Structure
Mexiletine hydrochloride is a class IB antiarrhythmic agent, structurally related to lidocaine but with an extended alkyl side chain to enhance oral bioavailability. It exists as the hydrochloride salt.
Chemical Formula: C₁₆H₂₅N₃O₂ · HCl
Mode of Action
Class IB Antiarrhythmic: Blocks fast sodium channels, shortening action potential duration and refractory period.
Selective on Ventricular Myocytes: More effective in ventricular tissues with rapid action potentials.
Effect on Heart Rate: Less impact on atrial tissues, making it useful for ventricular arrhythmias without significant atrial suppression.
Uses of Mexiletine hydrochloride
Ventricular Arrhythmias: Treats ventricular tachycardia and ventricular fibrillation, especially in ischemic heart disease.
Post-Myocardial Infarction: Prevents arrhythmias in the acute and chronic phases.
Neuropathic Pain: Used off-label for managing neuropathic pain conditions such as diabetic neuropathy and postherpetic neuralgia.
Brugada Syndrome: May be used in specific arrhythmic syndromes to stabilize cardiac rhythms.