Drug & supplement interaction

Gamma Butyrolactone (gbl) + Primidone

Primidone brand name: Mysoline.

Moderate Interaction
The bottom line Moderate

Primidone falls into 2 drug categories that Gamma Butyrolactone (gbl) can interact with; the most serious is rated moderate. Theoretically, concomitant use of GBL with CNS depressants may potentiate respiratory and CNS depression.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Gamma Butyrolactone (gbl) and Primidone

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Gamma Butyrolactone (gbl) interacts with whole categories of medication. Primidone falls into 2 of those categories, so it can interact with Gamma Butyrolactone (gbl) in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 2

Why this applies to Primidone

Primidone falls under CNS DEPRESSANTS — the group Gamma Butyrolactone (gbl) interacts with.

Theoretically, concomitant use of GBL with CNS depressants may potentiate respiratory and CNS depression.
GBL is metabolized to gamma-hydroxybutyrate (GHB). Concomitant use of CNS depressants with GHB may cause serious CNS and respiratory depression.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

First things first: GBL is not a real supplement. It's a toxic industrial solvent that your body turns into GHB, a heavy sedative. It's illegal for human use and can cause coma, seizures, and death on its own, so please don't take it. If you're looking for help with sleep, anxiety, or anything you're using it for, talk with your doctor or pharmacist instead.

Now, layering it on top of primidone makes things even more dangerous. Primidone already calms brain activity and causes drowsiness, dizziness, and slowed breathing. Stacking a strong sedative like GHB on top can deepen that slowdown, leading to extreme sedation, trouble breathing, or loss of consciousness. The evidence here is anecdotal, but the risk is real. Please don't combine them.

References
  1. Anon. Important message for health professionals: Report serious adverse events associated with dietary supplements containing GBL, GHB or BD. Food and Drug Administration, Rockville, MD. August 25, 1999. Available at: http://vm.cfsan.fda.gov/~dms/mwg
  2. Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8. DOI
  3. Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.
Moderate

ANTICONVULSANTS

2 of 2

Primidone also falls under ANTICONVULSANTS.

Theoretically, concomitant use of GBL with certain anticonvulsants may potentiate respiratory and central nervous system (CNS) depression or increase the risk of seizures.
GBL is metabolized to gamma-hydroxybutyrate (GHB). Concomitant use of anticonvulsants that have sedative effects with GHB may cause serious CNS and respiratory depression. GHB can also cause seizures and might reduce the effectiveness of anticonvulsants.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

First, the honest part: GBL is not a supplement. It is a toxic industrial solvent that your body turns into GHB, a heavy sedative. It is illegal to sell for human use and can cause coma, seizures, and death on its own. Please don't take it. If you're struggling with sleep, anxiety, or substance use, your doctor or pharmacist can help safely.

Pairing it with primidone is especially risky. Primidone already slows the brain (it partly breaks down into phenobarbital, a strong sedative), so stacking GHB's sedation on top can pile up into dangerous drowsiness and slowed or stopped breathing. GHB can also trigger seizures and work against the very seizure control primidone is meant to give you. The evidence here is largely theoretical and anecdotal, but the danger is real. Talk with your doctor.

References
  1. Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8. DOI
  2. Carotenuto A, De Feo V, Fattorusso E, et al. The flavonoids of Allium ursinum. Phytochem 1996;41:531-6. PubMed
  3. Product information for Xyrem. Jazz Pharmaceuticals, Inc. Palo Alto, CA. March 2022.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Gamma Butyrolactone (gbl) Also Interacts With Other Medications

Gamma Butyrolactone (gbl) has 270 moderate known drug interactions in our database — the Primidone one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Gamma Butyrolactone (gbl)

Covers the 2,830 medications we’ve checked against Gamma Butyrolactone (gbl). Pick one to open its full report.

From our Q&A

Questions About Gamma Butyrolactone (gbl) or Primidone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Gamma Butyrolactone (gbl) or Primidone, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Primidone

This page covers Gamma Butyrolactone (gbl) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Primidone page lists 124 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 7 major · 101 moderate · 16 minor.

Open the Primidone interaction page

How much people look this up

Where Gamma Butyrolactone (gbl) and Primidone Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Gamma Butyrolactone (gbl)
Steady interest

#1,208 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Primidone
Steady interest

#1,974 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Gamma Butyrolactone (gbl)

What is Gamma Butyrolactone (gbl)?

Gamma Butyrolactone (gbl)
  • Recreational intoxication and euphoria
  • Relaxation and sedation
  • Sleep aid (misused)
  • Bodybuilding/muscle building claims (unproven)
  • Industrial solvent and cleaner

Gamma butyrolactone (GBL) is a toxic industrial solvent, not a dietary supplement, and the body converts it into GHB, a powerful and dangerous sedative. It is illegal to sell or possess for human use in the United States, has no proven medical or supplemental benefit, and can cause coma, seizures, and death. Do not take GBL — if you are seeking help for sleep, anxiety, or substance use, talk to a doctor or pharmacist.

Read the full Gamma Butyrolactone (gbl) monograph & all interactions
Medication

About Primidone

What Is Primidone Used For?

Brand name: Mysoline

Primidone tablets — sold as Mysoline or under the generic name primidone — are used to control seizures in people with epilepsy. Both Mysoline and primidone tablets are approved for grand mal (generalized tonic-clonic), psychomotor, and focal (partial) epileptic seizures.

Primidone can be used alone or alongside other anti-seizure medicines. It may also help control grand mal seizures that haven't responded well to other anticonvulsant treatments.

See full Primidone drug information
Keep checking

Other Drugs & Gamma Butyrolactone (gbl)

Browse every other medication we’ve checked against Gamma Butyrolactone (gbl) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
270Moderate
0Minor
2,559No known interaction
Moderate

270 interactions

Showing 60 of 270 moderate interactions — see all 270 on the Gamma Butyrolactone (gbl) page.

No interaction 2,559 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Gamma Butyrolactone (gbl) and Primidone Together: Common Questions

Can you take Gamma Butyrolactone (gbl) with Primidone?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Gamma Butyrolactone (gbl) and Primidone?
Primidone belongs to more than one drug category, and Gamma Butyrolactone (gbl) interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Gamma Butyrolactone (gbl) and Primidone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.