Drug interactions
Fluconazole + Primidone
Severity: Moderate
Fluconazole 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 is converted to phenobarbital, an enzyme inducer that can lower fluconazole levels. Fluconazole may raise phenobarbital and primidone concentrations through CYP2C19 inhibition, increasing sedation.
What this interaction means in plain words
Fluconazole 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.
Fluconazole belongs to Anti Fungals; Primidone belongs to Central Nervous System.
Why it happens
Primidone-derived phenobarbital induces hepatic enzymes, and fluconazole inhibits CYP2C19 and CYP2C9.
What to do
Monitor for antifungal failure and sedation, and check anticonvulsant levels when fluconazole is started or stopped.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole 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 Fluconazole with Primidone?
MediHelp rates the interaction as moderate. Fluconazole 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 is converted to phenobarbital, an enzyme inducer that can lower fluconazole levels. Fluconazole may raise phenobarbital and primidone concentrations through CYP2C19 inhibition, increasing sedation.
How serious is the interaction between Fluconazole 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 for antifungal failure and sedation, and check anticonvulsant levels when fluconazole is started or stopped.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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