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Avatar universal

Mexitil For PVCS?

im 21 m been suffering from frequent pvcs been on torpol xl and atenolol now on atenolol at 150mg 50 in the morning 100 at night and dont get much relief i still feel my heart beating it just feels lighter the beat my dr talked about possible ablation so today i went for a 2nd opinion to see what someone else said..the halter monitor results from the first dr revealed frequent pvcs with probable short run of v.tahyadaca..so i went for the 2nd opinion today and he told me how theres not many options cause its not treatign a disease or a problem its treating symptoms theres no real cause for whats going on with me all my blood is fine,i dont eat or drink anything with caffiene i occasionally have anxiety but these pvcs are on an everyday basis.so he gave me a number for a console with someone that will do the ablation just to talk to them..there checking into to see if my insurance will cover a Transtelephonic monitor for a few weeks..and he gave me a prescription for Mexitil 150mg to take with the atenolol...he said its my choice whether i want to take it or not..the one thing that concerns me about Mexitil is what i read it says it could cause a new arthymmia should i be worried about that? what do you think i should do and anyone else on Mexitil for pvcs
4 Responses
257552 tn?1404602554
Hi,

I am no expert, but for the Doctor to give you a prescription for Mexitil 150mg and to tell you it's your choice whether or not to take it, I might consider another Cardiologist if I were you. I would think that close monitoring (EKGs) should occur while you initially begin the medication, and I wonder about the effect of Mexitil combined with Atenolol. (If I read you correctly, you take 50 mg Atenolol in the morning and 100 mg at night).

From one site: "Considering the known proarrhythmic properties of Mexitil and the lack of evidence of improved survival for any antiarrhythmic drug in patients without life-threatening arrhythmias, the use of Mexitil as well as other antiarrhythmic agents should be reserved for patients with life-threatening ventricular arrhythmia".

Please consult with your Doctor to make an educated decision about your Drug Choices.

Lastly, please please please (did I say please yet ;-) understand that when Stress or Anxiety is listed as a possible cause of an Arrhythmia, such as PVCs, and the heart is organically and structurally sound, the stress and anxiety are likely long term effects and not something that comes and goes in one day. I have heard so many people say that they were not stressed on the day of their symptoms. It is seldom that simple.

The Stress of Life is; work, crime, bills, Christmas, cars, bills, Children, desires for material goods, bills, dissatisfaction with your spouse or lover, etc, these are the long term and hidden stresses that foul the Autonomic Nervous System in ways beyond belief to most of us. It is these long term stresses that produce symptoms that won't go away. Sure, you may be stressed one day and have PVCs, I used to get so mad while driving that I thought I lost control of my heart. A smart person would say "that arrhythmia scared the hell out of me, I think I'll settle down while driving." But how many of us are that smart?

This is why I have taken a fondness to the Amish that live nearby a home that my wife and I rent. (sort of a home away from home, nothing special, but it’s away from the hectic city life). I am sure they are not perfect, but I know that they go the day without listening to the miseries imported by the media from points around the world. One summer a few years ago, the noon news had a story of a child that drowned in a swimming pool. I felt bad, and I listened. It turns out that the child drowned in Florida, and I was listening to the local news in Western Pennsylvania. Why did I need to be subject to such bad news? There was no local connection, save the possible warning to people with Children and people with pools to be careful that they both don’t unsafely meet. The Amish men aren’t seduced by women from around the world, they have no Televisions, no radios, no newspapers. The Amish have themselves. They don’t watch buggy commercials for the latest low rider version of buggies with spokes that spin backward when the buggy comes to a stop. They all dress the same, (men like other men, and women like other women, for any smart alec out there ;-) all have black buggies, and, I suspect, realize that they actually have much more than most of us will ever have. Friends and Family. Friends that don’t disappear when one becomes desperately sick.

Anyway, off the soapbox, wish the best to you and yours this ♪♪♫ Holiday Season ♫♫♪.
Avatar universal
thanks for responding and i understand what your saying about the anxiety but how can i cut out what isnt happening for the 9 months or so that ive had the pvcs so far ive had less anxiety then ive had in the past occasional im stressed but still for me to feel the heart pounding all day no matter what im doing or whats going on my lfie doesnt seem like its stress related to me i can go out to a concert and be excited and have a great time yet still be feeling these and thats the case everyday and i could not have one stressful moment or anxiety for a month and it doesnt change nothing seems to make it worse or better...

and about what the dr said the only reason he said that is because as well know pvcs in most caes are not dangerous and do not require treatment you only need it to get rid of the symptoms so he was giving me the option since im so bothered by it if want to try one more medicine before the ablation so he gave me the prescription and basically said think about it...me personally i thought the medicine doesnt really fit what im going through and is a little drastic for pvcs thats why i posted in the first place because of the warnings and litature says..

others material leads me to belive that the risk of another arhymma happening is greater when theres other problems with the heart such as heart disaease or a serious arthymma or  anything else like that where if its a less serious aryhtmma an adverse reaction is not as common

so thats basically why i posted was to get other opinions and knowledge on the situation and the medicine cause i would wanna try it if it were to help and probably could deal with other side effects but dont want anything serious to happen its like a no win situation at this point cause theres no guarantee with the ablation when it comes to pvcs

257552 tn?1404602554
Hi,

From the FDA, the following:

"Because of the proarrhythmic effects of MEXITIL, its use with lesser arrhythmias is generally not recommended. Treatment of patients with asymptomatic ventricular premature contractions should be avoided".

Yet, from the same source as the above is the following, supporting what you said in your response:

"Like other antiarrhythmics MEXITIL (mexiletine hydrochloride, USP) can cause worsening of arrhythmias. This has been uncommon in patients with less serious arrhythmias (frequent premature beats or non-sustained ventricular tachycardia: see ADVERSE REACTIONS), but is of greater concern in patients with life-threatening arrhythmias such as sustained ventricular tachycardia."

Still, keep in close contact with your Doctor, and be sure he/she does not wish to follow-up immediately after you begin (if you decide) to take the Mexitil.

Interestingly enough, as I examined the various classes of Antiarrhythmic Drugs, I noticed that Mexitil and Phenytoin are in the Class 1b. I have taken 300mg Phenytoin (for a seizure disorder) twice a day (600mg total per day) for the last 13 years with no apparent ill effects.

Class I agents interfere with the Na+ channel.
Class II agents are anti-sympathetic agents. All agents in this class are beta blockers.
Class III agents affect K+ influx
Class IV agents affect the AV node.
Class V agents work by other or unknown mechanisms.

Class Ia agents include quinidine, procainamide, disopyramide, and moricizine.
Class Ib agents include lidocaine, mexilitine (Mexitil), tocainide, and phenytoin.
Class Ic agents include flecainide and propafenone.

Class II agents are conventional beta blockers.
They act by slowing conduction through the AV node.
Class II agents include esmolol, propranolol, and metoprolol.

Class III agents include amiodarone, sotalol, dofetilide, ibutilide, and bretylium.

Class IV agents are slow calcium channel blockers.
They decrease conduction through the AV node.
Clas IV agents include verapamil and diltiazem.

Class V agents
Class V agents include adenosine and digoxin.

Just some food for thought.

Be well.
Avatar universal
thanks again im pretty sure thats what i read earlier..i dont think im going to attempt the medicine right now i might fill the prescription and change my mind later but i think i will go for the ablation console see what that dr has to say and go from there..generally theres no way before hand i will know if the med will cause me no ill effects..and i dont wanna take the chance when there conflicting info in what i read from that fact that one article states it reduces pvcs by 70 percent where others say it shouldnt used for that and other sides list pvcs has side effects proably just not worth it thanks again
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