Chapter: Basic & Clinical Pharmacology : Agents Used in Cardiac Arrhythmias

Mexiletine (SubGroup 1B)

Mexiletine is an orally active congener of lidocaine. Its electro-physiologic and antiarrhythmic actions are similar to those of lidocaine.

MEXILETINE (SUBGROUP 1B)

Mexiletine is an orally active congener of lidocaine. Its electro-physiologic and antiarrhythmic actions are similar to those of lidocaine. (The anticonvulsant phenytoin also exerts similar electrophysiologic effects and has been used as an antiarrhythmic.) Mexiletine is used in the treatment of ventricular arrhythmias. The elimination half-life is 8–20 hours and permits administration two or three times per day. The usual daily dosage of mexiletine is 600–1200 mg/d. Dose-related adverse effects are seen frequently at therapeutic dosage. These are predominantly neurologic, including tremor, blurred vision, and lethargy. Nausea is also a common effect.

Mexiletine has also shown significant efficacy in relieving chronic pain, especially pain due to diabetic neuropathy and nerve injury. The usual dosage is 450–750 mg/d orally. This application is off label.

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Basic & Clinical Pharmacology : Agents Used in Cardiac Arrhythmias : Mexiletine (SubGroup 1B) |