Drug interactions
Mexiletine + Nilotinib
Severity: Major
Mexiletine and Nilotinib: major 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
Nilotinib can inhibit CYP2D6 and may increase mexiletine exposure. Nilotinib also prolongs the QT interval, and mexiletine toxicity includes proarrhythmia, tremor, dizziness, and nausea. The combination may therefore raise both pharmacokinetic and arrhythmic risk.
What this interaction means in plain words
Mexiletine and Nilotinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Mexiletine belongs to Cardiovascular; Nilotinib belongs to Oncology.
Why it happens
Nilotinib inhibits CYP2D6 metabolism of mexiletine and has additive proarrhythmic potential through QT prolongation.
What to do
Obtain a baseline ECG, correct potassium and magnesium, and monitor the ECG during co-use. Watch for mexiletine toxicity and reduce its dose if needed, or choose an alternative.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Mexiletine and Nilotinib, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib Contraindicated
Frequently asked questions
Can I take Mexiletine with Nilotinib?
MediHelp rates the interaction as major. Mexiletine and Nilotinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Nilotinib can inhibit CYP2D6 and may increase mexiletine exposure. Nilotinib also prolongs the QT interval, and mexiletine toxicity includes proarrhythmia, tremor, dizziness, and nausea. The combination may therefore raise both pharmacokinetic and arrhythmic risk.
How serious is the interaction between Mexiletine and Nilotinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG, correct potassium and magnesium, and monitor the ECG during co-use. Watch for mexiletine toxicity and reduce its dose if needed, or choose an alternative.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
