Description of the medicine: Mexiletine hydrochloride
Mexiletine hydrochloride *. 1-Methyl-2- (2, 6-xylyloxy) -ethylamine hydrochloride.
Synonyms: Mexitel, Mexilen, Mexitec, Mexitil, Mexitilen, Moxitil, Tametil.
By chemical structure is close to lidocaine and, like the latter, it has an antiarrhythmic effect. Like lidocaine, it refers to antiarrhythmic drugs of group I. Suppresses the fast transmembrane current of potassium ions, has a strong membrane-stabilizing effect. In contrast to lidocaine, it is rapidly and completely absorbed when taken orally (lidocaine is sometimes prescribed as a dragee, but with this method it is ineffective.) It is allocated mainly through the kidneys.
Applied with ventricular extrasystoles, idiopathic or other ventricular arrhythmias, ventricular arrhythmias after myocardial infarction, for the prevention of ventricular fibrillation in acute myocardial infarction; At arrhythmias caused by an overdose of cardiac glycosides, etc.
To stop acute rhythm disturbances, mexiletine is administered intravenously (in isotonic sodium chloride solution). First enter at the rate of 0.17 mg / kg per minute for 15 minutes (using a pump for infusion); Then, depending on the clinical picture, re-poured: during the first three hours to 0.03 mg / kg per minute (2 mg / kg per hour), then to 12 hours or more, at 0.008 mg / kg per minute (0.5 Mg / kg per hour). For 1 hour before the end of the infusion, 200 mg (1 capsule) of the drug is administered orally. When switching to a permanent oral intake, 400 mg (2 capsules of 200 mg), then 200 mg (1 capsule) every 6 to 8 hours are prescribed first. In some cases, the single dose should be increased to 600 mg. Depending on the effect, the dose is gradually reduced.
With long-term treatment, mexiletine can be used in the form of a prolonged dosage form (mexitil-depot) - capsules containing 360 mg of the drug. The daily dose in this dosage form is usually 720 mg (2 capsules). If you need to use larger or smaller doses, use ordinary capsules mexiletine.
Capsules ("non-protracted" and "prolonged") are swallowed, not liquid, squeezed with water.
When applying mexiletine, there may be changes in taste sensations, nausea, vomiting, nystagmus, accommodation disorder, ataxia, tremor, paresthesia, drowsiness, confusion, dizziness.
In some cases, the drug can cause bradycardia, hypotension.
It is not excluded the arrhythmogenic action: development of ventricular extrasystoles, atrial fibrillation.
Contraindications: weakness of the sinus node, bradycardia, hypotension, severe heart failure, acute renal and hepatic insufficiency.
The drug penetrates the placenta and enters the mother's milk, so it should not be prescribed to women during pregnancy and lactation (except for life indications).
Form release: in capsules of 50 and 200 mg in a package of 30 pieces; In capsules-depot on 360 mg in a package of 20 pieces: 2, 5% solution in ampoules of 10 ml (250 mg).
Storage: List B.