Summary
In a preliminary study of mexiletine absorption in Coronary Care Unit patients with myocardial infarction, plasma mexiletine concentrations were significantly lower in those given narcotic analgesics. 166 patients then entered a comparative study of the effects of mexiletine and placebo on the incidence of ventricular arrhythmias after myocardial infarction (MI). Eighty-two patients were given mexiletine, 51 with MI. Mexiletine absorption was impaired in patients with MI and 66% failed to reach the minimum therapeutic plasma concentration of 1 µg/ml in 3 h. On the second and third hospital days, 34% and 25% respectively had subtherapeutic levels. In patients without MI, low plasma mexiletine concentrations were associated with the use of narcotic analgesics. The incidence of serious ventricular arrhythmias (VF, VT, R on T ectopic beats) was significantly lower in patients given mexiletine, and after 3 h most arrhythmias in this group occurred in patients with subtherapeutic mexiletine concentrations. Therapeutic failure of oral antiarrhythmic drugs soon after MI may be due to impaired absorption.
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Pottage, A., Campbell, R.W.F., Achuff, S.C. et al. The absorption of oral mexiletine in coronary care patients. Eur J Clin Pharmacol 13, 393–399 (1978). https://doi.org/10.1007/BF00566315
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DOI: https://doi.org/10.1007/BF00566315