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Drug Interactions between Attruby and primidone

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

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Interactions between your drugs

Moderate

primidone acoramidis

Applies to: primidone and Attruby (acoramidis)

GENERALLY AVOID: Coadministration with inducers of uridine diphosphoglucuronate-glucuronosyltransferase (UGT) enzymes and potent inducers of CYP450 3A4 isoenzymes may decrease the plasma concentrations of acoramidis. In vitro, acoramidis is a substrate of multiple UGT enzymes including UGT1A9, UGT1A1, and UGT2B7 and is primarily metabolized by UGT enzyme-mediated glucuronidation. Acoramidis beta-D-glucuronide (Acoramidis-AG) is the predominant metabolite of acoramidis. Acoramidis-AG is approximately 1/3 as pharmacologically active compared with acoramidis, has a low potential for covalent binding, and does not contribute to pharmacological activity. While acoramidis is not metabolized by CYP450 3A4, strong CYP450 3A4 inducers can also induce UGT enzymes.

MANAGEMENT: According to the manufacturer, concomitant use of acoramidis with inducers of UGT enzymes and potent inducers of CYP450 3A4 should generally be avoided due to the potential for reduced efficacy.

References (1)
  1. (2024) "Product Information. Attruby (acoramidis)." BridgeBio Pharma, Inc

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 (5)
  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

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.

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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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