PMID: 2179362Apr 1, 1990Paper

Low dose quinidine-mexiletine combination therapy versus quinidine monotherapy for treatment of ventricular arrhythmias

Journal of the American College of Cardiology
E G Giardina, M E Wechsler

Abstract

Low dose quinidine-mexiletine combination therapy was compared with quinidine monotherapy in 15 patients with frequent ventricular premature complexes and nonsustained ventricular tachycardia in a dose escalation cross-over study. Oral combination therapy was initiated with quinidine gluconate (165 mg) plus mexiletine (150 mg) every 8 h. If ventricular premature complexes were not suppressed greater than or equal to 80% and nonsustained ventricular tachycardia greater than or equal to 90%, the dose was increased to a maximum of 330 mg of quinidine plus 200 mg of mexiletine. Quinidine monotherapy was initiated with 330 mg and escalated to a maximum of 660 mg every 8 h if criteria for effectiveness were not met. Combination quinidine-mexiletine therapy suppressed 80% of ventricular premature complexes in 13 of 14 patients and suppressed 100% of episodes of ventricular tachycardia in 6 of 8 patients (mean quinidine dose 200 +/- 70 mg; mean mexiletine dose 146 +/- 24 mg every 8 h). The mean effective trough quinidine and mexiletine concentration was 1.0 +/- 0.7 and 0.9 +/- 0.4 microgram/ml, respectively. Monotherapy was less effective; that is, greater than or equal to 80% suppression of ventricular premature complexes was observed...Continue Reading

References

Aug 10, 1989·The New England Journal of Medicine·UNKNOWN Cardiac Arrhythmia Suppression Trial (CAST) Investigators
Apr 1, 1981·The American Journal of Cardiology·P J Podrid, B Lown
Jan 1, 1981·Therapeutic Drug Monitoring·R KellyS L Jacobs
Aug 2, 1980·British Medical Journal·E B LeaheyJ T Bigger

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Citations

Jun 1, 1991·Journal of the American College of Cardiology·M E WechslerE G Giardina
Aug 12, 2015·Clinical Pharmacology and Therapeutics·L JohannesenD G Strauss
Jan 6, 2001·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·T C Trujillo, P E Nolan
Jul 10, 2020·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·E YetkinJ Waltenberger
Jul 5, 2021·JACC. Clinical Electrophysiology·Dan L LiWilliam G Stevenson

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