Can you take Mysoline with Vincristine?
1 drug interaction and 43 additional warnings found for the following 2 drugs:
- Mysoline (primidone)
- vincristine
Drug interactions
Moderate drug interactions
Moderate:
primidone vinCRIStine
Applies to: Mysoline (primidone) and vincristine
Talk to your doctor before using vinCRIStine together with primidone. Combining these medications may reduce the blood levels and effects of vinCRIStine. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. 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.
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.
Disease interactions
42 potential interactions Applies to: 24 conditions, including Depression, Vitamin D Deficiency, Constipation, Peripheral Neuropathy, and Fever.
Acute Alcohol Intoxication
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:
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.
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.
Alcoholism
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.
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.
Asphyxia
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:
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.
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:
vincristine
vinCRIStine has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.
Vincristine induces dose-related myelosuppression. Leukopenia, thrombocytopenia, and anemia have been reported, however vincristine does not appear to have a consistent or significant effect on platelets or red blood cells. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Therapy with vincristine should be administered cautiously in patients with compromised bone marrow reserve. Monitor complete blood counts prior to each dose. If Grade 3 or 4 neutropenia, thrombocytopenia, or anemia develops, consider a dose modification or reduction as well as supportive care measures.
Constipation
Moderate:
vincristine
vinCRIStine has a moderate potential interaction with Constipation.
Vincristine can cause constipation. Ileus, bowel obstruction, and colonic pseudo-obstruction have occurred. When using this agent in people at risk of constipation, appropriate measures should be instituted to prevent such complications. A routine prophylactic regimen against constipation is recommended for all patients receiving vincristine.
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:
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:
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.
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.
Drug Dependence
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.
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.
Fever
Moderate:
vincristine
vinCRIStine has a moderate potential interaction with Fever.
Vincristine induces dose-related myelosuppression. Leukopenia, thrombocytopenia, and anemia have been reported, however vincristine does not appear to have a consistent or significant effect on platelets or red blood cells. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Therapy with vincristine should be administered cautiously in patients with compromised bone marrow reserve. Monitor complete blood counts prior to each dose. If Grade 3 or 4 neutropenia, thrombocytopenia, or anemia develops, consider a dose modification or reduction as well as supportive care measures.
Gastrointestinal Obstruction
Moderate:
vincristine
vinCRIStine has a moderate potential interaction with Gastrointestinal Obstruction.
Vincristine can cause constipation. Ileus, bowel obstruction, and colonic pseudo-obstruction have occurred. When using this agent in people at risk of constipation, appropriate measures should be instituted to prevent such complications. A routine prophylactic regimen against constipation is recommended for all patients receiving vincristine.
Hyperkinetic Syndrome of Childhood
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.
Infection
Moderate:
vincristine
vinCRIStine has a moderate potential interaction with Infection.
Vincristine induces mild, dose-related myelosuppression. The use of vincristine may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with vincristine. Clinical monitoring of hematopoetic function is recommended.
Liver Disease
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.
Moderate:
vincristine
vinCRIStine has a moderate potential interaction with Liver Disease.
Vincristine is primarily metabolized by the liver. The influence of severe hepatic impairment on the safety and efficacy of vincristine has not been evaluated. Additionally, fatal liver toxicity and elevated levels of aspartate aminotransferase have occurred in clinical trials. Vincristine should be reduced or interrupted if there is evidence of hepatic toxicity. Therapy with vincristine should be administered cautiously and dosages reduced in patients with compromised hepatic function. Close clinical monitoring of hepatic function is recommended.
Neurological Disorders
Major:
vincristine
vinCRIStine has a major potential interaction with Neurological Disorders.
The use of vincristine is contraindicated in patients with demyelinating conditions including Charcot-Marie-Tooth syndrome. Neurotoxicity associated with vincristine therapy is dose-related and frequently sequential. Sensorimotor (paresthesia, decreased deep- tendon reflex, ataxia, paralysis), autonomic (constipation and adynamic ileus), and CNS (mental status changes, seizures, coma) neurotoxicity have been reported. Patients with existing neuromuscular or neurologic diseases may be at increased risk for toxicity with vincristine therapy. Therapy with vincristine should be administered cautiously and dosage reduction considered in patients with neurologic dysfunction.
Panhypopituitarism
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.
Peripheral Neuropathy
Major:
vincristine
vinCRIStine has a major potential interaction with Peripheral Neuropathy.
The use of vincristine is contraindicated in patients with demyelinating conditions including Charcot-Marie-Tooth syndrome. Neurotoxicity associated with vincristine therapy is dose-related and frequently sequential. Sensorimotor (paresthesia, decreased deep- tendon reflex, ataxia, paralysis), autonomic (constipation and adynamic ileus), and CNS (mental status changes, seizures, coma) neurotoxicity have been reported. Patients with existing neuromuscular or neurologic diseases may be at increased risk for toxicity with vincristine therapy. Therapy with vincristine should be administered cautiously and dosage reduction considered in patients with neurologic dysfunction.
Porphyria
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.
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.
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:
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.
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:
vincristine
vinCRIStine has a major potential interaction with Pulmonary Impairment.
Acute shortness of breath and bronchospasm, some severe and life-threatening, have been reported with the use of vinca alkaloids. These reactions were observed most often during combination therapy with mitomycin C, occurring within minutes to several hours after administration of the vinca alkaloid or up to 2 weeks following the mitomycin dose. Therapy with vinca alkaloids should be administered cautiously in patients with preexisting pulmonary dysfunction. Aggressive treatment may be necessary, including use of supplemental oxygen, bronchodilators, and/or corticosteroids. In patients who develop progressive dyspnea requiring chronic therapy, vinca alkaloid should not be readministered.
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.
Moderate:
vincristine
vinCRIStine has a moderate potential interaction with Renal Dysfunction.
The influence of renal impairment on the safety, efficacy, and pharmacokinetics of vincristine has not been evaluated. Caution and monitoring of renal function is advised in patients with renal impairment.
Respiratory Arrest
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.
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.
SIADH
Moderate:
vincristine
vinCRIStine has a moderate potential interaction with SIADH.
A syndrome of sudden inappropriate antidiuretic hormone (SIADH) secretion has been reported rarely in association with the use of vincristine. Therapy with vincristine should be administered cautiously in patients with or predisposed to abnormal antidiuretic hormone release and/or suppression.
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
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:
vincristine
A total of 522 drugs are known to interact with vincristine.
- Vincristine is in the drug class mitotic inhibitors.
- Vincristine 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.