{"id":4559,"date":"2025-03-31T18:12:12","date_gmt":"2025-03-31T18:12:12","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/mexiletine-hydrochloride-txt\/"},"modified":"2025-03-31T18:12:12","modified_gmt":"2025-03-31T18:12:12","slug":"mexiletine-hydrochloride-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/mexiletine-hydrochloride-txt\/","title":{"rendered":"mexiletine hydrochloride.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nVentricular arrhythmias, especially after a myocardial infarction

DOSE IN NORMAL RENAL FUNCTION <\/H3>Oral: 400 mg loading dose, followed by 200\u2013250 mg 3\u20134 times daily commencing 2 hours after the loading doseIV injection: 100\u2013250 mg at a rate of 25 mg\/minute with ECG monitoring, followed by an infusion of 250 mg as a 0.1% solution over 1 hour, 125 mg\/hour for 2 hours then 500 micrograms\/minute thereafter

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :215.7<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :50\u201370<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 10<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :5\u20137<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :5\u201317\/16

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : 50\u201375% of normal dose and titrate according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Analgesics: opioids delay absorption\n
  • Anti-arrhythmics: increased myocardial depression with any combination of anti-arrhythmics\n
  • Antidepressants: metabolism inhibited by fluvoxamine (increased toxicity)Antihistamines: increased risk of ventricular arrhythmias with mizolastine \u2013 avoid concomitant use\n
  • Antipsychotics: increased risk of ventricular arrhythmias with antipsychotics that prolong the QT interval\n
  • Antivirals: possibly increased risk of arrhythmias with ritonavir\n
  • Beta-blockers: increased myocardial depression\n
  • Diuretics: action of mexiletine antagonised by hypokalaemia5HT 3 antagonists increased risk of ventricular arrhythmias with dolasetron \u2013 avoid concomitant use; caution with tropisetron

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>

    IV infusion <\/H4>, oral

    Rate of Administration <\/H4>Variable

    Comments<\/H4>Add 250\u2013500 mg mexiletine to 500 mL of infusion solution, e.g. sodium chloride 0.9%, glucose 5%, sodium bicarbonate 8.4%, sodium lactate, sodium chloride 0.9% with potassium chloride 0.3% or 0.6%

    OTHER INFORMATION <\/H4>Mexiletine has a narrow therapeutic index. Its therapeutic effect has been correlated with plasma concentrations of 0. 5\u20132 micrograms per mLMexiletine is metabolised in the liver and is excreted in the urine, mainly in the form of metabolitesRate of elimination increased with acidic urineInjection can be given orally; however, due to local anaesthetic effect, care needed with hot foods
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Ventricular arrhythmias, especially after a myocardial infarction DOSE<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4559","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4559","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4559"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4559\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4559"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4559"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4559"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}