Drug interactions
Everolimus + Primidone
Severity: Major
Everolimus and Primidone: major interaction.
Last updated Sources: Health Canada product monograph
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, an enzyme inducer, and can lower everolimus levels, leading to loss of efficacy such as transplant rejection or reduced antitumor effect.
What this interaction means in plain words
Everolimus 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.
Everolimus belongs to Oncology; Primidone belongs to Central Nervous System.
Why it happens
Primidone and its metabolite phenobarbital induce CYP3A4, increasing everolimus clearance.
What to do
Avoid if a non-inducing anticonvulsant can be substituted. If continued, monitor everolimus trough levels and increase the dose accordingly.
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 Everolimus
- Bcg vaccine live + Everolimus Contraindicated
- Everolimus + Influenza virus vaccine quadrivalent intranasal Contraindicated
- Everolimus + Levoketoconazole Contraindicated
- Everolimus + Measles mumps and rubella vaccine live Contraindicated
- Everolimus + Measles mumps rubella and varicella vaccine live Contraindicated
- Everolimus + Measles vaccine Contraindicated
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 Everolimus with Primidone?
MediHelp rates the interaction as major. Everolimus 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, an enzyme inducer, and can lower everolimus levels, leading to loss of efficacy such as transplant rejection or reduced antitumor effect.
How serious is the interaction between Everolimus 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 if a non-inducing anticonvulsant can be substituted. If continued, monitor everolimus trough levels and increase the dose accordingly.
What other medicines interact with Everolimus?
MediHelp also lists interactions of Everolimus with, for example, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal, Levoketoconazole. The full list is on the Everolimus page.
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