Mexitil® (mexiletine) capsules for ventricular arrhythmias

What Mexiletine Is and How It Works

Mexiletine is an oral antiarrhythmic used to treat documented, serious ventricular arrhythmias. It is the active ingredient in the brand Mexitil and belongs to class IB sodium channel blockers. By reducing abnormal sodium influx in heart muscle, it helps suppress premature ventricular complexes and ventricular tachycardia, and supports rhythm stability in people at risk of life‑threatening events linked to Ventricular Arrhythmias.

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Mexiletine comes as capsules, commonly 150 mg and 200 mg; some regions also have 100 mg. Doctors select a dose based on the arrhythmia type, ECG response, and tolerability. It is usually taken with food to lessen stomach upset. While mexiletine can help control dangerous rhythms, it is not used to prevent non‑life‑threatening irregular beats in otherwise stable patients.

Dosage and Usage

• Typical initiation: 200 mg by mouth every 8 hours with food. Some clinicians start at 150 mg every 8 hours if sensitivity is expected.
• Titration: adjust by 50–100 mg per dose at intervals of at least 2–3 days. Usual total daily dose ranges 600–900 mg, divided. Maximum is often 1,200 mg/day.
• Loading (select cases): a single 400 mg dose may be used, then resume scheduled doses as directed by your prescriber.
• Administration: swallow capsules whole with food or an antacid. Do not crush or chew unless your pharmacist confirms it is safe for your product.
• Missed dose: take it when remembered unless it is close to the next dose. Skip the missed dose if near the next scheduled time. Do not double doses.
• Monitoring: periodic ECGs and clinical assessment guide dose changes. Report new palpitations, fainting, or worsening symptoms promptly.
• Drug interactions: strong CYP1A2 or CYP2D6 inhibitors (for example, fluvoxamine, paroxetine, cimetidine) can raise mexiletine levels. Inducers (for example, phenytoin, rifampin) may reduce effect. Your prescriber will adjust doses if needed.
• Special populations: lower doses may be needed in liver disease, heart failure, or low body weight. Use is typically avoided in cardiogenic shock or in second‑/third‑degree AV block without a pacemaker.

Storage and travel

• Store capsules at 15–25 °C (59–77 °F) in a dry place. Keep the bottle tightly closed and away from moisture.
• Keep in the original labeled container. Use a pill organizer only if it protects from heat and humidity.
• Do not freeze. Avoid leaving medicine in a hot car or near heaters.
• For travel, pack in carry‑on luggage with a copy of your prescription. Bring enough for your trip plus a few extra days.
• Keep out of reach of children and pets.

Benefits and Savings

Mexiletine offers oral suppression of ventricular ectopy and ventricular tachycardia, which can reduce shocks in patients with implantable cardioverter‑defibrillators and improve symptoms like palpitations. It provides a convenient alternative to continuous IV lidocaine and can be combined with other rhythm agents when monitored by a cardiology team.

Ordering through YouDrugstore can lower your mexiletine cost compared with typical US retail. Many customers see 60–80% savings, especially with generics. Ask about the mexiletine 150 mg capsule and mexiletine 200 mg capsule to match your prescribed strength. Multi‑month supplies and periodic bulk promotions can further reduce your per‑month mexiletine price.

If you need a simple place to check deals, visit our mexiletine coupon page for current promotions.

Prices vary by strength. If your prescriber approves a switch between 150 mg and 200 mg capsules, we can quote the mexiletine 150 mg price or the mexiletine 200 mg price before you order. Brand‑name Mexitil may also be available in some markets; generics usually offer the best value.

Side Effects and Safety

• Common: nausea, heartburn, stomach discomfort, vomiting, constipation or diarrhea.
• Neurologic: dizziness, tremor, unsteady gait, numbness or tingling, blurred vision, headache.
• Cardiac: palpitations, chest discomfort.
• General: fatigue, coordination changes, sleep disturbance.

Serious but less common risks include worsening arrhythmia (proarrhythmia), liver injury (dark urine, jaundice, right‑upper‑quadrant pain), blood count changes, severe rash, or allergic reactions. The CAST findings showed increased mortality with certain antiarrhythmics after myocardial infarction; mexiletine is reserved for documented, life‑threatening ventricular arrhythmias under careful supervision. People with seizure disorders or significant conduction disease need extra caution. These are key mexiletine warnings to discuss with your prescriber.

Drug interactions can affect levels or rhythm stability. Tell your care team about all medicines, including amiodarone, beta‑blockers, phenytoin, theophylline, and antidepressants. Alcohol may increase dizziness. Do not change your dose without medical guidance.

Onset Time

Mexiletine is absorbed quickly. Many patients see reduced ventricular ectopy within hours of the first doses, with fuller effect as dosing is optimized. The half‑life is about 10–12 hours, so steady state is typically reached in 2–3 days of regular dosing.

If you are transitioning from IV lidocaine, your prescriber may overlap therapy briefly. Symptom control often improves during the first week as the target dose is reached and you adjust to side effects like nausea or tremor. Off‑label uses, such as certain muscle channelopathies, may require several days to a few weeks to assess benefit.

Compare With Alternatives

Sotalol is a class III antiarrhythmic with beta‑blocking properties. It can help with ventricular tachycardia but requires monitoring for QT prolongation and renal dosing adjustments. You can review options on our Sotalol page and discuss with your cardiologist which profile best fits your history.

Amiodarone is effective for many ventricular arrhythmias and is often first‑line in structural heart disease, but long‑term use has thyroid, lung, and liver toxicities. Mexiletine may be added to amiodarone to reduce shocks in patients with implantable defibrillators when supervised by specialists.

Dronedarone targets atrial arrhythmias and is not a standard choice for ventricular tachycardia. If atrial rhythm control is your focus, see Multaq® and speak with your prescriber about benefits and risks for atrial fibrillation. Anticoagulants such as Pradaxa are used to reduce stroke risk in atrial fibrillation, not to treat ventricular arrhythmias.

Combination Therapy

• With amiodarone: used to reduce recurrent ventricular tachycardia or defibrillator shocks; close ECG and liver monitoring are standard.
• With beta‑blockers: may improve suppression of ectopy and reduce sympathetic triggers; watch for dizziness or low heart rate.
• With implantable cardioverter‑defibrillator (ICD): medicine can decrease shocks and improve comfort; device programming is reviewed periodically.
• With electrolyte management: correcting low potassium or magnesium helps rhythm stability and may reduce required doses.
• Avoid unsupported combinations of multiple antiarrhythmics without specialist oversight due to additive proarrhythmia risk.

Patient Suitability and Cost-Saving Tips

Good candidates have documented, serious ventricular arrhythmias where the benefits of suppression outweigh risks. It is usually avoided in cardiogenic shock or in second‑ or third‑degree AV block unless a pacemaker is present. People with severe liver disease, seizure disorders, or significant conduction abnormalities require individualized dosing and careful follow‑up.

Mexiletine hydrochloride is a prescription drug that should be started and adjusted by clinicians familiar with arrhythmia care. Your prescriber may order baseline and periodic ECGs, liver tests, and review all interacting medicines. Do not use mexiletine to treat non‑dangerous palpitations after a heart attack, as this has been linked to harm.

To reduce costs, ask your prescriber about generic mexiletine hydrochloride. Compare the mexiletine 150 mg price versus mexiletine 200 mg price if either strength fits your regimen. Ordering a 2–3 month supply can lower the per‑month cost, and you can turn on simple email or SMS reminders to reorder before you run out.

Authoritative Sources

FDA Prescribing Information for Mexitil (mexiletine) capsules

Health Canada Drug Product Database: Mexiletine products

DailyMed listings for mexiletine hydrochloride

Order Mexitil® from YouDrugstore: add to cart, upload your prescription, and we ship with prompt, express, cold-chain handling.

This information is educational and does not replace advice from your healthcare professional. Always follow your prescriber’s directions for diagnosis, treatment, and monitoring.