Mexiletine Digoxin

Drugs that may be affected by SSRIs Drugs that may be affected by SSRIs include alcohol, benzodiazepines, beta blockers, buspirone, carbamazepine, cisapride, clozapine, cyclosporine, diltiazem, digoxin, haloperidol, hydantoins, lithium, methadone, mexiletine, nonsedating antihistamines, NSAIDs, olanzapine, phenothiazines, phenytoin, pimozide, procyclidine, ritonavir, ropivacaine, sumatriptan, sulfonylureas, sympathomimetics, tacrine, theophylline, tolbutamide, tricyclic antidepressants, and warfarin. 

Rifampin is known to induce the hepatic microsomal enzymes that metabolize various drugs such as acetaminophen, oral anticoagulants, barbiturates, benzodiazepines, beta blockers, chloramphenicol, clofibrate, oral contraceptives, corticosteroids, cyclosporine, disopyramide, estrogens, hydantoins, mexiletine, quinidine, sulfones, sulfonylureas, theophyllines, tocainide, verapamil, digoxin, enalapril, morphine, nifedipine, ondansetron, progestins, protease inhibitors, buspirone, delavirdine, doxycycline, fluoroquinolones, losartan, macrolides, sulfonylureas, tacrolimus, thyroid hormones, TCAs, zolpidem, zidovudine, and ketoconazole. The therapeutic effects of these drugs may be decreased. 

When digoxin was given with 30 mL of an aluminium/magnesium hydroxide antacid and mexiletine, the digoxin AUC was approximately halved. As mexiletine , (p.931) does not appear to interact with digoxin the interaction was attributed to the antacid. ... 

Saris SD, Lowenlhal DT, Aftiime MB. Steady-state digoxin concentration during cral mexiletine administiaticn. Curr TherRes (1983) 34,662-66. 

Serum digoxin levels are not siignificantly altered by mexiletine. 

Mexiletine 200 mg every 8 hours for 4 days slightly redueed the serum levels of digoxin 250 mierograms daily from 0.32 to 0.27 nanograms/mL in 10 healthy subjeets. Two other studies in a total of 17 patients confirmed that mexiletine does not significantly affect serum digoxin levels. 

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