Can you take Butabarbital with Mysoline?
1 drug interaction and 49 additional warnings found for the following 2 drugs:
- butabarbital
- Mysoline (primidone)
Drug interactions
Moderate drug interactions
Moderate:
primidone butabarbital
Applies to: Mysoline (primidone) and butabarbital
Using primidone together with butabarbital may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Therapeutic duplication warnings
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition.
It can be intentional, when combining drugs with similar actions adds demonstrated therapeutic benefit — or unintentional, such as when a patient sees multiple prescribers or fills prescriptions at more than one pharmacy, which can lead to adverse effects.
Duplication:
Barbiturates
The recommended maximum number of medicines in the 'barbiturates' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'barbiturates' category:
- butabarbital
- Mysoline (primidone)
Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
primidone Alcohol (Ethanol)
Applies to: Mysoline (primidone)
Ask your doctor before using primidone together with ethanol (alcohol), this can add to dizziness, drowsiness and other side effects of primidone. Be careful if you drive or do activities that require you to be awake and alert. Talk with your doctor before using any medications together, or drinking alcohol with primidone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Major:
butabarbital Alcohol (Ethanol)
Applies to: butabarbital
Ask your doctor before using butabarbital together with ethanol (alcohol), this can add to dizziness, drowsiness and other side effects of butabarbital. Be careful if you drive or do activities that require you to be awake and alert. Talk with your doctor before using any medications together, or drinking alcohol with butabarbital. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
46 potential interactions Applies to: 17 conditions, including Depression, Vitamin D Deficiency, Psychosis, Adrenal Insufficiency, and Liver Disease.
Acute Alcohol Intoxication
Major:
butabarbital
Butabarbital has a major potential interaction with Acute Alcohol Intoxication.
The use of barbiturates is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of barbiturates may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with barbiturates should be administered cautiously in patients who might be prone to acute alcohol intake.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Acute Alcohol Intoxication.
The use of barbiturates is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of barbiturates may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with barbiturates should be administered cautiously in patients who might be prone to acute alcohol intake.
Adrenal Insufficiency
Moderate:
butabarbital
Butabarbital has a moderate potential interaction with Adrenal Insufficiency.
Barbiturates, especially phenobarbital, secobarbital and butabarbital, may diminish the systemic effects of exogenous and endogenous corticosteroids via induction of hepatic microsomal enzymes, thereby accelerating the metabolism of corticosteroids. In addition, barbiturates may interfere with pituitary corticotropin production. Therapy with barbiturates should be administered cautiously in patients with adrenal insufficiency. Patients with borderline hypoadrenalism should be monitored closely, and patients receiving steroid supplementation may require an adjustment in dosage when barbiturates are added to or withdrawn from their medication regimen.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Adrenal Insufficiency.
Barbiturates, especially phenobarbital, secobarbital and butabarbital, may diminish the systemic effects of exogenous and endogenous corticosteroids via induction of hepatic microsomal enzymes, thereby accelerating the metabolism of corticosteroids. In addition, barbiturates may interfere with pituitary corticotropin production. Therapy with barbiturates should be administered cautiously in patients with adrenal insufficiency. Patients with borderline hypoadrenalism should be monitored closely, and patients receiving steroid supplementation may require an adjustment in dosage when barbiturates are added to or withdrawn from their medication regimen.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Adrenal Insufficiency.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Alcoholism
Major:
butabarbital
Butabarbital has a major potential interaction with Alcoholism.
Barbiturates have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages. Abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance to a barbiturate, overdosage can still produce respiratory depression and death, and cross-tolerance usually will occur with other agents in the class. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with barbiturates. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of barbiturates should be undertaken gradually using a dosage-tapering schedule.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Alcoholism.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Alcoholism.
Barbiturates have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages. Abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance to a barbiturate, overdosage can still produce respiratory depression and death, and cross-tolerance usually will occur with other agents in the class. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with barbiturates. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of barbiturates should be undertaken gradually using a dosage-tapering schedule.
Asphyxia
Major:
butabarbital
Butabarbital has a major potential interaction with Asphyxia.
Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Asphyxia.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Asphyxia.
Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.
Bone Marrow Depression/Low Blood Counts
Moderate:
butabarbital
Butabarbital has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.
Hematologic toxicity, including agranulocytosis, thrombocytopenic purpura and megaloblastic anemia, has been reported rarely during use of barbiturates. Therapy with barbiturates should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Blood counts are recommended prior to and periodically during long-term therapy, and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, easy bruising, petechiae, bleeding, pallor, dizziness, or jaundice. Barbiturate therapy should be discontinued if blood dyscrasias occur.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.
Hematologic toxicity, including agranulocytosis, thrombocytopenic purpura and megaloblastic anemia, has been reported rarely during use of barbiturates. Therapy with barbiturates should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Blood counts are recommended prior to and periodically during long-term therapy, and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, easy bruising, petechiae, bleeding, pallor, dizziness, or jaundice. Barbiturate therapy should be discontinued if blood dyscrasias occur.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Depression
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Depression.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Moderate:
butabarbital
Butabarbital has a moderate potential interaction with Depression.
Barbiturates depress the central nervous system and may cause or exacerbate mental depression. Therapy with barbiturates should be administered cautiously in patients with a history of depression or suicidal tendencies. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Depression.
Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Depression.
Barbiturates depress the central nervous system and may cause or exacerbate mental depression. Therapy with barbiturates should be administered cautiously in patients with a history of depression or suicidal tendencies. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Dermatitis, Drug-Induced
Major:
butabarbital
Butabarbital has a major potential interaction with Dermatitis, Drug-Induced.
Skin eruptions may precede rare but potentially fatal barbiturate-induced reactions such as systemic lupus erythematosus and exfoliative dermatitis, the latter of which may be accompanied by hepatitis and jaundice. Therapy with barbiturates should be administered cautiously in patients with preexisting drug-induced dermatitis, since it may delay the recognition of a potential reaction to barbiturates. Barbiturate therapy should be withdrawn promptly at the first sign of a dermatologic adverse effect. However, cutaneous reactions may proceed to an irreversible stage even after cessation of medication due to the slow rate of metabolism and excretion of barbiturates. Patients should be advised to promptly report signs that may indicate impending development of barbiturate-related cutaneous lesions, including high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Rashes may be more likely to occur with phenobarbital and mephobarbital.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Dermatitis, Drug-Induced.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Dermatitis, Drug-Induced.
Skin eruptions may precede rare but potentially fatal barbiturate-induced reactions such as systemic lupus erythematosus and exfoliative dermatitis, the latter of which may be accompanied by hepatitis and jaundice. Therapy with barbiturates should be administered cautiously in patients with preexisting drug-induced dermatitis, since it may delay the recognition of a potential reaction to barbiturates. Barbiturate therapy should be withdrawn promptly at the first sign of a dermatologic adverse effect. However, cutaneous reactions may proceed to an irreversible stage even after cessation of medication due to the slow rate of metabolism and excretion of barbiturates. Patients should be advised to promptly report signs that may indicate impending development of barbiturate-related cutaneous lesions, including high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Rashes may be more likely to occur with phenobarbital and mephobarbital.
Drug Dependence
Major:
butabarbital
Butabarbital has a major potential interaction with Drug Dependence.
Barbiturates have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages. Abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance to a barbiturate, overdosage can still produce respiratory depression and death, and cross-tolerance usually will occur with other agents in the class. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with barbiturates. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of barbiturates should be undertaken gradually using a dosage-tapering schedule.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Drug Dependence.
Barbiturates have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages. Abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance to a barbiturate, overdosage can still produce respiratory depression and death, and cross-tolerance usually will occur with other agents in the class. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with barbiturates. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of barbiturates should be undertaken gradually using a dosage-tapering schedule.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Drug Dependence.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Hyperkinetic Syndrome of Childhood
Moderate:
butabarbital
Butabarbital has a moderate potential interaction with Hyperkinetic Syndrome of Childhood.
Paradoxical reactions characterized by excitability and restlessness may occur in pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with barbiturates.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Hyperkinetic Syndrome of Childhood.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Hyperkinetic Syndrome of Childhood.
Paradoxical reactions characterized by excitability and restlessness may occur in pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with barbiturates.
Liver Disease
Major:
butabarbital
Butabarbital has a major potential interaction with Liver Disease.
Barbiturates are extensively metabolized by the liver. The plasma clearance of barbiturates may be decreased and the half-lives prolonged in patients with impaired hepatic function. Therapy with barbiturates should be administered cautiously and initiated at reduced dosages in patients with liver disease. Barbiturates are not recommended for use in patients with cirrhosis, hepatic failure, hepatic coma, or other severe hepatic impairment.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Liver Disease.
During chronic administration, primidone is slowly metabolized by the liver and excreted in the urine as phenylethylmalonamide (PEMA), phenobarbital and p-hydroxyphenobarbital, the latter two of which are pharmacologically active. The plasma clearance of primidone and its metabolites may be decreased and the half-lives prolonged in patients with impaired hepatic and/or renal function. Therapy with primidone should be administered cautiously and initiated at reduced dosages in patients with liver and/or renal disease.
Panhypopituitarism
Moderate:
butabarbital
Butabarbital has a moderate potential interaction with Panhypopituitarism.
Barbiturates, especially phenobarbital, secobarbital and butabarbital, may diminish the systemic effects of exogenous and endogenous corticosteroids via induction of hepatic microsomal enzymes, thereby accelerating the metabolism of corticosteroids. In addition, barbiturates may interfere with pituitary corticotropin production. Therapy with barbiturates should be administered cautiously in patients with adrenal insufficiency. Patients with borderline hypoadrenalism should be monitored closely, and patients receiving steroid supplementation may require an adjustment in dosage when barbiturates are added to or withdrawn from their medication regimen.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Panhypopituitarism.
Barbiturates, especially phenobarbital, secobarbital and butabarbital, may diminish the systemic effects of exogenous and endogenous corticosteroids via induction of hepatic microsomal enzymes, thereby accelerating the metabolism of corticosteroids. In addition, barbiturates may interfere with pituitary corticotropin production. Therapy with barbiturates should be administered cautiously in patients with adrenal insufficiency. Patients with borderline hypoadrenalism should be monitored closely, and patients receiving steroid supplementation may require an adjustment in dosage when barbiturates are added to or withdrawn from their medication regimen.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Panhypopituitarism.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Porphyria
Major:
butabarbital
Butabarbital has a major potential interaction with Porphyria.
The use of barbiturates is contraindicated in patients with a history of porphyria. Barbiturates may exacerbate acute intermittent porphyria or porphyria variegata by inducing the enzymes responsible for porphyrin synthesis.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Porphyria.
The use of barbiturates is contraindicated in patients with a history of porphyria. Barbiturates may exacerbate acute intermittent porphyria or porphyria variegata by inducing the enzymes responsible for porphyrin synthesis.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Porphyria.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Psychosis
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Psychosis.
Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.
Pulmonary Impairment
Major:
butabarbital
Butabarbital has a major potential interaction with Pulmonary Impairment.
Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Pulmonary Impairment.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Pulmonary Impairment.
Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.
Renal Dysfunction
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Renal Dysfunction.
During chronic administration, primidone is slowly metabolized by the liver and excreted in the urine as phenylethylmalonamide (PEMA), phenobarbital and p-hydroxyphenobarbital, the latter two of which are pharmacologically active. The plasma clearance of primidone and its metabolites may be decreased and the half-lives prolonged in patients with impaired hepatic and/or renal function. Therapy with primidone should be administered cautiously and initiated at reduced dosages in patients with liver and/or renal disease.
Respiratory Arrest
Major:
butabarbital
Butabarbital has a major potential interaction with Respiratory Arrest.
Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Respiratory Arrest.
Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.
Major:
Mysoline
The primidone in Mysoline has a major potential interaction with Respiratory Arrest.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Vitamin D Deficiency
Moderate:
butabarbital
Butabarbital has a moderate potential interaction with Vitamin D Deficiency.
Rickets and osteomalacia have rarely been reported following prolonged use of barbiturates, possibly due to increased metabolism of vitamin D as a result of enzyme induction by barbiturates. Long-term therapy with barbiturates should be administered cautiously in patients with vitamin D deficiency.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Vitamin D Deficiency.
Since primidone is structurally related to the barbiturate-derivative anticonvulsants and also partially metabolized to phenobarbital during chronic administration, the usual contraindications, warnings and precautions applicable to barbiturates should be observed with primidone.
Moderate:
Mysoline
The primidone in Mysoline has a moderate potential interaction with Vitamin D Deficiency.
Rickets and osteomalacia have rarely been reported following prolonged use of barbiturates, possibly due to increased metabolism of vitamin D as a result of enzyme induction by barbiturates. Long-term therapy with barbiturates should be administered cautiously in patients with vitamin D deficiency.
More resources
butabarbital
A total of 603 drugs are known to interact with butabarbital.
- Butabarbital is in the drug class barbiturates.
- Butabarbital is used to treat the following conditions:
Mysoline
A total of 730 drugs are known to interact with Mysoline.
- Mysoline is in the drug class barbiturate anticonvulsants.
- Mysoline is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.