Paroxetine with Primidone Interaction Details
Brand Names Associated with Paroxetine
- Brisdelle®
- Paroxetine
- Paxil®
- Paxil® CR
- Pexeva®
Brand Names Associated with Primidone
- Desoxyphenobarbital
- Mysoline®
- Primaclone
- Primidone
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 13, 2023
Interaction Effect
Reduced PARoxetine exposure
Interaction Summary
Avoid concomitant use of PHENobarbital with other products with a known potential to prolong the QTc interval or products that may increase concentrations of PHENobarbital. PHENobarbital causes QTc interval prolongation. Concomitant use of PHENobarbital with other products that prolong the QTc interval may result in a greater increase in the QTc interval and adverse reactions associated with QTc interval prolongation. Also, coadministration of PHENobarbital and PARoxetine has led to significantly decreased PARoxetine plasma levels . If concomitant use of PARoxetine and PHENobarbital is unavoidable, monitor patients for increased risk of QTc interval prolongation and clinical effect of PARoxetine. Dose adjustments should be made based on clinical efficacy and tolerability .
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Avoid the concomitant use of PHENobarbital with other products with a known potential to prolong the QTc interval or products that may increase concentrations of PHENobarbital. PHENobarbital causes QTc interval prolongation. Concomitant use of PHENobarbital with other products that prolong the QTc interval may result in a greater increase in the QTc interval and adverse reactions associated with QTc interval prolongation. Also, coadministration of PHENobarbital and PARoxetine has led to significantly decreased PARoxetine plasma levels . If concomitant use of PARoxetine and PHENobarbital is unavoidable, monitor patients for increased risk of QTc interval prolongation and clinical effect of PARoxetine. Dose adjustments should be made based on clinical efficacy and tolerability .
Mechanism Of Interaction
Inhibition of CYP2D6-mediated PARoxetine metabolism; inhibition of CYP450-mediated PARoxetine metabolism
Literature Reports
A) PHENobarbital induces many cytochrome P450 enzymes. When a single oral 30 mg dose of PARoxetine was administered at PHENobarbital steady state (100 mg once daily for 14 days), PARoxetine AUC and t 1/2 were reduced (by an average of 25% and 38% respectively) compared to PARoxetine administered alone. The effect of PARoxetine on PHENobarbital pharmacokinetics was not studied .
Paroxetine Overview
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Paroxetine tablets, suspension (liquid), and extended-release (long-acting) tablets are used to treat depression, panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Paroxetine tablets and suspension are also used to treat obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), generalized anxiety disorder (GAD; excessive worrying that is difficult to control), and posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience). Paroxetine extended-release tablets are also used to treat premenstrual dysphoric disorder (PMDD, physical and psychological symptoms that occur before the onset of the menstrual period each month). Paroxetine capsules (Brisdelle) are used to treat hot flashes (sudden feelings of warmth, especially in the face, neck, and chest) in women who are experiencing menopause (stage of life when menstrual periods become less frequent and stop and women may experience other symptoms and body changes). Paroxetine is in a class of medications called selective serotonin-reuptake inhibitors (SSRIs). It treats depression and other mental illnesses by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. There is not enough information available at this time to know how paroxetine works to treat hot flashes.
Primidone Overview
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Primidone is used alone or with other medications to control certain types of seizures. Primidone is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.