Drug Interaction Report

Primidone and Dolutegravir: Interaction Details

A pharmacist-reviewed analysis of the Primidone and Dolutegravir interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Primidone

Mysoline
+

Dolutegravir

Juluca® (as a combination product containing dolutegravir, rilpivirine) Tivicay Tivicay® Tivicay® PD
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 204 documented Primidone interactions, 190 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Reduced dolutegravir exposure and reduced efficacy of dolutegravir

Interaction Deep Dive

Avoid concomitant use of dolutegravir or dolutegravir-containing combinations with PHENobarbital. There are insufficient data to make dosing recommendations3421.

Why it happens (mechanism)

Induction of CYP3A-mediated metabolism of dolutegravir

Common questions

Can I take Primidone and Dolutegravir together?

Reduced dolutegravir exposure and reduced efficacy of dolutegravir Always confirm with your pharmacist or prescriber before making any change.

How serious is the Primidone and Dolutegravir interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Primidone or Dolutegravir need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (4)

  1. Product Information: TIVICAY oral tablets, dolutegravir oral tablets. ViiV Healthcare (per FDA), Research Triangle Park, NC, 2022. DailyMed
  2. Product Information: DOVATO oral tablets, dolutegravir lamivudine oral tablets. ViiV Healthcare (per manufacturer), Research Triangle Park, NC, 2019. DailyMed
  3. Product Information: TRIUMEQ oral tablets, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Durham, NC, 2023. DailyMed
  4. Product Information: TRIUMEQ PD oral tablets for suspension, abacavir, dolutegravir, lamivudine oral tablets. ViiV Healthcare (per FDA), Durham, NC, 2023. DailyMed
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Primidone

Keep reading about Primidone

All Primidone interactions (204)
Also serious with: Nifedipine Maraviroc Doravirine Orlistat
Dolutegravir

Keep reading about Dolutegravir

All Dolutegravir interactions (51) Dolutegravir drug information
Also serious with: Dofetilide Ensitrelvir Abametapir Letermovir Injection
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Primidone + 1,4-butanediol Activated Charcoal Beer Gamma-hydroxybutyrate (ghb) Kava L-tryptophan Wine 5-htp + 116 more
Dolutegravir + Activated Charcoal Calcium St. John's Wort Bitter Melon Black Pepper Breadfruit Brussels Sprout Bulbine Natalensis + 57 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.