Drug interactions
Mexiletine + Paroxetine
Severity: Moderate
Mexiletine and Paroxetine: 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
Paroxetine strongly inhibits CYP2D6, one of the pathways metabolizing mexiletine, so mexiletine concentrations may increase. This can intensify tremor, dizziness, nausea and proarrhythmic effects.
What this interaction means in plain words
Mexiletine and Paroxetine 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 belongs to Cardiovascular; Paroxetine belongs to Central Nervous System.
Why it happens
Paroxetine inhibits CYP2D6, decreasing mexiletine clearance.
What to do
Monitor for mexiletine toxicity and ECG changes and reduce the mexiletine dose if needed when paroxetine is started.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Mexiletine with Paroxetine?
MediHelp rates the interaction as moderate. Mexiletine and Paroxetine 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. Paroxetine strongly inhibits CYP2D6, one of the pathways metabolizing mexiletine, so mexiletine concentrations may increase. This can intensify tremor, dizziness, nausea and proarrhythmic effects.
How serious is the interaction between Mexiletine and Paroxetine?
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 ECG changes and reduce the mexiletine dose if needed when paroxetine is started.
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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