mysoline and Jantoven Interactions

Interactions between mysoline(primidone) and Jantoven (warfarin)

warfarin and primidone (Major Drug-Drug)

GENERALLY AVOID: Barbiturates reduce the effects of oral anticoagulants by inducing their hepatic metabolism. Anticoagulant dosage requirements may be increased by 30% to 60%. After the barbiturate is discontinued, excessive anticoagulation and bleeding may occur if the anticoagulant dose is not reduced.

MANAGEMENT: Close attention should be paid to alterations in coagulation if a patient must take both drugs and for several weeks after the dose of the barbiturate is changed or discontinued. Alternatively, a benzodiazepine might be used instead of a barbiturate, if appropriate. Patients should be advised to promptly report any signs of blood clots (e.g. chest pain, shortness of breath, sudden loss of vision, or pain, redness or swelling in an extremity).