Involvement of CYP1A2 in mexiletine metabolism

Br J Clin Pharmacol. 1998 Jul;46(1):55-62. doi: 10.1046/j.1365-2125.1998.00048.x.


Aims: Mexiletine has been reported to be hydroxylated by cytochrome P450 2D6 (CYP2D6) in humans. However, the involvement of CYP1A2 in the metabolism of mexiletine has been proposed based on the interaction with theophylline which is mainly metabolized by CYP1A2. The aim of this study was to clarify the role of human CYP1A2 in mexiletine metabolism.

Methods: Human CYP isoforms involved in mexiletine metabolism were investigated using microsomes from human liver and B-lymphoblastoid cells expressing human CYPs. The contributions of CYP1A2 and CYP2D6 to mexiletine metabolism were estimated by the relative activity factor (RAF).

Results: Mexiletine p- and 2-hydroxylase activities in human liver microsomes were inhibited by ethoxyresorufin and furafylline as well as quinidine. Mexiletine p- and 2-hydroxylase activities in microsomes from nine human livers correlated significantly with bufuralol 1'-hydroxylase activity (r = 0.907, P < 0.001 and r = 0.886, P < 0.01, respectively). Microsomes of B-lymphoblastoid cells expressing human CYP1A2 exhibited lower mexiletine p- and 2-hydroxylase activities than those expressing human CYP2D6. It was estimated by RAF that the major isoform involved in mexiletine metabolism was CYP2D6, and the contribution of CYPIA2 to both mexiletine p- and 2-hydroxylase activities was 7-30% in human liver microsomes. However, the Km values of the expressed CYP1A2 (approximately 15 microM) were almost identical with those of the expressed CYP2D6 (approximately 22 microM) and human liver microsomes.

Conclusions: Mexiletine is a substrate of CYP1A2. The data obtained in this study suggest that the interaction of mexiletine with theophylline might be due to competitive inhibition of CYP1A2.

MeSH terms

  • Anti-Arrhythmia Agents / metabolism
  • Anti-Arrhythmia Agents / pharmacokinetics*
  • Bronchodilator Agents / pharmacokinetics
  • Cytochrome P-450 CYP1A2 / metabolism*
  • Drug Interactions
  • Humans
  • In Vitro Techniques
  • Liver / drug effects
  • Liver / metabolism
  • Mexiletine / metabolism
  • Mexiletine / pharmacokinetics*
  • Microsomes
  • Theophylline / pharmacokinetics


  • Anti-Arrhythmia Agents
  • Bronchodilator Agents
  • Mexiletine
  • Theophylline
  • Cytochrome P-450 CYP1A2