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Side Effects > Mexitil

Mexitil Side Effects

Generic Name: Mexiletine

Please note - some side effects for Mexitil may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).


For the consumer

For the professional

Side Effects of Mexitil - for the consumer


Mexitil

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Mexitil:

Blurred vision; clumsiness; constipation; diarrhea; dizziness or lightheadedness; headache; heartburn; incoordination; nausea; nervousness; stomach discomfort; tremor; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Mexitil:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision problems; chest pain; fainting; fever; irregular, fast, or slow heartbeat; severe dizziness or lightheadedness; severe stomach pain; sore throat; yellowing of the skin or eyes.

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For the professional


Mexitil

Mexitil (mexiletine hydrochloride, USP) commonly produces reversible gastrointestinal and nervous system adverse reactions but is otherwise well tolerated. Mexitil has been evaluated in 483 patients in one-month and three-month controlled studies and in over 10,000 patients in a large compassionate use program. Dosages in the controlled studies ranged from 600-1200 mg/day; some patients (8%) in the compassionate use program were treated with higher daily doses (1600-3200 mg/day). In the three-month controlled trials comparing Mexitil to quinidine, procainamide and disopyramide, the most frequent adverse reactions were upper gastrointestinal distress (41%), lightheadedness (10.5%), tremor (12.6%) and coordination difficulties (10.2%). Similar frequency and incidence were observed in the one-month placebo-controlled trial. Although these reactions were generally not serious, and were dose-related and reversible with a reduction in dosage, by taking the drug with food or antacid or by therapy discontinuation, they led to therapy discontinuation in 40% of patients in the controlled trials. Table 1 presents the adverse events reported in the one-month placebo-controlled trial.

Table 1 : Comparative Incidence (%) of Adverse Events Among Patients Treated with Mexiletine and Placebo in the 4- Week, Double-blind Crossover Trial
Mexiletine
N=53
Placebo
N=49
Cardiovascular
   Palpitations 7.5 10.2
   Chest Pain 7.5 4.1
   Increased Ventricular
      Arrhythmia /PVC's

1.9

-
Digestive
   Nausea/Vomiting/Heartburn 39.6 6.1
Central Nervous System
   Dizziness/
      Lightheadedness

26.4

14.3
   Tremor 13.2
   Nervousness 11.3 6.1
   Coordination Difficulties 9.4
   Changes in Sleep Habits 7.5 16.3
   Paresthesias/Numbness 3.8 2.0
   Weakness 1.9 4.1
   Fatigue 1.9 2.0
   Tinnitus 1.9 4.1
   Confusion/Clouded Sensorium 1.9 2.0
Other
   Headache 7.5 6.1
   Blurred Vision/Visual
      Disturbances

7.5

2.0
   Dyspnea/Respiratory 5.7 10.2
   Rash 3.8 2.0
   Non-specific Edema 3.8

Table 2 presents the adverse reactions occurring in one percent or more of patients in the three-month controlled studies.

Table 2: Comparative Incidence (%) of Adverse Events Among Patients Treated with Mexiletine or Control Drugs in the 12-Week Double-blind Trials
Mexiletine Quinidine Procainamide Disopyramide
N = 430 N = 262 N = 78 N = 69
Cardiovascular
   Palpitations 4.3 4.6 1.3 5.8
   Chest Pain 2.6 3.4 1.3 2.9
   Angina/Angina-
      like Pain

1.7

1.9

2.6

2.9
   Increased Ventricular
      Arrhythmias/PVC's

1.0

2.7

2.6

Digestive
   Nausea/Vomiting/Heartburn 39.3 21.4 33.3 14.5
   Diarrhea 5.2 33.2 2.6 8.7
   Constipation 4.0 6.4 11.6
   Changes in Appetite 2.6 1.9
   Abdominal Pain/Cramps/Discomfort 1.2 1.5 1.4
Central Nervous System
   Dizziness/Lightheadedness 18.9 14.1 14.1 2.9
   Tremor 13.2 2.3 3.8 1.4
   Coordination Difficulties 9.7 1.1 1.3
   Changes in Sleep Habits 7.1 2.7 11.5 8.7
   Weakness 5.0 5.3 7.7 2.9
   Nervousness 5.0 1.9 6.4 5.8
   Fatigue 3.8 5.7 5.1 1.4
   Speech Difficulties 2.6 0.4
   Confusion/Clouded Sensorium 2.6 3.8
   Paresthesias/Numbness 2.4 2.3 2.6
   Tinnitus 2.4 1.5
   Depression 2.4 1.1 1.3 1.4
Other
   Blurred Vision/Visual Disturbances 5.7 3.1 5.1 7.2
   Headache 5.7 6.9 7.7 4.3
   Rash 4.2 3.8 10.3 1.4
   Dyspnea/ Respiratory 3.3 3.1 5.1 2.9
   Dry Mouth 2.8 1.9 5.1 14.5
   Arthralgia 1.7 2.3 5.1 1.4
   Fever 1.2 3.1 2.6

Less than 1%: Syncope, edema, hot flashes, hypertension, short-term memory loss, loss of consciousness, other psychological changes, diaphoresis, urinary hesitancy/retention, malaise, impotence/decreased libido, pharyngitis, congestive heart failure.

An additional group of over 10,000 patients has been treated in a program allowing administration of Mexitil (mexiletine hydrochloride, USP) under compassionate use circumstances. These patients were seriously ill with the large majority on multiple drug therapy. Twenty-four percent of the patients continued in the program for one year or longer. Adverse reactions leading to therapy discontinuation occurred in 15 percent of patients (usually upper gastrointestinal system or nervous system effects). In general, the more common adverse reactions were similar to those in the controlled trials. Less common adverse events possibly related to Mexitil use include:

Cardiovascular System: Syncope and hypotension, each about 6 in 1000; bradycardia, about 4 in 1000; angina/angina-like pain, about 3 in 1000; edema, atrioventricular block/conduction disturbances and hot flashes, each about 2 in 1000; atrial arrhythmias, hypertension and cardiogenic shock, each about 1 in 1000.

Central Nervous System: Short-term memory loss, about 9 in 1000 patients; hallucinations and other psychological changes, each about 3 in 1000; psychosis and convulsions/seizures, each about 2 in 1000; loss of consciousness, about 6 in 10,000.

Digestive: Dysphagia, about 2 in 1000; peptic ulcer, about 8 in 10,000; upper gastrointestinal bleeding, about 7 in 10,000; esophageal ulceration, about 1 in 10,000. Rare cases of severe hepatitis/acute hepatic necrosis.

Skin: Rare cases of exfoliative dermatitis and Stevens-Johnson Syndrome with Mexitil (mexiletine hydrochloride, USP) treatment have been reported.

Laboratory: Abnormal liver function tests, about 5 in 1000 patients; positive ANA and thrombocytopenia, each about 2 in 1000; leukopenia (including neutropenia and agranulocytosis), about 1 in 1000; myelofibrosis, about 2 in 10,000 patients.

Other: Diaphoresis, about 6 in 1000; altered taste, about 5 in 1000; salivary changes, hair loss and impotence/decreased libido, each about 4 in 1000; malaise, about 3 in 1000; urinary hesitancy/retention, each about 2 in 1000; hiccups, dry skin, laryngeal and pharyngeal changes and changes in oral mucous membranes, each about 1 in 1000; SLE syndrome, about 4 in 10,000.

Hematology

Blood dyscrasias were not seen in the controlled trials but did occur among 10,867 patients treated with mexiletine in the compassionate use program.

Myelofibrosis was reported in two patients in the compassionate use program: one was receiving long-term thiotepa therapy and the other had pretreatment myeloid abnormalities.

In post-marketing experience, there have been isolated, spontaneous reports of pulmonary changes including pulmonary infiltration and pulmonary fibrosis during Mexitil therapy with or without other drugs or diseases that are known to produce pulmonary toxicity. A causal relationship to Mexitil therapy has not been established. In addition, there have been isolated reports of drowsiness, nystagmus, ataxia, dyspepsia, hypersensitivity reaction, and exacerbation of congestive heart failure in patients with pre-existing compromised ventricular function. There have been rare reports of pancreatitis associated with Mexitil treatment.

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More resources:

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