Drug interactions
Amiodarone + Mexiletine
Severity: Major
Amiodarone and Mexiletine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amiodarone inhibits CYP2D6 and may raise mexiletine levels, and both drugs affect cardiac conduction. The combination can increase the risk of mexiletine toxicity, QT prolongation and proarrhythmia.
What this interaction means in plain words
Amiodarone and Mexiletine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Mexiletine belongs to Cardiovascular.
Why it happens
CYP2D6 inhibition by amiodarone plus additive electrophysiologic effects.
What to do
Monitor ECG including QTc and consider a lower mexiletine dose; watch for CNS and GI toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Mexiletine
- Fezolinetant + Mexiletine Contraindicated
- Mexiletine + Pimozide Contraindicated
- Alosetron + Mexiletine Major
- Clozapine + Mexiletine Major
- Cobicistat + Mexiletine Major
- Dofetilide + Mexiletine Major
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Mexiletine?
MediHelp rates the interaction as major. Amiodarone and Mexiletine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Amiodarone inhibits CYP2D6 and may raise mexiletine levels, and both drugs affect cardiac conduction. The combination can increase the risk of mexiletine toxicity, QT prolongation and proarrhythmia.
How serious is the interaction between Amiodarone and Mexiletine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG including QTc and consider a lower mexiletine dose; watch for CNS and GI toxicity.
What other medicines interact with Mexiletine?
MediHelp also lists interactions of Mexiletine with, for example, Fezolinetant, Pimozide, Alosetron. The full list is on the Mexiletine page.
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