Drug interactions
Aripiprazole + Primidone
Severity: Major
Aripiprazole and Primidone: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Primidone is metabolized to phenobarbital and induces CYP3A4, which can lower aripiprazole concentrations and reduce efficacy. Additive sedation also occurs.
What this interaction means in plain words
Aripiprazole and Primidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Aripiprazole belongs to Central Nervous System; Primidone belongs to Central Nervous System.
Why it happens
CYP3A4 induction increases aripiprazole clearance, plus additive CNS depression.
What to do
Consider doubling the aripiprazole dose per labeling for strong inducers and titrate by response. Reduce the dose if primidone is stopped, and monitor sedation.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Aripiprazole
- Aripiprazole + Pimozide Contraindicated
- Aripiprazole + Thioridazine Contraindicated
- Amisulpride + Aripiprazole Major
- Aripiprazole + Arsenic trioxide Major
- Aripiprazole + Calcium / magnesium / potassium / sodium oxybates Major
- Aripiprazole + Carbamazepine Major
Other interactions of Primidone
- Lorlatinib + Primidone Contraindicated
- Lurasidone + Primidone Contraindicated
- Primidone + Ranolazine Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Voriconazole Contraindicated
- Abiraterone + Primidone Major
Frequently asked questions
Can I take Aripiprazole with Primidone?
MediHelp rates the interaction as major. Aripiprazole and Primidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Primidone is metabolized to phenobarbital and induces CYP3A4, which can lower aripiprazole concentrations and reduce efficacy. Additive sedation also occurs.
How serious is the interaction between Aripiprazole and Primidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider doubling the aripiprazole dose per labeling for strong inducers and titrate by response. Reduce the dose if primidone is stopped, and monitor sedation.
What other medicines interact with Aripiprazole?
MediHelp also lists interactions of Aripiprazole with, for example, Pimozide, Thioridazine, Amisulpride. The full list is on the Aripiprazole page.
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