Mexiletine Fluoxetine

Inhibitors codeine, encainide, flecainide, fluoxetine, haloperidol, hydrocodone, 4-methoxy-amphetamine, metoprolol, mexiletine, oxycodone, paroxetine, propafenone, propoxyphene, risperidone, selegiline (deprenyl), thioridazine, most tricyclic antidepressants, timolol Fluoxetine, haloperidol, paroxetine, quinidine... 

IMATINIB 1. ANTIARRHYTHMICS -flecainide, mexiletine, propafenone 2. ANTIDEPRESSANTS - fluoxetine, paroxetine, TCAs, trazodone, venlafaxine 3. ANTIPSYCHOTICS -clozapine, haloperidol, perphenazine, risperidone, thioridazine 4. BETA-BLOCKERS - metoprolol, propanolol, timolol 5. DONEPEZIL 6. METHAMPHETAMINE Imatinib may cause t plasma concentrations of these drugs, with a risk of toxic effects Inhibition of CYP2D6-mediated metabolism of these drugs Watch for early features of toxicity of these drugs... 

Ajmaline, alprenolol, amiflamine, amphetamine, aprindine, captopril, chlorpheniramine, cinnarizine, citalopram, clomipramine, clozapine, codeine, desipramine, dolasteron, encainide, flecainide, fluoxetine, fluphenazine, haloperidol, hydrocordone, imipramine, loratidine, methoxyphenamine, 3,4-methylenedioxymethamphetamine, metoprolol, mexiletine, (S)- and (i )-mianserin, nifedipine, olanzapine, omeprazole, oxycodone, perhexiline, phenformin, propaphenone, propranolol, remoxipride, ritonavir, saquinavir, selegiline, tamsulosin, timolol, tomoxetine, tramadol, trifluperidol, zolpidem... 

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... 

Extracted acetazolamide, amitriptyline, chlordiazepoxide, chlorpromazine, desipramine, dextromethorphan, diphenhydramine, doxepin, encainide, fentanyl, flecainide, fluoxetine, flurazepam, haloperidol, hydroxyethylflurazepam, ibuprofen, imipramine, lidocaine, ma-protiline, methadone, methaqualone, mexiletine, norchlorimipramine, nordoxepin, norfluoxetine, nordiazepam, nortriptyline, norverapamil, pentazocine, promazine, propafenone, propoxyphene, propranolol, protriptyline, quinidine, temazepam, trazodone, tri-mipramine, verapamil... 

Fluvoxamine markedly increases the AUC of mexiletine by inhibiting CYP1A2. Fluoxetine and paroxetine might also be expected to interact, albeit by inhibiting CYP2D6, but sertraline is possibly unlikely to interact. 

Mexiletine is also metabolised by CYP2D6 (e.g. see Mexiletine + Propafenone , p.269). In an in vitro study using human liver microsomes, paroxetine, fluoxetine, and sertraline extensively inhibited the metabolism of mexiletine. Using a model to prediet in vivo interactions, it was suggested that both fluoxetine and paroxetine may interact with mexiletine to a clinically relevant extent, whereas sertraline is less likely to interact. ... 

Flecainide and mexiletine are predominantly or partly metabolised by CYP2D6 but there appear to be no clinical cases of interactions between these drugs and fluoxetine. However, fluoxetine does interact with propafenone , (p.275), which is also metabolised by CYP2D6 so it would seem prudent to be alert for increased and prolonged effects of these drugs if fluoxetine is added. 

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