Drug interactions
Lidocaine-prilocaine + Mexiletine
Severity: Moderate
Lidocaine-prilocaine 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 a class IB antiarrhythmic structurally related to lidocaine, so its effects are additive with lidocaine if enough lidocaine is absorbed. With topical lidocaine-prilocaine on intact skin in usual amounts this is unlikely to matter, but large areas, broken skin or prolonged application could add to systemic toxicity such as neurologic or cardiac effects.
What this interaction means in plain words
Lidocaine-prilocaine 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-prilocaine belongs to Genitourinary; Mexiletine belongs to Cardiovascular.
Why it happens
Additive sodium channel blockade and cardiac/CNS effects of two class IB local anesthetic agents.
What to do
Limit the treated area, dose and duration of lidocaine-prilocaine in patients on mexiletine. Watch for dizziness, tremor, paresthesia or arrhythmia if large amounts are applied.
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-prilocaine
- Lidocaine-prilocaine + Phenazopyridine Major
- Bupivacaine implant + Lidocaine-prilocaine Moderate
- Bupivacaine liposome + Lidocaine-prilocaine Moderate
- Disopyramide + Lidocaine-prilocaine Moderate
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Lidocaine-prilocaine Moderate
- Lidocaine-prilocaine + Nirmatrelvir / ritonavir Moderate
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-prilocaine with Mexiletine?
MediHelp rates the interaction as moderate. Lidocaine-prilocaine 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 a class IB antiarrhythmic structurally related to lidocaine, so its effects are additive with lidocaine if enough lidocaine is absorbed. With topical lidocaine-prilocaine on intact skin in usual amounts this is unlikely to matter, but large areas, broken skin or prolonged application could add to systemic toxicity such as neurologic or cardiac effects.
How serious is the interaction between Lidocaine-prilocaine 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: Limit the treated area, dose and duration of lidocaine-prilocaine in patients on mexiletine. Watch for dizziness, tremor, paresthesia or arrhythmia if large amounts are applied.
What other medicines interact with Lidocaine-prilocaine?
MediHelp also lists interactions of Lidocaine-prilocaine with, for example, Phenazopyridine, Bupivacaine implant, Bupivacaine liposome. The full list is on the Lidocaine-prilocaine page.
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