A randomized trial of amitriptyline and mexiletine
for painful neuropathy in HIV infection.
a review of its therapeutic use in painful diabetic neuropathy.
Eighteen drugs are in Phase III development in the US including two GABA receptor agonists pregabalin (Pfizer) and gabapentin GR (Depomed); a sodium channel antagonist mexiletine
(Boehringer Ingelheim); three glutamate / NMDA antagonists ketamine intranasal (Javelin), a dextromethorphan/quinidine combination (Avanir), and NP-1 (EpiCept/Epitome); two serotonin/norepinephrine reuptake inhibitors desvenlafaxine (Wyeth), and paroxetine (GSK/Novo Nordisk); an alpha-2 adrenergic receptor antagonist/norepinehrine reuptake inhibitor reboxetine (Pfizer); an opioid receptor agonist/norepinephrine reuptake inhibitor tapentadol (Ortho-McNeil); a dopamine receptor agonist sodium oxybate (Jazz), and a neuromuscular blocking agent botulinum toxin A (Allergan).
Therefore, concomitant use of tizanidine with other CYPA12 inhibitors, such as zileuton, other fluoroquinolones, antiarrhythmics (amiodarone, mexiletine
, propafenone, and verapamil), cimetidine, famotidine, oral contraceptives, acyclovir, and ticlopidine should be ordinarily avoided," the letter said.
is a local anesthetic, taken by mouth, which is similar to lidocaine and has been studied in symptomatic management of neuropathic pain of various ideologies.
Lidocaine and mexiletine
inhibit mitochondrial oxidation in rat ventricular myocytes.
In addition, mexiletine
and transdermal lidocaine have shown benefit for neuropathic pain states as well (Lipman, 1998).
, used to regulate heartbeat, has been effective in treating pain in several clinical trials.
All nine of the heart medications studied (labetalol HCI, captopril, diltiazem HCI, enalapril maleate, hydrochlorothiazide, propranolol HCI, mexiletine
HCI, procainamide HCI, and propafenone HCI) were described as being predominantly bitter, with other negative qualities including metallic, medicinal, sour, sharp, and astringent.
Other options being tested include the heart drug mexiletine
and antiseizure medications Tegretol and Dilantin.
However, syncope, aborted cardiac arrest, and sudden death do continue to occur In cases in which [Beta]-blockers cannot be used, as in patients with asthma, other medications have been tried, such as mexiletine
Today Novopharm USA markets drugs in 20 groups, including such popular products as naproxen, naproxen sodium, loperaminde, flurbiprofen, mexiletine
, annoxicillin, nifedipine, glyburide, cephalexin, piroxicam, diclofenac and selegiline and cimetidine.
Instead of stopping antiarrhythmic therapy, however, physicians responded to promotional campaigns by other companies and prescribed a similar drug, mexiletine
Absence of approved drugs and the high use of off-label generic drugs such as prednisolone, deflazacort, mexiletine
, naproxen and others will act as a barrier to the MD therapeutics market.