Mirabegron with Mexiletine Interaction Details
Brand Names Associated with Mirabegron
- Mirabegron
- Myrbetriq®
Brand Names Associated with Mexiletine
- Mexiletine
- Mexitil®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 03, 2023
Interaction Effect
Increased mexiletine plasma concentrations
Interaction Summary
Concurrent treatment with mexiletine, a CYP2D6 substrate, and mirabegron, a moderate CYP2D6 inhibitor , may increase mexiletine plasma concentrations and the risk of adverse effects. In a small study (n=15) of patients who were either poor or extensive metabolizers of CYP2D6, concomitant administration of mexiletine with propafenone, a potent CYP2D6 inhibitor, decreased the metabolic clearance of mexiletine by approximately 70% in the extensive metabolizer group; kinetics in the poor metabolizer group were not altered . Appropriate monitoring is advised when mirabegron is used concomitantly with a CYP2D6 substrate .
Severity
Moderate
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of mexiletine, a CYP2D6 substrate, and mirabegron, a moderate CYP2D6 inhibitor , may result in increased mexiletine plasma concentrations and risk of adverse effects. Appropriate monitoring is advised when mirabegron is used concomitantly with a CYP2D6 substrate; dose adjustment may be necessary .
Mechanism Of Interaction
Inhibition of CYP2D6-mediated mexiletine metabolism by mirabegron
Mirabegron Overview
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Mirabegron is used alone or in combination with solifenacin (Vesicare) to treat overactive bladder (a condition in which the bladder muscles contract uncontrollably and cause frequent urination, urgent need to urinate, and inability to control urination) in adults. It is also used to treat neurogenic detrusor overactivity (a bladder control condition caused by brain, spinal cord or nerve problem) in children 3 years of age and older. Mirabegron is in a class of medications called beta-3 adrenergic agonists. It works by relaxing the bladder muscles to prevent urgent, frequent, or uncontrolled urination.
Mexiletine Overview
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Mexiletine is used to treat certain types of ventricular arrhythmias (abnormal heart rhythms). Mexiletine is in a class of medications called antiarrhythmics. It works by blocking certain electrical signals in the heart to stabilize the heart rhythm.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.