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Drug Interactions between ponesimod and primidone

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

primidone ponesimod

Applies to: primidone and ponesimod

GENERALLY AVOID: Coadministration with potent inducers of CYP450 3A4 and uridine diphosphate glucuronosyltransferase (UGT) 1A1 inducers (e.g., rifampicin, phenytoin, carbamazepine), may decrease the systemic exposure of ponesimod. Experiments with human liver preparations indicate that metabolism of ponesimod to inactive metabolites occurs through a combination of non-CYP450 oxidative enzymes, multiple CYP450 (2J2, 3A4, 3A5, 4F3A, and 4F12) enzymes, and direct glucuronidation (mainly UGT1A1 and UGT2B7). Limited clinical data are available, and it is unclear whether this decrease in ponesimod systemic exposure would be considered of clinical relevance.

MANAGEMENT: Until more information is available, concomitant use of ponesimod with potent CYP450 3A4 and UGT1A1 inducers should generally be avoided.

References

  1. (2021) "Product Information. Ponvory (ponesimod)." Janssen Pharmaceuticals

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Drug and food interactions

Major

primidone food

Applies to: primidone

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References

  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
View all 5 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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