lidocaine topical vs mexiletine
Side-by-side comparison of lidocaine topical and mexiletine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
moderate Known Drug Interaction
Drug Interactions Antiarrhythmic Drugs LIDODERM should be used with caution in patients receiving Class I antiarrhythmic drugs (such as tocainide and mexiletine) since the toxic effects are additive and potentially synergistic.
Recommendation: Your doctor should use caution and may need to adjust your dosages. Tell your healthcare provider right away if you feel dizzy or notice changes in your heartbeat.
Lidoderm
Mexitil
Lidoderm is a skin patch that contains the numbing medicine lidocaine. It is used to relieve nerve pain after shingles.
Mexiletine is a medicine used to treat life-threatening heart rhythm problems. It helps to stabilize your heartbeat.
Lidoderm is used to relieve pain caused by post-herpetic neuralgia. This is nerve pain that can happen after you have shingles. The patch should only be applied to skin that is not broken or irritated.
Mexiletine is used to treat serious, life-threatening ventricular arrhythmias, like sustained ventricular tachycardia. These are problems with the rhythm of the lower chambers of your heart. It is generally not recommended for less severe arrhythmias or asymptomatic premature ventricular contractions.
Lidoderm contains lidocaine, a local anesthetic. It works by numbing the area where you apply the patch. This reduces pain signals in that area.
Mexiletine belongs to a class of drugs called antiarrhythmics. It works by slowing down the electrical signals in your heart. This helps to make your heartbeat more regular.
- • Blisters where you put the patch
- • Bruising where you put the patch
- • Burning feeling where you put the patch
- • Skin color changes where you put the patch
- • Skin irritation where you put the patch
- • Nausea
- • Vomiting
- • Heartburn
- • Dizziness
- • Lightheadedness
No adverse event reports.
- Tiredness 31
- Fast heartbeat in the lower heart chambers 30
- Shortness of breath 26
- Feeling sick to your stomach 24
- Not sleeping well 24
Using Lidoderm with certain drugs can increase the risk of a blood disorder called methemoglobinemia. Tell your doctor about all other medicines you take.
Mexiletine may increase the risk of death or cardiac arrest in some patients with a history of heart attack. It should only be used for life-threatening ventricular arrhythmias. This medicine can also cause liver problems, especially if you have congestive heart failure or ischemia.
Tell your doctor if you are pregnant or breastfeeding before using Lidoderm. It is not known if Lidoderm can harm your unborn baby. It is also not known if Lidoderm passes into breast milk.
Tell your doctor if you are pregnant or plan to become pregnant. The effects of mexiletine during pregnancy are not fully known. Talk to your doctor about the risks and benefits of taking this medicine while pregnant or breastfeeding.
How to Read This lidocaine topical vs mexiletine Comparison
lidocaine topical is classified in the Topical Anesthetic drug class, while mexiletine sits within the Class IB Antiarrhythmic class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, lidocaine topical has 0 submissions while mexiletine has 135. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known moderate interaction flagged in FDA labeling, attributed to these drugs have similar effects on the body, so taking them together can cause their toxic side effects to build up. this makes the risk of a bad reaction much higher than taking just one.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between lidocaine topical and mexiletine - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.