Drug interactions
Mexiletine + Ranolazine
Severity: Moderate
Mexiletine and Ranolazine: 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 metabolized by CYP2D6, so ranolazine may raise its concentrations. Both drugs affect cardiac sodium channels, so higher mexiletine levels may produce dizziness, tremor, nausea or proarrhythmic effects.
What this interaction means in plain words
Mexiletine and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Weak CYP2D6 inhibition by ranolazine increases mexiletine exposure, with overlapping sodium channel effects.
What to do
Monitor for neurologic and gastrointestinal adverse effects and review the ECG. Reduce the mexiletine dose if toxicity occurs.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
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 Mexiletine with Ranolazine?
MediHelp rates the interaction as moderate. Mexiletine and Ranolazine 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 metabolized by CYP2D6, so ranolazine may raise its concentrations. Both drugs affect cardiac sodium channels, so higher mexiletine levels may produce dizziness, tremor, nausea or proarrhythmic effects.
How serious is the interaction between Mexiletine and Ranolazine?
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 neurologic and gastrointestinal adverse effects and review the ECG. Reduce the mexiletine dose if toxicity occurs.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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