Drug interactions
Darunavir + Mexiletine
Severity: Moderate
Darunavir 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
Darunavir, usually boosted with ritonavir or cobicistat, may raise mexiletine concentrations. Higher exposure can cause neurological toxicity such as tremor, dizziness and ataxia, as well as proarrhythmic effects.
What this interaction means in plain words
Darunavir 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.
Darunavir belongs to Anti Virals; Mexiletine belongs to Cardiovascular.
Why it happens
Inhibition of CYP3A4 (and CYP2D6 by the booster) reduces mexiletine metabolic clearance.
What to do
Monitor ECG and for signs of mexiletine toxicity when starting or stopping darunavir regimens. Consider mexiletine serum level monitoring and reduce the dose if 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?
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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 Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Mexiletine?
MediHelp rates the interaction as moderate. Darunavir 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. Darunavir, usually boosted with ritonavir or cobicistat, may raise mexiletine concentrations. Higher exposure can cause neurological toxicity such as tremor, dizziness and ataxia, as well as proarrhythmic effects.
How serious is the interaction between Darunavir 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 for signs of mexiletine toxicity when starting or stopping darunavir regimens. Consider mexiletine serum level monitoring and reduce the dose if 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.
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