Adverse Side Effects Associated with Mexiletine

Mexiletine is a new antiar-rhythmic drug that has minor negative inotropic effects even in patients with underlying left ventricular dysfunction. The drug can be used in patients with underlying conduction system disease although reports of worsening sinus node function or atrioventicular conduction abnormalities have been noted. Mexiletine may aggravate venticular arrhythmias. The drug can be used safely with other cardioactive agents. Side effects are frequent but can be minimized by starting with low doses and titrating the dosage as tolerated. Mexiletine should be administered with meals or a snack or with antacids or possibly cimetidine to reduce gastrointestinal side effects. Mexiletine can cause abnormal liver function tests, hematologic abnormalities, and elevated titers of antinuclear antibodies (ANA). Regular monitoring of these parameters is suggested.

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