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Review
. 2023 Nov;46(11):1348-1356.
doi: 10.1111/pace.14846. Epub 2023 Oct 17.

Mexiletine: Antiarrhythmic mechanisms, emerging clinical applications and mortality

Farah Olleik  1 , Mohammed Hussein Kamareddine  1 , Jenna Spears  1 , Gary Tse  2   3   4 , Tong Liu  2 , Gan-Xin Yan  1   5   6
Affiliations
Review

Mexiletine: Antiarrhythmic mechanisms, emerging clinical applications and mortality

Farah Olleik et al. Pacing Clin Electrophysiol. 2023 Nov.

Abstract

Mexiletine, a class Ib antiarrhythmic drug, exhibits its major antiarrhythmic effect via inhibition of the fast and late Na+ currents in myocardial tissues that are dependent on the opening of Na+ channels for their excitation. Through a comprehensive examination of mexiletine's therapeutic benefits and potential risks, we aim to provide valuable insights that reinforce its role as a vital therapeutic option for patients with ventricular arrhythmias, long QT syndrome, and other heart rhythm disorders. This review will highlight the current understandings of the antiarrhythmic effects and rationales for recent off-label use and address the mortality and proarrhythmic effects of mexiletine utilizing published basic and clinical studies over the past five decades.

Keywords: antiarrhythmic effects; atrial fibrillation; drug safety; long QT syndrome; mexiletine; mortality; pharmacokinetics; proarrhythmias; ventricular tachycardia.

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References

REFERENCES

    1. Talbot RG, Nimmo J, Julian DG, Clark RA, Neilson JM, Prescott LF. Treatment of ventricular arrhythmias with mexiletine (Ko 1173). Lancet. 1973;2:399-404. doi:10.1016/s0140-6736(73)92270-8. S0140-6736(73)92270-8 [pii].
    1. Herzog P, Holtermuller Kh, Kasper W, Meinertz T, Trenk D, Jahnchen E. Absorption of mexiletine after treatment with gastric antacids. Br J Clin Pharmacol. 1982;14:746-747. doi:10.1111/j.1365-2125.1982.tb04969.x
    1. Wing LM, Meffin PJ, Grygiel JJ, Smith KJ, Birkett DJ. The effect of metoclopramide and atropine on the absorption of orally administered mexiletine. Br J Clin Pharmacol. 1980;9:505-509.
    1. Joseph SP, Holt DW. Electrophysiological properties of mexiletine assessed with respect to plasma concentrations. Eur J Cardiol. 1980;11:115-121.
    1. Baudinet G, Henrard L, Quinaux N, et al. Pharmacokinetics of mexiletine in renal insufficiency. Acta Cardiol Suppl. 1980:55-65.

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