Drug interactions
Lidocaine + Mexiletine
Severity: Moderate
Lidocaine 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
Both drugs are class IB antiarrhythmics with sodium channel blocking activity, and their combination can produce additive neurotoxicity and cardiac effects. Mexiletine may also modestly raise lidocaine exposure, increasing the risk of dizziness, tremor, confusion, seizures and conduction disturbances, especially with systemic lidocaine.
What this interaction means in plain words
Lidocaine 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.
Lidocaine belongs to Cardiovascular; Mexiletine belongs to Cardiovascular.
Why it happens
Additive sodium channel blockade, with possible reduction of lidocaine metabolism by mexiletine.
What to do
Avoid giving systemic lidocaine to patients on mexiletine unless needed; if used, reduce the lidocaine dose and monitor ECG and for CNS toxicity.
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 Lidocaine
- Bupivacaine liposome + Lidocaine Major
- Disopyramide + Lidocaine Major
- Ex vivo expanded autologous human corneal epithelial cells containing stem cells + Lidocaine Major
- Lidocaine + Nirmatrelvir / ritonavir Major
- Lidocaine + Ombitasvir / paritaprevir / ritonavir and dasabuvir Major
- Lidocaine + Pimozide Major
Other interactions of Mexiletine
- Fezolinetant + Mexiletine Contraindicated
- Mexiletine + Pimozide Contraindicated
- Alosetron + Mexiletine Major
- Amiodarone + Mexiletine Major
- Clozapine + Mexiletine Major
- Cobicistat + Mexiletine Major
Frequently asked questions
Can I take Lidocaine with Mexiletine?
MediHelp rates the interaction as moderate. Lidocaine 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. Both drugs are class IB antiarrhythmics with sodium channel blocking activity, and their combination can produce additive neurotoxicity and cardiac effects. Mexiletine may also modestly raise lidocaine exposure, increasing the risk of dizziness, tremor, confusion, seizures and conduction disturbances, especially with systemic lidocaine.
How serious is the interaction between Lidocaine 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: Avoid giving systemic lidocaine to patients on mexiletine unless needed; if used, reduce the lidocaine dose and monitor ECG and for CNS toxicity.
What other medicines interact with Lidocaine?
MediHelp also lists interactions of Lidocaine with, for example, Bupivacaine liposome, Disopyramide, Ex vivo expanded autologous human corneal epithelial cells containing stem cells. The full list is on the Lidocaine page.
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