Drug interactions
Givosiran + Mexiletine
Severity: Moderate
Givosiran 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 mainly metabolized by CYP1A2 and CYP2D6, and givosiran reduces CYP1A2 activity. Mexiletine concentrations may rise, increasing the risk of dose-related neurologic and gastrointestinal toxicity and arrhythmia.
What this interaction means in plain words
Givosiran 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.
Givosiran belongs to Miscellaneous; Mexiletine belongs to Cardiovascular.
Why it happens
Givosiran-related reduction in CYP1A2 activity decreases mexiletine clearance.
What to do
Monitor for mexiletine toxicity and consider lowering the mexiletine dose; check ECG and plasma levels where available.
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 Givosiran
- Duloxetine + Givosiran Major
- Givosiran + Pimozide Major
- Givosiran + Propafenone Major
- Givosiran + Theophylline Major
- Givosiran + Thioridazine Major
- Givosiran + Tizanidine Major
Frequently asked questions
Can I take Givosiran with Mexiletine?
MediHelp rates the interaction as moderate. Givosiran 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 mainly metabolized by CYP1A2 and CYP2D6, and givosiran reduces CYP1A2 activity. Mexiletine concentrations may rise, increasing the risk of dose-related neurologic and gastrointestinal toxicity and arrhythmia.
How serious is the interaction between Givosiran 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 and consider lowering the mexiletine dose; check ECG and plasma levels where available.
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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