Drug Interaction Report

Primidone and Linagliptin: Interaction Details

A pharmacist-reviewed analysis of the Primidone and Linagliptin 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
+

Linagliptin

Tradjenta Tradjenta® Trijardy® (as a combination product containing Empagliflozin, Linagliptin, Metformin)
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 linagliptin exposure

Interaction Deep Dive

Coadministration of linagliptin (a CYP3A4 and P-gp substrate) with a strong CYP3A4 or P-gp inducer may reduce linagliptin exposure and lead to a loss of linagliptin efficacy. AUC and Cmax of linagliptin were decreased by 40% and 44%, respectively, with concurrent use of rifampin, a strong CYP3A4 and P-gp inducer. Use of an alternative treatment to linagliptin is strongly recommended213.

Why it happens (mechanism)

Induction of CYP3A4-mediated linagliptin metabolism and P-glycoprotein mediated linagliptin efflux transport

Literature reports

1 report — tap to read

a) AUC and Cmax of a linagliptin 5 mg once daily steady-state regimen decreased by 40% and 44%, respectively, with concurrent use of the strong CYP3A4 and P-gp inducer rifampin 600 mg/day 21.

Common questions

Can I take Primidone and Linagliptin together?

Reduced linagliptin exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Primidone and Linagliptin 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 Linagliptin 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 (3)

  1. Product Information: TRADJENTA(R) oral tablets, linagliptin oral tablets. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2020. DailyMed
  2. Product Information: GLYXAMBI(R) oral tablets, empagliflozin linagliptin oral tablets. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2021. DailyMed
  3. Product Information: JENTADUETO(R) oral tablets, linagliptin metformin HCl oral tablets. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2020. DailyMed
Was this write-up helpful?
Primidone

Keep reading about Primidone

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

Keep reading about Linagliptin

All Linagliptin interactions (165) Linagliptin drug information
Also serious with: Ensitrelvir Pramlintide Ofloxacin Otic Pimozide
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
Linagliptin + Activated Charcoal Siberian Cocklebur St. John's Wort Acai Adrafinil African Wild Potato Agaricus Mushroom Agmatine + 276 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.