Drug interactions
Elranatamab + Mexiletine
Severity: Moderate
Elranatamab 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
Elranatamab-induced cytokine release syndrome can temporarily suppress CYP enzyme activity. This may raise levels of CYP1A2 substrates such as mexiletine, particularly around step-up dosing, risking toxicity in a narrow-therapeutic-index drug.
What this interaction means in plain words
Elranatamab 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.
Elranatamab belongs to Oncology; Mexiletine belongs to Cardiovascular.
Why it happens
Cytokine release during CRS downregulates hepatic CYP enzymes including CYP1A2, reducing mexiletine clearance.
What to do
During step-up dosing and for the following 2 weeks or during CRS, monitor for mexiletine toxicity and consider checking serum levels. 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?
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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 Elranatamab
- Elranatamab + Ergotamine Major
- Elranatamab + Pimozide Major
- Bendamustine + Elranatamab Moderate
- Carbamazepine + Elranatamab Moderate
- Clomipramine + Elranatamab Moderate
- Clozapine + Elranatamab Moderate
Frequently asked questions
Can I take Elranatamab with Mexiletine?
MediHelp rates the interaction as moderate. Elranatamab 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. Elranatamab-induced cytokine release syndrome can temporarily suppress CYP enzyme activity. This may raise levels of CYP1A2 substrates such as mexiletine, particularly around step-up dosing, risking toxicity in a narrow-therapeutic-index drug.
How serious is the interaction between Elranatamab 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: During step-up dosing and for the following 2 weeks or during CRS, monitor for mexiletine toxicity and consider checking serum levels. 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.
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