Mexiletine

Mexiletine is a medication primarily used to treat neuropathic pain. It belongs to a class of drugs known as antiarrhythmics, specifically a Class Ib antiarrhythmic, though its antiarrhythmic properties are less commonly utilized in modern practice compared to its pain-relieving effects. Mexiletine works by blocking sodium channels in nerve cells, which can help to reduce abnormal electrical activity and thus alleviate pain signals.

The typical indications for mexiletine include chronic pain conditions such as painful diabetic neuropathy, post-herpetic neuralgia, and other forms of nerve damage. It may also be used for certain types of myotonia, a condition characterized by delayed muscle relaxation. The dosage of mexiletine is individualized and usually started at a low dose, gradually increased as needed and tolerated. It is taken orally, typically in capsule form.

Common side effects of mexiletine can include gastrointestinal disturbances such as nausea, vomiting, and diarrhea. Neurological side effects like dizziness, lightheadedness, tremor, and confusion may also occur. Cardiovascular effects, such as changes in heart rate and blood pressure, are also possible. Due to potential side effects and interactions, mexiletine requires careful medical supervision. It is not recommended for individuals with certain heart conditions. Mexiletine is metabolized by the liver, and its use may need adjustment in patients with liver impairment. It is important for patients to discuss their medical history and any other medications they are taking with their healthcare provider before starting mexiletine.