Mexiletine Ciprofloxacin

A2 Fluvoxamine Ciprofloxacin, mexiletine, propafenone, zileuton Acyclovir, cimetidine, famotidine, norfloxacin, verapamil... 

Ciprofloxacin slightly reduces the clearance of mexiletine, but this is unlikely to be clinically relevant. 

A study in healthy subjects found that the oral clearance of mexiletine was reduced by about 8 to 20% when a single dose was given on day 3 of a 5-day course of ciprofloxacin 750 mg twice daily. This was due to a decrease in the metaljolic clearance of mexiletine, presumed to occur as a result of ciprofloxacin-induced inhibition of the cj chrome P450 isoenzyme CYP1A2, which is involved in the metabolism of mexiletine. It is unlikely that changes of this magnitude would be clinically relevant. 

Labbe L, Robitaille NM, Lefez C, Potvin D, Gilbert LL O Hara G, Turgeon J. Effects of ciprofloxacin on the stereoselective disposition of mexiletine in man. Ther Drug Monit (2004) 26, 492-8. 

Are there contraindications to concomitant drug use For instance, tizanidine is contraindicated in patients with concomitant use of CYP450 1A2 inhibitors such as fluvoxamine, amiodarone, mexiletine, propafenone, cimetidine, fluoroquinolones (ciprofloxacin, norfloxacin), rofecoxib, oral contraceptives, and ticlopidine [27]. 

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