Drug interactions
Carbamazepine + Mexiletine
Severity: Moderate
Carbamazepine 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
Carbamazepine is a strong enzyme inducer and can lower mexiletine concentrations, potentially causing loss of arrhythmia or pain control. Both agents also affect sodium channels and conduction.
What this interaction means in plain words
Carbamazepine 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.
Carbamazepine belongs to Central Nervous System; Mexiletine belongs to Cardiovascular.
Why it happens
Carbamazepine induces hepatic metabolism of mexiletine.
What to do
Monitor clinical response and consider a higher mexiletine dose; reassess dosing when carbamazepine is started or stopped.
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Mexiletine?
MediHelp rates the interaction as moderate. Carbamazepine 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. Carbamazepine is a strong enzyme inducer and can lower mexiletine concentrations, potentially causing loss of arrhythmia or pain control. Both agents also affect sodium channels and conduction.
How serious is the interaction between Carbamazepine 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 clinical response and consider a higher mexiletine dose; reassess dosing when carbamazepine is started or stopped.
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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