Drug interactions
Doxorubicin + Primidone
Severity: Moderate
Doxorubicin 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, through its active metabolite phenobarbital, induces CYP3A4 and other enzymes and may lower doxorubicin exposure. This could reduce antitumor efficacy, although doxorubicin is cleared mainly by other pathways, so the effect is uncertain. Phenobarbital has also been reported to increase doxorubicin clearance.
What this interaction means in plain words
Doxorubicin 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.
Doxorubicin belongs to Oncology; Primidone belongs to Central Nervous System.
Why it happens
Enzyme induction (CYP3A4 and other hepatic enzymes) by primidone/phenobarbital increases doxorubicin metabolism.
What to do
Where possible, choose a non-inducing anticonvulsant such as levetiracetam in patients receiving doxorubicin. If combined, monitor for reduced tumor response.
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 Doxorubicin
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 Doxorubicin with Primidone?
MediHelp rates the interaction as moderate. Doxorubicin 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, through its active metabolite phenobarbital, induces CYP3A4 and other enzymes and may lower doxorubicin exposure. This could reduce antitumor efficacy, although doxorubicin is cleared mainly by other pathways, so the effect is uncertain. Phenobarbital has also been reported to increase doxorubicin clearance.
How serious is the interaction between Doxorubicin 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: Where possible, choose a non-inducing anticonvulsant such as levetiracetam in patients receiving doxorubicin. If combined, monitor for reduced tumor response.
What other medicines interact with Doxorubicin?
MediHelp also lists interactions of Doxorubicin with, for example, Adenovirus types 4 and 7 live, Belatacept, Cobicistat. The full list is on the Doxorubicin page.
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