This drug is not commonly used... There were a few posts a very long
time ago on our old BT board back in 2000 I think...
The side effect profile is very poor (common) and since the antiarrthymic
value of this drug is low, it is just not used much anymore.
It is sort of a last resort thing, I think.
Quote:
Vol. 150 No. 2, February 1, 1990 TABLE OF CONTENTS
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Mexiletine. Long-term efficacy and side effects in patients with chronic drug-resistant potentially lethal ventricular arrhythmias
N. Z. Kerin, E. Aragon, G. Marinescu, K. Faitel, H. Frumin and M. Rubenfire
Department of Medicine, Sinai Hospital of Detroit, Mich 48235-2899.
The antiarrhythmic efficacy of mexiletine hydrochloride (Mexitil) was evaluated in 100 patients with potentially lethal and drug-resistant ventricular arrhythmia. The efficacy of arrhythmia suppression was assessed by Holter monitoring. The overall arrhythmia suppression of ventricular premature contractions of 70% and greater was low and seen in only 22% of patients, with an additional 16% responding to a combination of mexiletine and an additional antiarrhythmic drug. The suppression of high-grade forms, couplets of 90% and greater, and complete abolition of nonsustained runs of ventricular tachycardia was achieved in 22% of patients, with 9% responding to the addition of another antiarrhythmic agent. Ventricular premature contractions, couplets, and nonsustained ventricular tachycardia were suppressed in only 16% of the cohort. The drug was poorly tolerated, with intolerable side effects developing in 49% of patients receiving mexiletine alone and in 57% of patients receiving a combination of antiarrhythmic agents. Tolerable adverse effects were relatively common but transient and dose related.
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This is a good description of this drug:
http://dailymed.nlm.nih.gov/dailymed...fo.cfm?id=1642
Mostly GI disturbance and CNS effects are predominate.
This is a study that is fairly recent:
Quote:
June 04, 2005
J Orthop Sci. 2005;10(3):315-20.
We studied the efficacy of mexiletine as a sodium channel blocker for neuropathic pain by investigating the effect of mexiletine on the pathological ectopic firing pattern in a chronic constriction nerve injury (CCI) model. The experiment was conducted with 60 male Wistar rats. The CCI model was created by loosely ligating the sciatic nerve. After breeding 7 days, the frequency and pattern of ectopic firing antidromically recorded from the sural nerve and the amplitude of antidromic sensory nerve-evoked potential were analyzed. The CCI rats were given an intravenous injection of normal saline and mexiletine (5 or 15 mg/kg). Mexiletine significantly suppressed spontaneous firing frequency, an on-off firing pattern that consisted of cyclic bursting spikes and ectopic firing generation under the hypoxic condition. Mexiletine did not influence the amplitude of A-delta component in the antidromic sensory nerve-evoked potential. Mexiletine suppressed ectopic firing by blocking activity of the abnormal sodium channel at the nerve-injured site and dorsal root ganglion without blocking nerve conduction. This study suggests that mexiletine is useful for treating neuropathic pain in peripheral neuropathy.
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from
http://www.dejerine-sottas.com/archi...ment/index.php
All of these agents that affect heart rhythm can impact even a normal patient. Hence they are not used frequently. You will need to be monitored carefully, while on this drug. Also the GI effects can be huge..usually they are the reason people discontinue it.
And a warning for people with ocular issues (vision)
http://www.blackwell-synergy.com/lin...1.01027.x/abs/
Most drug stores do not carry this as a regular item..you might have to have it special ordered...so a delay may occur in receiving it.
I tried searching the old board for you, but I don't get any hits on this drug.
It was a LONG TIME ago that I saw someone with PN posting about it.
Is this a result of your recent visit to Mayo?
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