Drug interactions
Cannabidiol + Mexiletine
Severity: Moderate
Cannabidiol 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 metabolized by CYP1A2 and CYP2D6, and cannabidiol can both inhibit and induce CYP1A2 and inhibits CYP2D6. Mexiletine exposure may therefore rise or fall. Mexiletine has a narrow therapeutic index, with neurological and proarrhythmic toxicity.
What this interaction means in plain words
Cannabidiol 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.
Cannabidiol belongs to Central Nervous System; Mexiletine belongs to Cardiovascular.
Why it happens
Cannabidiol may alter CYP1A2 and CYP2D6 activity, changing mexiletine clearance.
What to do
Monitor for mexiletine toxicity (tremor, dizziness, nausea) or loss of effect, and check ECG or plasma levels if available. Adjust the mexiletine dose as needed.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cannabidiol and Mexiletine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Cannabidiol
- Cannabidiol + Phenytoin Major
- Cannabidiol + Sodium valproate Major
- Cannabidiol + Tacrolimus Major
- Abiraterone + Cannabidiol Moderate
- Alogliptin-pioglitazone + Cannabidiol Moderate
- Amiodarone + Cannabidiol Moderate
Frequently asked questions
Can I take Cannabidiol with Mexiletine?
MediHelp rates the interaction as moderate. Cannabidiol 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 metabolized by CYP1A2 and CYP2D6, and cannabidiol can both inhibit and induce CYP1A2 and inhibits CYP2D6. Mexiletine exposure may therefore rise or fall. Mexiletine has a narrow therapeutic index, with neurological and proarrhythmic toxicity.
How serious is the interaction between Cannabidiol 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 toxicity (tremor, dizziness, nausea) or loss of effect, and check ECG or plasma levels if available. Adjust the mexiletine dose as needed.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
