Drug interactions
Dabigatran etexilate + Primidone
Severity: Major
Dabigatran etexilate and Primidone: major 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 is metabolized to phenobarbital, a P-gp inducer, which may lower dabigatran exposure. Reduced efficacy raises the risk of thromboembolism.
What this interaction means in plain words
Dabigatran etexilate 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.
Dabigatran etexilate belongs to Cardiovascular; Primidone belongs to Central Nervous System.
Why it happens
P-glycoprotein induction by primidone and its metabolite phenobarbital reduces dabigatran absorption.
What to do
Avoid the combination and use a non-inducing antiseizure drug or switch to warfarin with INR monitoring. If both are required, monitor closely for thrombotic events.
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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Other interactions of Dabigatran etexilate
- Dabigatran etexilate + Defibrotide Contraindicated
- Dabigatran etexilate + Ketorolac Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
- Abciximab + Dabigatran etexilate Major
- Alteplase + Dabigatran etexilate Major
- Amiodarone + Dabigatran etexilate 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 Dabigatran etexilate with Primidone?
MediHelp rates the interaction as major. Dabigatran etexilate 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, a P-gp inducer, which may lower dabigatran exposure. Reduced efficacy raises the risk of thromboembolism.
How serious is the interaction between Dabigatran etexilate 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: Avoid the combination and use a non-inducing antiseizure drug or switch to warfarin with INR monitoring. If both are required, monitor closely for thrombotic events.
What other medicines interact with Dabigatran etexilate?
MediHelp also lists interactions of Dabigatran etexilate with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dabigatran etexilate page.
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