Dizziness mexiletine

Mexiletine Dizziness, sedation, anxiety, confusion, paresthesia, tremor, ataxia, blurred vision, nausea, vomiting, anorexia, aggravation of underlying conduction disturbances or ventricular arrhythmias... 

MEXILETINE ANTICANCER AND IMMUNOMODULATING DRUGS-IMATINIB Imatinib may cause an T in plasma concentrations of mexiletine and a risk of toxic effects, e.g. nausea, vomiting, constipation, taste disturbances, dizziness and confusion Imatinib is a potent inhibitor of CYP2D6 isoenzymes, which metabolize mexiletine Mexiletine is used for life-threatening ventricular arrhythmias. Close monitoring of BP and ECG is mandatory, and watch for signs and symptoms of heart failure... 

MEXILETINE H2 RECEPTOR BLOCKERS Cimetidine may t plasma concentrations of mexiletine Cimetidine inhibits CYP2D6-mediated metabolism of mexiletine. Ranitidine is a much weaker CYP2D6 inhibitor Monitor PR and BP at least weekly until stable. Warn patients to report symptoms of hypotension (lightheadedness, dizziness on standing, etc.). Consider alternative acid-suppression therapy... 

In an open study of the antidystonic effect of mexiletine (200 mg/day increasing to a maximum of 800 mg/day) in spasmodic torticollis in six patients, mexiletine produced significant improvement and there were no adverse effects in five of the six patients in the other patient dizziness occurred at the highest dose and required a reduction in dosage (11). 

Mexiletine has been used to treat painful peripheral neuropathy in patients with HIV infection, without any evidence of efficacy (15,16). In one study of 22 patients, nine had adverse effects probably related to mexiletine, including nausea in five, vomiting in four, and abdominal pain, diarrhea, dizziness, insomnia, rises in liver enzymes, and skin rash in one patient each (15). Adverse effects in seven patients required dosage reduction in four cases and withdrawal in three (because of a rash in one case and gastrointestinal effects in two). 

Adverse reactions Minor side effects of lidocaine are drowsiness, dizziness, paresthesia, and euphoria. More serious side effects include CNS and cardiovascular effects. Tocainide and mexiletine both have a high incidence of Gl side effects (nausea and vomiting) and CNS side effects (dizziness, numbness, and paresthesias). Additionally, tocainide has a 15% incidence of rash and may cause agranulocytosis. 

Overdosage with mexiletine causes dizziness, drowsiness, nausea, hypotension, sinus bradycardia, paresthesia, seizures, intermittent left-bundle branch block, and temporary asystole. With massive overdoses, coma and respiratory arrest may occur (see also Eigure 84). 

Nervous system Mexiletine 600-1500 mg/ day has been investigated in nine patients with refractory chronic headache. Although it was much more effective or more effective than previous medications, adverse effects such as nausea, fatigue, tremor, dizziness, incoordination, and, to a lesser extent, palpitation led to withdrawal in most patients [78 ]. 

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