Drug interactions
Asenapine + Mexiletine
Severity: Moderate
Asenapine and Mexiletine: moderate 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
Asenapine is a weak CYP2D6 inhibitor and may modestly increase mexiletine levels. Both drugs can affect cardiac conduction, so additive QT effects are conceivable.
What this interaction means in plain words
Asenapine and Mexiletine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Asenapine belongs to Central Nervous System; Mexiletine belongs to Cardiovascular.
Why it happens
Weak CYP2D6 inhibition by asenapine; possible additive QT effects.
What to do
Monitor for mexiletine adverse effects and obtain an ECG if other QT-prolonging factors are present.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Mexiletine
- Fezolinetant + Mexiletine Contraindicated
- Mexiletine + Pimozide Contraindicated
- Alosetron + Mexiletine Major
- Amiodarone + Mexiletine Major
- Clozapine + Mexiletine Major
- Cobicistat + Mexiletine Major
Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Frequently asked questions
Can I take Asenapine with Mexiletine?
MediHelp rates the interaction as moderate. Asenapine and Mexiletine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Asenapine is a weak CYP2D6 inhibitor and may modestly increase mexiletine levels. Both drugs can affect cardiac conduction, so additive QT effects are conceivable.
How serious is the interaction between Asenapine and Mexiletine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for mexiletine adverse effects and obtain an ECG if other QT-prolonging factors are present.
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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