Drug interactions
Clomipramine + Mexiletine
Severity: Moderate
Clomipramine 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 may inhibit CYP1A2 and increase clomipramine levels, and both drugs can prolong cardiac conduction. This raises the risk of anticholinergic effects, seizures and arrhythmia.
What this interaction means in plain words
Clomipramine 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.
Clomipramine belongs to Central Nervous System; Mexiletine belongs to Cardiovascular.
Why it happens
CYP1A2 inhibition by mexiletine plus additive effects on cardiac conduction.
What to do
Monitor ECG and clomipramine adverse effects; consider reducing the clomipramine dose.
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 Clomipramine
- Arsenic trioxide + Clomipramine Contraindicated
- Clomipramine + Dofetilide Contraindicated
- Clomipramine + Droperidol Contraindicated
- Clomipramine + Isocarboxazid Contraindicated
- Clomipramine + Methylene blue Contraindicated
- Clomipramine + Pentamidine Contraindicated
Frequently asked questions
Can I take Clomipramine with Mexiletine?
MediHelp rates the interaction as moderate. Clomipramine 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 may inhibit CYP1A2 and increase clomipramine levels, and both drugs can prolong cardiac conduction. This raises the risk of anticholinergic effects, seizures and arrhythmia.
How serious is the interaction between Clomipramine 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 ECG and clomipramine adverse effects; consider reducing the clomipramine dose.
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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