Overview

Namuscla is a medicine used to treat symptoms of myotonia (muscle stiffness) in patients with non-dystrophic myotonic disorders, a group of inherited muscle disorders. Non-dystrophic means no muscle wasting occurs in patients affected by the condition.

Patients with non-dystrophic myotonic disorders experience muscle stiffness and pain because their muscles are slow to relax after contraction.

Myotonic disorders are rare, and Namuscla was designated an ‘orphan medicine’ (a medicine used in rare diseases) on 19 November 2014. 

Namuscla is available as capsules to be taken by mouth. The recommended starting dose is 1 capsule a day. The dose can be increased up to 3 capsules a day, depending on the intensity of the symptoms and how the patient responds to treatment. Patients should have tests to check how well their heart is working before beginning treatment and regularly during treatment.

Namuscla can only be obtained with a prescription. For more information about using Namuscla, see the package leaflet or contact your doctor or pharmacist.

The active substance in Namuscla, mexiletine, works by blocking channels in muscle cells that allow sodium ions (electrically charged particles) to pass in and out. These sodium channels play a role in the contraction and relaxation of muscles and are hyperactive in patients with myotonic disorders, causing excessive contractions and stiffness. By blocking them, the medicine helps to reduce the stiffness that occurs when the contractions are prolonged.

Because it has a similar effect on the heart muscle, mexiletine has also been used for many years in patients with abnormal heart rhythm.

In one study involving 25 patients with non-dystrophic myotonia, Namuscla was shown to be more effective than placebo (a dummy treatment) at reducing muscle stiffness.

Muscle stiffness was self-assessed by each patient before and after treatment, and scored on a scale running from 0 to 100 (most severe). After 18 days of treatment, the average score for patients treated with Namuscla decreased from 66 to 24, while the score for patients given placebo went from 75 to 66.

The company also provided supportive data on the effectiveness of Namuscla from the literature.

The most common side effects with Namuscla (which may affect more than 1 in 10 people) are abdominal (belly) pain and insomnia (difficulty sleeping). The most serious side effects reported (which may affect up to 1 in 10,000 people) are arrhythmias (disturbances of heart rhythm) and a severe reaction affecting skin, blood and internal organs, known as drug reaction with eosinophilia and systemic symptoms (DRESS). For the full list of side effects of Namuscla, see the package leaflet.

Namuscla must not be used in patients who are hypersensitive (allergic) to the active substance, mexiletine, to any other ingredients of the medicine, or to local anaesthetics (medicines that block out sensation used to prevent pain in a part of the body). Namuscla must also not be used in patients with various heart problems, or together with certain medicines. For the full list of restrictions, see the package leaflet.

Namuscla was shown to be effective at easing the symptoms of myotonia in patients with non-dystrophic myotonic disorders, thus improving their quality of life. The safety profile of Namuscla is well known and its side effects affecting the heart are considered to be manageable with restrictions in use and monitoring during treatment.

The European Medicines Agency therefore decided that Namuscla’s benefits are greater than its risks and it can be authorised for use in the EU.

The company that markets Namuscla will provide educational material for doctors and a ‘patient alert card’ with important information about the risks associated with the medicine, in particular the risk of arrhythmias.

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Namuscla have also been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Namuscla are continuously monitored. Side effects reported with Namuscla are carefully evaluated and any necessary action taken to protect patients.

Namuscla received a marketing authorisation valid throughout the EU on 18 December 2018.

Namuscla : EPAR - Medicine overview

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Namuscla : EPAR - Risk-management-plan summary

Product information

Namuscla : EPAR - Product information

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Latest procedure affecting product information: IB/0012

20/02/2023

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This medicine’s product information is available in all official EU languages.
Select 'available languages' to access the language you need.

Product information documents contain:

  • summary of product characteristics (annex I);
  • manufacturing authorisation holder responsible for batch release (annex IIA);
  • conditions of the marketing authorisation (annex IIB);
  • labelling (annex IIIA);
  • package leaflet (annex IIIB).

Namuscla : EPAR - All authorised presentations

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Product details

Name of medicine
Namuscla
Active substance
Mexiletine hydrochloride
International non-proprietary name (INN) or common name
mexiletine hcl
Therapeutic area (MeSH)
Myotonic Disorders
Anatomical therapeutic chemical (ATC) code
C01BB02

Pharmacotherapeutic group

Cardiac therapy

Therapeutic indication

Namuscla is indicated for the symptomatic treatment of myotonia in adult patients with non-dystrophic myotonic disorders.

Authorisation details

EMA product number
EMEA/H/C/004584

Orphan

This medicine was designated an orphan medicine. This means that it was developed for use against a rare, life-threatening or chronically debilitating condition or, for economic reasons, it would be unlikely to have been developed without incentives. For more information, see Orphan designation.

Marketing authorisation holder
Lupin Europe GmbH

Hanauer Landstraße 139-143
60314 Frankfurt am Main
Germany

Opinion adopted
18/10/2018
Marketing authorisation issued
18/12/2018
Revision
5

Assessment history

Namuscla : EPAR - Procedural steps taken and scientific information after authorisation

Namuscla : Orphan maintenance assessment report (initial authorisation)

Namuscla : EPAR - Public assessment report

CHMP summary of positive opinion for Namuscla

Topics

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