Mexiletine Metoclopramide

Drugs that may affect mexiletine include aluminum-magnesium hydroxide, atropine, narcotics, cimetidine, fluvoxamine, hydantoins, metoclopramide, propafenone, rifampin, urinary acidifiers, and urinary alkalinizers. 

Drugs and chemicals are known to cause activated interaction. The depressant action of opioid drugs is enhanced by drugs acting on the central nervous system (CNS) such as alcohol, anesthetics, anxiolytics, hypnotics, tricyclic antidepressants, and antipsychotics. Concomitant administration of opioid analgesics and monoamine oxidase inhibitors (MAOIs) should be avoided, or extra care should be taken if such a therapy is inevitable. Fatal reactions are reported when treated along with selegiline. Interactions also are reported with cyclizine, cimetidine, mexiletine, cisapride, metoclopramide, or domperidone. 

Also analyzed acebutolol, acetaminophen, alprazolam, amphetamine, atenolol, betaxolol, brotizolam, caffeine, camazepam, captopril, chloroquine, clobazam, clomipramine, cloth-iapine, clotiazepam, cloxazolam, cocaine, codeine, diclofenac, dihydralazine, dihydrocodeine, dihydroergotamine, diphenhydramine, domperidone, doxepin, droperidol, ergota-mine, ethyl loflazepate, fenethylline, fluoxetine, flupentixol, flurazepam, furosemide, gliclazide, hydrochlorothiazide, hydroxyzine, ibuprofen, imipramine, ketazolam, loprazo-1am, lorazepam, lormetazepam, maprotUine, medazepam, mepyramine, methadone, methaqualone, methyldopa, methylphenidate, metoclopramide, metoprolol, mexiletine, mianserin, midazolam, minoxidil, morphine, nadolol, nitrazepam, oxprenolol, papaverine, pentazocine, phenprocoumon, phenylbutazone, pipamperone, piritramide, practolol, pra-zepam, prazosin, promazine, promethazine, propoxyphene, propranolol, prothipendyl, quinine, sotalol, sulpride, thioridazine, trazodone, triazolam, trimipramine, tripelennamine, lyramine, verapeunil, yohimbine... 

The rate of absorption of mexiletine is slowed by the antacid al-masilate and atropine and hastened by metoclopramide, but the extent of the absorption is unaltered. 

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). 

---