Comparative Pharmacology
Head-to-head clinical analysis: MEXILETINE HYDROCHLORIDE versus TONOCARD.
Peer-Reviewed Evidence
Head-to-head clinical analysis: MEXILETINE HYDROCHLORIDE versus TONOCARD.
MEXILETINE HYDROCHLORIDE vs TONOCARD
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Class Ib antiarrhythmic agent; blocks sodium channels, decreases action potential duration, and increases the ratio of refractory period to action potential duration.
Class Ib antiarrhythmic agent; blocks sodium channels, decreasing the rate of phase 0 depolarization, and shortens action potential duration. Increases the fibrillation threshold of the ventricles.
200–300 mg orally every 8 hours; maximum 1200 mg/day. Loading dose: 400 mg orally, then 200 mg after 8 hours if needed. IV use is investigational. Administer with food to reduce GI upset.
Intravenous loading: 1.0-1.5 mg/kg over 10-15 minutes, followed by continuous infusion of 1-4 mg/min; maximum dose: 4 mg/min; oral: not applicable.
None Documented
None Documented
10-12 hours (prolonged in hepatic impairment, acute MI, and urine pH >6.5)
Terminal elimination half-life: 2–3 hours; prolonged to 8–12 hours in severe hepatic impairment; clinical context: requires q8h dosing for arrhythmia suppression
Renal: ~90% (10% unchanged, remainder as metabolites); Biliary/fecal: <10%
Renal: ~90% (10% unchanged, remainder as metabolites); biliary/fecal: minimal (<5%)
Category C
Category C
Antiarrhythmic (Class IB)
Antiarrhythmic (Class IB)