Drug interactions
Mexiletine + Sodium citrate / citric acid
Severity: Moderate
Mexiletine and Sodium citrate / citric acid: 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
Citrate is metabolized to bicarbonate and alkalinizes the urine, which decreases mexiletine renal excretion. Plasma levels may rise and toxicity can follow.
What this interaction means in plain words
Mexiletine and Sodium citrate / citric acid 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
Urinary alkalinization increases passive tubular reabsorption of mexiletine.
What to do
Monitor for mexiletine toxicity and consider levels with regular citrate use. Reduce the mexiletine dose if needed.
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 Sodium citrate / citric acid?
MediHelp rates the interaction as moderate. Mexiletine and Sodium citrate / citric acid 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. Citrate is metabolized to bicarbonate and alkalinizes the urine, which decreases mexiletine renal excretion. Plasma levels may rise and toxicity can follow.
How serious is the interaction between Mexiletine and Sodium citrate / citric acid?
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 consider levels with regular citrate use. Reduce the mexiletine dose if needed.
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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