Drug interactions
Asenapine + Primidone
Severity: Moderate
Asenapine and Primidone: moderate interaction.
Last updated
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, which is metabolized to phenobarbital, adds to the sedative effect of asenapine and may cause excessive drowsiness or impaired coordination. Enzyme induction by primidone may also reduce asenapine concentrations.
What this interaction means in plain words
Asenapine and Primidone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Asenapine belongs to Central Nervous System; Primidone belongs to Central Nervous System.
Why it happens
Additive CNS depression; enzyme induction by primidone and its phenobarbital metabolite may lower asenapine exposure.
What to do
Monitor sedation and psychiatric response, adjusting asenapine dosing if efficacy falls. Counsel patients regarding driving and alcohol.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine 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 Asenapine with Primidone?
MediHelp rates the interaction as moderate. Asenapine and Primidone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Primidone, which is metabolized to phenobarbital, adds to the sedative effect of asenapine and may cause excessive drowsiness or impaired coordination. Enzyme induction by primidone may also reduce asenapine concentrations.
How serious is the interaction between Asenapine and Primidone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and psychiatric response, adjusting asenapine dosing if efficacy falls. Counsel patients regarding driving and alcohol.
What other medicines interact with Asenapine?
MediHelp also lists interactions of Asenapine with, for example, Pimozide, Thioridazine, Vandetanib. The full list is on the Asenapine page.
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