Drug interactions
Hydrocortisone + Primidone
Severity: Moderate
Hydrocortisone 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 metabolized to phenobarbital, an inducer of CYP3A4, which can increase hydrocortisone clearance. Corticosteroid effect may fall, which matters in adrenal insufficiency.
What this interaction means in plain words
Hydrocortisone 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.
Hydrocortisone belongs to Endocrine; Primidone belongs to Central Nervous System.
Why it happens
CYP3A4 induction by primidone and its metabolite phenobarbital increases hydrocortisone metabolism.
What to do
Monitor clinical response and raise the hydrocortisone dose if symptoms of under-replacement appear. Reassess after primidone is discontinued.
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 Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone 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 Hydrocortisone with Primidone?
MediHelp rates the interaction as moderate. Hydrocortisone 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 metabolized to phenobarbital, an inducer of CYP3A4, which can increase hydrocortisone clearance. Corticosteroid effect may fall, which matters in adrenal insufficiency.
How serious is the interaction between Hydrocortisone 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 clinical response and raise the hydrocortisone dose if symptoms of under-replacement appear. Reassess after primidone is discontinued.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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