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Generic Mexitil Mexiletine hydrochloride, esmolol hydrochloride 50mg

If Mexitil is taken with certain other drugs, the effects of either may be increased, decreased, or altered. Marked leukopenia or agranulocytosis did not occur in any patient receiving Mexitil alone; five of the six cases of agranulocytosis were associated with procainamide (sustained release preparations in four) and one with vinblastine. If significant hematologic changes are observed, the patient should be carefully evaluated, and, if warranted, Mexitil should be discontinued. Blood counts usually return to normal within one month of discontinuation. Convulsions (seizures) did not occur in Mexitil controlled clinical trials.

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Mexitil Side Effects

Among 10,867 patients treated with mexiletine in the compassionate use program, marked leukopenia (neutrophils less than 1000/mm) or agranulocytosis were seen in 0.06% and milder depressions of leukocytes were seen in 0.08%, and thrombocytopenia was observed in 0.16%. Many of these patients were seriously ill and receiving concomitant medications with known hematologic adverse effects. Rechallenge with mexiletine in several cases was negative. In the compassionate use program, convulsions were reported in about 2 of 1000 patients.

Precautions

The effects of Mexitil during pregnancy have not been adequately studied. However, the metabolic clearance of mexiletine in the extensive metabolizer phenotype decreased by about 70% making the poor and extensive metabolizer groups indistinguishable. In this crossover steady state study, the pharmacokinetics of propafenone were unaffected in either phenotype by the coadministration of mexiletine. Addition of mexiletine to propafenone did not lead to further electrocardiographic parameters changes of QRS, QTc, RR, and PR intervals than propafenone alone. When concomitant administration of either of these two drugs with mexiletine is initiated, the dose of mexiletine should be slowly titrated to desired effect.

Special Information If You Are Pregnant Or Breastfeeding

Mexitil appears in human milk in concentrations similar to those observed in plasma. Mexitil (mexiletine hydrochloride, USP) commonly produces reversible gastrointestinal and nervous system adverse reactions but is otherwise well tolerated. Mexitil has been evaluated in 483 patients in one-month and three-month controlled studies and in over 10,000 patients in a large compassionate use program. Dosages in the controlled studies ranged from 600-1200 mg/day; some patients (8%) in the compassionate use program were treated with higher daily doses (1600-3200 mg/day).

Recommended Dosage For Mexitil

In a large compassionate use program Mexitil has been used concurrently with commonly employed antianginal, antihypertensive, and anticoagulant drugs without observed interactions. A variety of antiarrhythmics such as quinidine or propranolol were also added, sometimes with improved control of ventricular ectopy. When phenytoin or other hepatic enzyme inducers such as rifampin and phenobarbital have been taken concurrently with Mexitil , lowered Mexitil plasma levels have been reported. Monitoring of Mexitil plasma levels is recommended during such concurrent use to avoid ineffective therapy. In a formal study, benzodiazepines were shown not to affect Mexitil plasma concentrations. ECG intervals (PR, QRS, and QT) were not affected by concurrent Mexitil and digoxin, diuretics, or propranolol.