The absorption of oral mexiletine in coronary care patients

A. Pottage, R. W F Campbell, Stephen C Achuff, A. Murray, D. G. Julian, L. F. Prescott

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)393-399
Number of pages7
JournalEuropean Journal of Clinical Pharmacology
Volume13
Issue number6
DOIs
Publication statusPublished - Nov 1978
Externally publishedYes

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Keywords

  • absorption
  • myocardial infarction
  • Oral mexiletine
  • plasma concentrations
  • ventricular arrhythmias

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)

Cite this

Pottage, A., Campbell, R. W. F., Achuff, S. C., Murray, A., Julian, D. G., & Prescott, L. F. (1978). The absorption of oral mexiletine in coronary care patients. European Journal of Clinical Pharmacology, 13(6), 393-399. https://doi.org/10.1007/BF00566315