Drug interactions
Mexiletine + Riluzole
Severity: Moderate
Mexiletine and Riluzole: 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
Riluzole is cleared mainly by CYP1A2, so mexiletine may increase riluzole exposure. This could raise the risk of riluzole adverse effects such as nausea, asthenia and liver enzyme elevation.
What this interaction means in plain words
Mexiletine and Riluzole 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; Riluzole belongs to Miscellaneous.
Why it happens
Mexiletine inhibits CYP1A2, the main pathway of riluzole metabolism.
What to do
Monitor liver enzymes and tolerability of riluzole when mexiletine is co-prescribed, as is often done for ALS cramps; reduce the riluzole dose if adverse effects appear.
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 Riluzole
- Fluvoxamine + Riluzole Major
- Cannabidiol + Riluzole Moderate
- Ciprofloxacin + Riluzole Moderate
- Elranatamab + Riluzole Moderate
- Epcoritamab + Riluzole Moderate
- Fexinidazole + Riluzole Moderate
Frequently asked questions
Can I take Mexiletine with Riluzole?
MediHelp rates the interaction as moderate. Mexiletine and Riluzole 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. Riluzole is cleared mainly by CYP1A2, so mexiletine may increase riluzole exposure. This could raise the risk of riluzole adverse effects such as nausea, asthenia and liver enzyme elevation.
How serious is the interaction between Mexiletine and Riluzole?
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 liver enzymes and tolerability of riluzole when mexiletine is co-prescribed, as is often done for ALS cramps; reduce the riluzole dose if adverse effects appear.
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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