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Precautions and Warnings With Mexiletine

Specific Mexiletine Precautions and Warnings

Some warnings and precautions to be aware of prior to using this drug include the following:
 
  • In a clinical study, people who took certain antiarrhythmia medicines, such as mexiletine, after having a heart attack had a higher risk of their heart stopping and death than people who did not take the antiarrhythmia medications. It is unknown whether people who have not had a recent heart attack have the same risk.
 
  • Because of the potential risks associated with its use, and because mexiletine has not been shown to help people with arrhythmias live longer, the medication should only be used to treat life-threatening heart rhythm problems.
 
  • Liver damage and abnormal liver function tests, which could be a sign of liver problems, have been reported in people taking this medication, especially in people with CHF or other forms of heart disease. Let your healthcare provider know if you develop any signs of liver problems during treatment, such as:
 
    • Yellowing of the skin or whites of the eyes (jaundice)
    • Dark urine
    • Upper-right abdominal (stomach) pain.
 
  • Mexiletine can worsen your existing heart rhythm problem or cause a new heart rhythm problem. Let your healthcare provider know if you experience a fast, slow, or irregular heartbeat during treatment.
 
  • This medication can worsen existing heart failure and cause severe low blood pressure (hypotension). If you have heart failure, let your healthcare provider know if your symptoms get worse during treatment.
 
  • People with liver disease will need to be carefully monitored while taking this medication.
 
  • Certain diets, including diets rich in citrus fruits, vegetables, and legumes, can change the way mexiletine is removed from the body by the kidneys. Let your healthcare provider know if you eat a lot of citrus fruits, vegetables, or legumes, or if you have been told to eat a diet that will change the pH of your urine.
 
  • A decrease in blood platelets and white blood cells has been observed in some people taking mexiletine, which could increase the risk for bleeding problems and infection. It should be noted that this happened very rarely. In addition, most of the people who developed the problem were quite ill and were taking other medications that can lower platelets and white blood cell counts. Therefore, it is difficult to say for certain whether the problem was caused by mexiletine or something else.
 
  • Although rare, there have been reports of seizures occurring in people taking mexiletine, even in people who have never had a seizure before. Make sure your healthcare provider knows if you have a seizure disorder before starting treatment.
 
 
  • Mexiletine is a pregnancy Category C medication. This means that it may not be safe for use during pregnancy (see Mexitil and Pregnancy).
 
  • Mexiletine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Mexitil and Breastfeeding).
 
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Mexiletine Drug Information

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