Drug Interaction Report

Rasagiline and Mexiletine: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Rasagiline

Azilect
+

Mexiletine

Mexitil®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
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.

Of 50 documented Rasagiline interactions, 9 are rated moderate — including this one.
Onset
unspecified
Evidence
theoretical
Severity
Moderate

What happens

Increased rasagiline plasma concentrations and risk of rasagiline adverse effects

Interaction Deep Dive

Rasagiline is primarily metabolized by the CYP1A2 isozyme. Concomitant use of ciprofloxacin, a CYP1A2 inhibitor, and rasagiline resulted in a significant increase of rasagiline AUC. Although not studied with mexiletine, also a CYP1A2 inhibitor, a similar interaction can be expected. Therefore, the rasagiline dose should be reduced to 0.5 mg daily when coadministration of mexiletine and rasagiline is necessary1.

Why it happens (mechanism)

Inhibition of CYP1A2-mediated rasagiline metabolism by mexiletine

Common questions

Can I take Rasagiline and Mexiletine together?

Increased rasagiline plasma concentrations and risk of rasagiline adverse effects Always confirm with your pharmacist or prescriber before making any change.

How serious is the Rasagiline 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 Rasagiline 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 (1)

  1. Product Information: AZILECT(R) oral tablets, rasagiline oral tablets. Teva Pharmaceuticals, Kfar Saba, Israel, 2006. DailyMed
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Beyond drug–drug

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.