, 250 MG CAP
100 MG, 200 MG GELATIN CAPSULE
Indications
FDA labeled indications
Ventricular arrhythmias, life-threatening
Contraindications
cardiogenic shock
hypersensitivity to mexiletine
second- or third-degree AV block
Precautions
alterations in defibrillation thresholds in patients with implantable cardioverter defibrillators
alterations in urinary pH (alkalization of the urine can prolong the half-life)
blood dyscrasias
congestive heart failure
electrolyte abnormalities (ie, hypokalemia)
hypotension
liver disease
mexiletine should not be used in postmyocardial infarction patients with asymptomatic or minimally symptomatic non-life threatening ventricular arrhythmias (increased mortality)
Parkinson's disease (prominent side effect is tremors)
proarrhythmic events; new or worsened arrhythmias
seizure disorders
severe renal impairment
treatment of asymptomatic ventricular premature contractions should be avoided
Adverse Effects
COMMON
hypotension, palpitations (4%-7%)
ataxia (20%), confusion (3%-5%), coordination difficulties (10%), depression (2%)
dizziness (19%), fatigue (4%), headache, lightheadedness (19%)
nervousness (5%), paresthesia, tinnitus, tremors (13%)
constipation, diarrhea, dyspepsia, dysphagia
nausea, unpleasant taste, vomiting
elevated liver enzymes (1%-2%)
blurred vision (6%), diplopia (6%), nystagmus (6%)
dyspnea (3%), skin rash (4%), arthralgias (1.7%)
SERIOUS
angina (2%), bradycardia, chest pain (2%-7%), heart failure (1%)
blood dyscrasias (rare), proarrhythmic events, seizures (rare)
systemic lupus erythematosus (rare)
Drug Interactions
disopyramide
fluvoxamine
fosphenytoin
levomethadyl
licorice
phenytoin
propafenone
quinidine
rifampin
rifapentine
ritonavir
Pregnancy Category
C
Breast Feeding
safe
Notes
mexiletine should be reserved for use in patients with immediately life-threatening arrhythmias


1974 - 2005 Thomson MICROMEDEX. All rights reserved.


I knew you'd jump on it. :)  Thanks!

Lizzie :)

Title: Re: Mexiletene
Post by floridian on Jan 19th, 2005, 11:09am
Hope your feeling better soon.  :)

Title: Re: Mexiletene
Post by Lizzie2 on Jan 19th, 2005, 11:14am
Thanks...

I may be playing devil's advocate for my doctor because I got angry about meds and certain other things, but I took it again this morning.  I have an appointment this afternoon, so I figured that if they weren't going to call me back, then they could see the side effects in living colour when I show up...  Good idea?  Ehh prolly not...

I learned from micromedex that mexiletine should be started in the hospital on cardiac monitoring.  I had an EKG done yesterday after taking my first dose of mexiletine, but I was having zero symptoms at the time.  I was mid-dinner when I started to have symptoms, and my dad took my blood pressure...it kept erroring out so I said that my pressure was too low for his machine.  That happens to me all the time on the verap.  However, when it registered, he got it twice at a normal reading.  So it was probably erroring on the heart rate...104...fairly normal for me, but should not be that high on my dose of verap.

In the hospital, I kept having episodes of Sinus V-Tach, and my doc said it was from IV thorazine and not from the lido.  I really dont' know enough about all of them to know what causes what...

So...I'm not sure what the deal is with the mexiletine, but hopefully they will have some answers for me today.  And who knows...maybe it'll actually help!

Title: Re: Mexiletene
Post by Lizzie2 on Jan 19th, 2005, 2:43pm

Just got home from my post-hospital visit with the neuro nurse practitioner.  She went over the stuff on mexiletine with my neuro, and they decided to just keep me on 150mg a day for a month and then maybe double the dose...they said the side effects should go down.  They better!!!  Job interview on Friday for a REAL job!

Lizzie



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