Mexiletine Hydrochloride and Prozac Capsules

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using mexiletine together with FLUoxetine may increase the effects of mexiletine. Contact your doctor if you experience tiredness, dizziness, confusion, difficulty breathing, heart attack, and a worsening irregular heartbeat. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with certain selective serotonin reuptake inhibitors (SSRIs) may increase the plasma concentrations of antiarrhythmic agents that are metabolized by CYP450 2D6 such as encainide, flecainide, mexiletine, and propafenone. The mechanism is decreased drug clearance due to inhibition of the isoenzyme by some SSRIs. The interaction has been studied specifically with fluoxetine and propafenone. In nine healthy 2D6-extensive metabolizers, fluoxetine pretreatment (20 mg once a day for 10 days) significantly increased the elimination half-life, peak plasma concentration (Cmax), and area under the concentration-time curve (AUC) of both the S- and R-enantiomers of propafenone (400 mg single dose). Oral clearance decreased by about 34% for both enantiomers. In vitro inhibition data suggest that fluoxetine and paroxetine have the most significant effects on 2D6 metabolism of propafenone, while fluvoxamine and sertraline have only modest effects.

MANAGEMENT: Caution is advised if certain SSRIs, particularly fluoxetine or paroxetine, must be used concomitantly with antiarrhythmic agents that are metabolized by CYP450 2D6. Lower initial dosages of the antiarrhythmic agent may be appropriate. Patients who are already stabilized on their antiarrhythmic regimen should be monitored for altered effects on myocardial conduction following addition or discontinuation of SSRI therapy (up to 2 weeks for most SSRIs and 5 weeks for fluoxetine due to its long half-life), and the antiarrhythmic dosage adjusted if necessary. Alternatively, an antidepressant that does not interfere with 2D6 metabolism may be considered, such as citalopram, escitalopram, or venlafaxine.

Mexiletine Hydrochloride

Generic Name: mexiletine

Brand name: Mexitil

Synonyms: Mexiletine

What is Mexiletine Hydrochloride?

Prozac Capsules

Generic Name: fluoxetine

Brand name: Prozac, Prozac Weekly, Sarafem, Rapiflux, Selfemra, PROzac Pulvules

Synonyms: Prozac

What is Prozac Capsules?