Summary
To study the effects of acute myocardial infarction on its pharmacokinetics a single oral dose of 400 mg mexiletine HCl was administered to seven patients. The study was performed within 24 h of the onset of pain (Study I) and was repeated 10–14 days later, during the recovery phase (Study II). Mexiletine in plasma and urine was quantified by a GLC method. The peak plasma concentrations of mexiletine were 0.65±0.05 (SEM) µg/ml and 1.08±0.11 µg/ml (p<0.05) in Studies I and II, respectively. The corresponding peak times were 4.68±2.04 h and 1.46±0.17 h (N.S.). The lag time averaged 0.48±0.08 h in Study I and 0.39±0.05 h in Study II (N.S.). The area under the plasma concentration-time curve remained unchanged. The elimination half-life was 15.03±0.61 h and 11.75±0.80 h (p<0.01) in Studies I and II, respectively. The recovery of unchanged mexiletine in urine and its renal clearance was also the same in both studies. The plasma protein binding of mexiletine was similar in Studies I and II (61±2% and 63±3%; N.S.). Thus, the rate of gastrointestinal absorption of mexiletine was definitely slowed in the acute phase of myocardial infarction, whereas the extent of absorption was not altered. The prolongation of the elimination half-life of mexiletine in the acute phase of myocardial infarction is probably related to an increase in its volume of distribution.
Similar content being viewed by others
References
Koch-Weser J (1971) Pharmacokinetics of procainamide in man. Ann NY Acad Sci 179: 370–382
Jounela AJ, Pentikäinen PJ, Oksanen K (1982) The pharmacokinetics of disopyramide in patients with acute myocardial infarction. Int J Clin Pharmacol Ther Toxicol 20: 276–282
Hagemeijer A (1975) Absorption, half-life and toxicity of oral aprindine in patients with acute myocardial infarction. Eur J Clin Pharmacol 9: 21–25
Prescott LF, Pottage A, Clements JA (1977) Absorption, distribution and elimination of mexiletine. Postgrad Med J 53 [Suppl 1]: 50–55
Pottage A, Campbell RWF, Achuff SC, Murray A, Julian DG, Prescott LF (1978) The absorption of oral mexiletine in coronary care patients. Eur J Clin Pharmacol 13: 393–399
Pentikäinen PJ, Halinen MO, Helin MJ (1983) Pharmacokinetics of intravenous mexiletine in patients with acute myocardial infarction. J Cardiovasc Pharmacol (in press)
Holt DW, Flanagan RJ, Hayler AM, Loizou M (1979) Simple gas-liquid chromatographic method for the measurement of mexiletine and lignocaine in blood-plasma or serum. J Chromatogr 169: 295–301
Gibaldi M, Perrier D (1975) Drugs and the pharmaceutical sciences. In: Swarbrick J (ed) Pharmacokinetics, vol 1, 1st edn. Dekker, New York, pp 33–40
Metzler CM, Elfring GL, McEven AJ (1974) A package of computer programs for pharmacokinetic modeling. Biometrics 30: 562
Ehrnebo M, Agurell S, Jalling B, Borus LO (1971) Age differences in drug binding by plasma proteins: Studies on human foetus, neonates and adults. Eur J Clin Pharmacol 3: 189–193
Pentikäinen PJ, Halinen M, Helin M (1983) Pharmacokinetics of mexiletine in patients with acute myocardial infarction. II World Conference on Clinical Pharmacology and Therapeutics, Washington, D.C. July 31–August 5, Abstracts, No. 96, p 17
Pentikäinen PJ, Koivula IH, Hiltunen HA (1982) Effect of rifamipicin treatment on the kinetics of mexiletine. Eur J Clin Pharmacol 23: 261–266
Campbell RWF, Achuff SC, Pottage A, Murray A, Prescott LF, Julian DG (1979) Mexiletine in the prophylaxis of ventricular arrhythmias during acute myocardial infarction. J Cardiovasc Pharmacol 1: 43–52
Halinen MO, Pentikäinen PJ, Helin MJ, Rehnberg S (1983) Prophylactic mexiletine in acute myocardial infarction: A double blind placebo-controlled study. Eur Heart J 4 [Suppl, E]: 15
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pentikäinen, P.J., Halinen, M.O. & Helin, M.J. Pharmacokinetics of oral mexiletine in patients with acute myocardial infarction. Eur J Clin Pharmacol 25, 773–777 (1983). https://doi.org/10.1007/BF00542518
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00542518