Dangerous Drug: Mexiletine Hydrochloride(mex ill’ i teen)
Mexitil, Novo-Mexiletine (CAN)
PREGNANCY CATEGORY C
Drug class
Antiarrhythmic
Therapeutic Actions
Type I antiarrhythmic: Decreases automaticity of ventricular cells by membrane stabilization.
Indications
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Treatment of documented life-threatening ventricular arrhythmias (use with lesser arrhythmias is not recommended)
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Unlabeled uses: Prophylactic use to decrease arrhythmias in acute phase of acute MI (mortality may not be affected); reduction of pain, dysesthesia, and paresthesia associated with diabetic neuropathy
Contraindications and Cautions
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Contraindicated with allergy to mexiletine, cardiogenic shock, hypotension, second- or third-degree heart block (without artificial pacemaker), lactation.
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Use cautiously with hepatic disease, seizure disorders, hypotension, severe HF, pregnancy.
Available Forms
Capsules—150, 200, 250 mg
Dosages
Adults
200 mg every 8 hr PO. Increase in 50- to 100-mg increments every 2–3 days until desired antiarrhythmic effect is obtained. Maximum dose, 1,200 mg/day PO. Rapid control, 400 mg loading dose, then 200 mg every 8 hr PO.
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Transferring from other antiarrhythmics: Lidocaine: Stop the lidocaine with the first dose of mexiletine; leave IV line open until adequate arrhythmia suppression is ensured. Quinidine sulfate: Initial dose of 200 mg 6–12 hr PO after the last dose of quinidine. Procainamide: Initial dose of 200 mg 3–6 hr PO after the last dose of procainamide. Disopyramide: 200 mg 6–12 hr PO after the last dose of disopyramide.
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