CHF and arrhythmias:
Indications for Mexiletine:
Documented life-threatening ventricular arrhythmias.
Take with food or antacid. Initially 200mg every 8hrs. Adjust dose if needed at not less than 2–3 day intervals in 50–100mg increments. Usual dose: 200–300mg every 8hrs; max 1.2g/day. If arrhythmia is controlled by ≤300mg every 8hrs, may try dividing same daily dose every 12hrs; max 450mg every 12hrs. See literature for information on rapid induction and changing from other antiarrhythmics.
Cardiogenic shock. 2nd- or 3rd- degree AV block unless paced.
Hepatic impairment. Severe heart failure. Sinus node dysfunction or intraventricular conduction defects. Hypotension. Epilepsy. Monitor ECG, blood and liver function. Pregnancy (Cat.C). Nursing mothers: not recommended.
Class IB antiarrhythmic.
May potentiate other antiarrhythmics, theophylline. Monitor control if used with hepatic enzyme-inducing drugs. Avoid drugs or diets that alter urinary pH.
GI upset, dizziness, tremor, nervousness, ataxia, chest pain, blurred vision, exacerbated arrhythmias, hepatotoxicity.
Formerly known under the brand name Mexitil.