Agomelatine and Mexiletine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Mexiletine
Agomelatine
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased exposure to agomelatine
Interaction Deep Dive
Concomitant use of agomelatine (a CYP1A2 substrate) with a moderate CYP1A2 inhibitor may increase exposure to agomelatine. Concomitant administration of agomelatine with estrogen (moderate CYP1A2 inhibitor) led to a several-fold increase in agomelatine exposure. If concomitant administration of agomelatine and a moderate CYP1A2 inhibitor is required, proceed with caution12. Consider monitoring for agomelatine toxicity and adjusting the agomelatine dosage, if needed.
Why it happens (mechanism)
Inhibition of CYP1A2-mediated metabolism of agomelatine
Common questions
Can I take Agomelatine and Mexiletine together?
Increased exposure to agomelatine Always confirm with your pharmacist or prescriber before making any change.
How serious is the Agomelatine and Mexiletine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Agomelatine or Mexiletine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
- Product Information: Thymanax film-coated tablets, agomelatine film-coated tablets. Les Laboratoires Servier Industrie (per EMA), Gidy, France, 2012.
- Product Information: Valdoxan oral film-coated tablets, agomelatine oral film-coated tablets. Les Laboratoires Servier (per EMA), Suresnes, France, 2012.
Keep reading about Mexiletine
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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