Hello Carter, In the Netherlands where I live mexiletine has been banned from health care insurance, due to that the price has been increased 20 times. I believe 1x 150mg has an average costprice of 185usd for each pill. So the option to start with it is not something easy to do so. I also understand getting mexiletine to buy it is also not easy.
Wat is your experience with buying/getting mexiletine for your treatment of EM?
Last week I was told by a medical specialist Mexiletine is a good way to start with my condition, but seems not easy to do with this situation.
That’s unfortunate. Mexiletine is easily available in the United States and covered by health insurance. Without insurance, using a popular discount program, I could get mexiletine locally with a prescription for 43 cents per pill. With insurance the cost is simply a $10 generic drug copay for a 3 month supply of 270 pills.
Serious, that is significantly a huge leap of difference. Many thanks for sharing the feedback on it. Strange world we live in where the same pill costs a fortune crossing the Atlantic. If I would decide to try mexiletine for one year with 300mg doses this will cost me personally 45k euro’s that’s 60k USD. This is no option for me.
For severe cases oral mexiletine is sometimes combined with intravenous lidocaine, as both are in the same drug class. Mexiletine is considered the oral analogue of lidocaine. Responsiveness to a lidocaine infusion is considered a good indicator for mexiletine responsiveness. That might be an option if you want to gage your EM responsiveness to class Ib antiarrhythmics. Intravenous lidocaine should be more easily obtainable.
Thanks Carter! that’s very kind of you to provide this useful information. Wasn’t aware that mexiletine is considered the oral analogue of lidocaine. I have seen there are options in NL for intravenous Lidocaine, so I will definitely take that in consideration.
I have been advised by one clinic to try out Ketanest infusion for one day, which is planned in November. So this is step 1 one for me.
As you may can imagine, it is quite difficult to find a general GP that can coordinate the diagnose and treatment options for EM patients. This is the reason I am talking with 2 specialists at 2 different hospitals and one clinic at the moment. My main hospital round the corner, doesn’t seem to know really how to treat my symptoms, as they say they can’t find anything as a cause. So that’s whyI am haveing Ketanest through a different clinic.
Last week I visited an academic hospital in Amsterdam and talked with a senior internist. He was very good and said that mexilitne seems to work quite good, but suggested ventaflaxine as alternative to have options. Although first having some more blood test running before stepping in to that and want to be a bit careful before taking ventaflaxine at once, due to that it’s a antidepressant.
I have been using capsasicine creme 0.75% the last couple of days, but not sure if this is really helping the route cause.