Drug interactions
Bupropion + Mexiletine
Severity: Moderate
Bupropion 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
Mexiletine is partly metabolized by CYP2D6, so bupropion may increase its concentrations. Mexiletine has a narrow therapeutic range, and higher levels may cause neurological toxicity and arrhythmias.
What this interaction means in plain words
Bupropion 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.
Bupropion belongs to Central Nervous System; Mexiletine belongs to Cardiovascular.
Why it happens
CYP2D6 inhibition by bupropion reduces mexiletine clearance.
What to do
Monitor for tremor, dizziness, nausea and ECG changes, and consider mexiletine dose reduction or level monitoring when bupropion is added.
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 Bupropion
- Bupropion + Isocarboxazid Contraindicated
- Bupropion + Linezolid Contraindicated
- Bupropion + Phenelzine Contraindicated
- Bupropion + Rasagiline Contraindicated
- Bupropion + Selegiline Contraindicated
- Bupropion + Selegiline transdermal Contraindicated
Other interactions of Mexiletine
- Fezolinetant + Mexiletine Contraindicated
- Mexiletine + Pimozide Contraindicated
- Alosetron + Mexiletine Major
- Amiodarone + Mexiletine Major
- Clozapine + Mexiletine Major
- Cobicistat + Mexiletine Major
Frequently asked questions
Can I take Bupropion with Mexiletine?
MediHelp rates the interaction as moderate. Bupropion 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. Mexiletine is partly metabolized by CYP2D6, so bupropion may increase its concentrations. Mexiletine has a narrow therapeutic range, and higher levels may cause neurological toxicity and arrhythmias.
How serious is the interaction between Bupropion 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 tremor, dizziness, nausea and ECG changes, and consider mexiletine dose reduction or level monitoring when bupropion is added.
What other medicines interact with Bupropion?
MediHelp also lists interactions of Bupropion with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Bupropion page.
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