Amiodarone and Mexiletine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amiodarone
Mexiletine
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 antiarrhythmic levels
Interaction Deep Dive
Amiodarone may inhibit the metabolism of certain antiarrhythmics. Limit the coadministration of amiodarone and another antiarrhythmic drug to patients with life-threatening ventricular arrhythmia that is unresponsive to amiodarone or another single drug. Once amiodarone is confirmed effective, evaluate whether the other antiarrhythmic drug may be discontinued. When transitioning from another antiarrhythmic to amiodarone, reduce the dose of the other antiarrhythmic by 30% to 50% several days after amiodarone initiation (when amiodarone begins suppressing the arrhythmia). If another antiarrhythmic is initiated while taking amiodarone, reduce the initial dose of the other antiarrhythmic to approximately half the recommended dose and monitor the patient closely for cardiovascular adverse effects, including conduction disturbances and tachyarrhythmia exacerbations1.
Why it happens (mechanism)
Unknown
Common questions
Can I take Amiodarone and Mexiletine together?
Increased antiarrhythmic levels Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amiodarone and Mexiletine interaction?
It is rated major. Potentially serious — often needs a change or close 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.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amiodarone 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 a safer alternative to one of these medications for me?
References (1)
- Product Information: Cordarone(R) oral tablets, amiodarone HCl oral tablets. Wyeth Pharmaceuticals Inc (per FDA), Philadelphia, PA, 2016. DailyMed
Keep reading about Amiodarone
Keep reading about Mexiletine
These medications also interact with supplements
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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