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Mexiletine Diamorphine

Opioids such as diamorphine, pethidine, and pentazocine strongly inhibit gastric emptying and greatly reduce the absorption rate of paracetamol. Codeine, however, has no significant effect on paracetamol absorption. Morphine and diamorphine have been shown to reduce the absorption of antiarrhyth-mics such as mexiletine in patients with myocardial infarction. [Pg.250]

OPIOIDS MEXILETINE 1. Absorption of oral mexiletine is 1 by co-administration with morphine or diamorphine 2. Methadone may t mexiletine levels 1. Uncertain but thought to be due to an opioid-induced delay in gastric emptying 2. Methadone inhibits CYP2D6-mediated metabolism of mexiletine 1. Watch for poor response to mexiletine consider starting at a higher or using the intravenous route 2. Monitor PR, BP and ECG closely watch for mexiletine toxicity... [Pg.471]

A study in 8 healthy subjects found that a single 600-microgram dose of intravenous atropine reduced the rate of absorption of a single 400-mg oral dose of mexiletine, but the mexiletine AUC remained unaffected. Intravenous metoclopramide 10 mg hastened the absorption of mexiletine but similarly did not affect the AUC. Metoclopramide tended to reverse the effect of diamorphine on plasma mexiletine levels in one clinical trial (see also Mexiletine + Opioids , p.268). [Pg.267]

The absorption of mexiletine is reduced following myocardial infarction, and very markedly reduced and delayed if diamorphine or morphine is used concurrently. A higher loading dose may be needed if oral mexiletine is required during the first few hours following a myocardial infarction. [Pg.268]

A pharmacokinetic study showed that the mean plasma levels of mexiletine (400 mg orally followed by 200 mg 2 hours later) in the first 3 hours were more than 50% lower in 6 patients who had suffered a myocardial infarction and who had been given diamorphine 5 to 10 mg or morphine lOto 15 mg than in 4 patients who had not been given opioids. In addition, the AUCo.8 was 38.6% lower in those who had received opioids. ... [Pg.268]

In a further study about the prophylactic use of mexiletine, the same authors found that plasma mexiletine levels 3 hours after the first oral dose were 31% lower in 10 patients who had received opioids than in 6 patients who had not. These patients were from a subset who were subsequently shown not to have had a myocardial infarction. In another similar trial of mexiletine in acute myocardial infarction, use of diamorphine was associated with low plasma mexiletine levels at 3 hours, and possible reduced efficacy of mexiletine. In this study, pretreatment with intravenous meto-clopramide tended to reduce the effect of diamorphine on mexiletine absorption, although this was not noted in the other report. ... [Pg.268]


See other pages where Mexiletine Diamorphine is mentioned: [Pg.22]    [Pg.62]    [Pg.1287]    [Pg.1453]    [Pg.99]    [Pg.548]    [Pg.62]    [Pg.1287]    [Pg.1453]   
See also in sourсe #XX -- [ Pg.268 ]




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