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Genetic and Rare Diseases Information Center (GARD)

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Other Names for this Disease
  • Mitchell disease (formerly)
  • Primary erythermalgia
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Your Question

I have been diagnosed with erythromelalgia, and received a prescription for mexiletine.  I noticed on the patient information sheet that it said that this medication is an anti-arrhythmic used to treat irregular heartbeat.  Have you heard about mexiletine being used for erythromelalgia?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is erythromelalgia?

Erythromelalgia (EM) is a rare condition characterized by episodes of burning pain, warmth, swelling and redness in parts of the body, particularly the hands and feet. This condition may occur spontaneously (primary EM) or secondary to neurological diseases, autoimmune diseases, or myeloproliferative disorders (secondary EM). Episodes may be triggered by increased body temperature, alcohol, and eating spicy foods. About 15% of cases are caused by mutations in the SCN9A gene and are inherited in an autosomal dominant manner. Other cases may be caused by unidentified genes or by non-genetic factors. Treatment depends on the underlying cause and may include topical and/or oral medications. In some cases, the condition goes away without treatment.[1][2]
Last updated: 12/11/2013

Is mexiletine used as a treatment for erythromelagia?

Although we cannot provide medical or treatment advise we have been able to research documenting the use of mexiletine as a treatment option for erythromelagia.[3][4] Mexiletine is an oral medication is often paired with intravenous lidocaine for the treatment of erythromelagia.[3] Local anesthetics such as lidocaine and mexiletine prevent or relive pain in erythromelagia by interrupting nerve conduction. Mexiletine is an oral analog of lidocaine (both IB antiarrythmia drugs) that share the ability to block the sodium channel.[3]
Last updated: 7/9/2013

Where can I find more information about using mexiletine as a treatment for erythromelalgia?

You can find relevant articles on treatment for erythromelalgia with mexiletine through PubMed, a searchable database of biomedical journal articles. Although not all of the articles are available for free online, most articles listed in PubMed have a summary available. To obtain the full article, contact a medical/university library or your local library for interlibrary loan. You can also order articles online through the publisher’s Web site.

The National Library of Medicine (NLM) Web site has a page for locating libraries in your area that can provide direct access to these journals (print or online). The Web page also describes how you can get these articles through interlibrary loan and Loansome Doc (an NLM document-ordering service). You can access this page at the following link: You can also contact the NLM toll-free at 888-346-3656 to locate libraries in your area.
Last updated: 12/11/2013