Drug interactions
Mexiletine + Rifampin
Severity: Moderate
Mexiletine and Rifampin: 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
Rifampin is a potent enzyme inducer and substantially lowers mexiletine concentrations, which may lead to loss of antiarrhythmic or analgesic effect.
What this interaction means in plain words
Mexiletine and Rifampin 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.
Why it happens
Rifampin induces hepatic enzymes (including CYP1A2 and CYP2D6), increasing mexiletine clearance.
What to do
Monitor clinical response and mexiletine levels, and increase the dose as needed. Reduce the dose again after rifampin is stopped to avoid 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 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 Rifampin?
MediHelp rates the interaction as moderate. Mexiletine and Rifampin 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. Rifampin is a potent enzyme inducer and substantially lowers mexiletine concentrations, which may lead to loss of antiarrhythmic or analgesic effect.
How serious is the interaction between Mexiletine and Rifampin?
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 clinical response and mexiletine levels, and increase the dose as needed. Reduce the dose again after rifampin is stopped to avoid toxicity.
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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