Introduction
Primidone is a prescription drug approved by the U.S. Food and Drug Administration. It is used to treat some types of seizures caused by epilepsy in adults and children. Primidone is also known by its brand name Mysoline.
Uses for
Primidone is used to treat certain types of seizures caused by epilepsy or other medical conditions in adults and children. Primidone is also sometimes used to treat tremors.
| Brand Name | Primidone |
|---|---|
| Type | |
| Weight | |
| Generic | Primidone |
| Manufacturer | |
| Available in | English বাংলা |
Mechanism of Action
Primidone acts as an anticonvulsant by reducing the overactivity of certain nerve fibers in the brain. Primidone metabolyzes into the anticonvulsant drugs phenobarbital and phenylethylmalonamide. These drugs act by further suppressing the abnormal electrical activity of the brain.
How long does it take to work?
The effects of primidone are usually noticeable within a few days to a few weeks after starting treatment. However, it can take up to several months for a patient to fully benefit from its effects.
Absorption
Primidone is absorbed rapidly and completely after oral administration.
Route of Elimination
Primidone is eliminated through the kidneys and to a lesser extent, through the liver.
Dosage
Patients 8 years of age and older who have received no previous treatment may be started on primidone according to the following regimen using either 50 mg or scored 250 mg primidone tablets:- Days 1 to 3: 100 to 125 mg at bedtime.
- Days 4 to 6: 100 to 125 mg. twice a day.
- Days 7 to 9: 100 to 125 mg three times a day.
- Day 10 to maintenance: 250 mg three times a day.
Dosage should be individualized to provide maximum benefit. In some cases, serum blood level determinations of primidone may be necessary for optimal dosage adjustment. The clinically effective serum level for primidone is between 5 to 12 mcg/mL.
Primidone dosage depends on the individual. It is typically taken one to three times daily with or without food. The dose can range from 250 to 500 milligrams per day, depending on the severity of the condition. The maximum daily dose should not exceed 1000 milligrams per day.
Administration
Primidone is typically taken by mouth. It is recommended to take primidone with food and to take the medication exactly as prescribed. It is important not to skip or miss any doses of primidone.
Side Effects
The most common side effects of primidone include dizziness, fatigue, blurred vision, headaches, and nausea. Other side effects may include gastrointestinal problems, depression, confusion, and sleep disturbances. Primidone may also cause an allergic reaction in some people.
Toxicity
If taken in large doses or in combination with other medications, primidone can cause toxicity. Signs of primidone toxicity include confusion, slurred speech, loss of coordination, and inability to concentrate. If these side-effects persist, seek medical attention immediately.
Precaution
It is important to tell your healthcare provider if you have a history of stroke, liver disease, kidney disease, alcoholism, or any other medical conditions. It is also important to tell your provider if you are taking any other medications, including vitamins, herbal supplements, or over-the-counter medications.
Interaction
Primidone may interact with certain other medications and supplements, including birth control pills, anticonvulsant drugs, antacids, and St. John's Wort. It is important to tell your healthcare provider about all the medications you are taking before taking primidone.
Disease Interactions
Primidone is not recommended for people with certain conditions including liver or kidney disease, alcoholism, depression, or any other conditions associated with an increased risk of seizures.
Drug Interactions
It is important to talk to your doctor before taking Primidone if you are taking any other medications, including non-prescription medications, vitamins, supplements, or herbal remedies. Primidone may interact with medications such as anticonvulsants, antacids, or St. John's Wort.
Food Interactions
Primidone should not be taken with food that contains calcium, such as milk or yogurt, as this may reduce the absorption of the medication. It is best to take Primidone on an empty stomach or with a light meal.
Pregnancy Use
Primidone is known to cause harm to an unborn child. Primidone should never be used during pregnancy, unless absolutely necessary. If your healthcare provider decides that the benefits of taking Primidone outweigh the risks, you should be monitored for any signs of fetal harm.
Lactation Use
Primidone has been known to pass into breast milk. Primidone should not be used during breastfeeding unless absolutely necessary. If your healthcare provider decides that the benefits of taking Primidone outweigh the risks, you should be monitored for any signs of infant harm.
Acute Overdose
An acute overdose of Primidone can cause rapid heart rate, agitation, confusion, seizures, nausea, vomiting, or unconsciousness. If you suspect an overdose, contact emergency medical services or contact the Poison Control Center immediately.
Contraindication
Primidone is contraindicated in patients with known hypersensitivity or with a history of barbiturate or phenobarbital induced porphyria.
Direction of Use
Primidone should be taken exactly as prescribed by your healthcare provider. The dose can range from 250 to 500 milligrams per day, depending on the severity of the condition. The maximum daily dose should not exceed 1000 milligrams per day. Primidone should be taken one to three times daily with or without food.
Storage Conditions
Primidone should be stored at room temperature, away from heat, light, and moisture. It should be kept out of the reach of children and pets.
Volume of Distribution
Primidone is widely distributed throughout the body and distributed into breast milk. It has not been established how much of the drug is distributed in the brain.
Half Life
The elimination half-life of primidone, usually expressed as its active metabolite, phenobarbital, is approximately 80 hours in healthy adults. This half-life may be prolonged in elderly and in patients with renal or hepatic impairment.
Clearance
Primidone is eliminated primarily through the kidneys and to a lesser extent through the hepatic system. The average renal clearance of Primidone is approximately 0.5-1.0 mL/min/kg in healthy adults.
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