mysoline and Acthar gel h p Interactions

Interactions between mysoline(primidone) and Acthar gel h p (corticotropin)

primidone and corticotropin (Moderate Drug-Drug)

MONITOR: Barbiturates may decrease the plasma concentrations and systemic effects of both endogenous and exogenous corticosteroids. The mechanism is accelerated corticosteroid metabolism due to induction of the CYP450 3A4 enzymatic pathway by barbiturates.

MANAGEMENT: Patients treated concomitantly with a barbiturate may require higher dosages of corticosteroids or adrenocorticotropic agents. Pharmacologic response to these agents should be monitored more closely whenever a barbiturate is added to or withdrawn from therapy in patients stabilized on their existing corticosteroid or adrenocorticotropic regimen, and the dosage(s) adjusted as necessary.