Drug interactions
Isosorbide dinitrate + Primidone
Severity: Minor
Isosorbide dinitrate and Primidone: minor 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 and its metabolite phenobarbital induce hepatic enzymes, which may reduce nitrate exposure somewhat. Barbiturates may also add to hypotension.
What this interaction means in plain words
Isosorbide dinitrate and Primidone have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Isosorbide dinitrate belongs to Cardiovascular; Primidone belongs to Central Nervous System.
Why it happens
Enzyme induction by phenobarbital (via primidone) with additive hypotensive effects.
What to do
Monitor anginal control and blood pressure. Increase the nitrate dose only if clinically needed.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Isosorbide dinitrate
- Avanafil + Isosorbide dinitrate Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Isosorbide dinitrate + Sildenafil Contraindicated
- Isosorbide dinitrate + Tadalafil Contraindicated
- Isosorbide dinitrate + Vardenafil Contraindicated
- Ergotamine + Isosorbide dinitrate 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 Isosorbide dinitrate with Primidone?
MediHelp rates the interaction as minor. Isosorbide dinitrate and Primidone have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Primidone and its metabolite phenobarbital induce hepatic enzymes, which may reduce nitrate exposure somewhat. Barbiturates may also add to hypotension.
How serious is the interaction between Isosorbide dinitrate and Primidone?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor anginal control and blood pressure. Increase the nitrate dose only if clinically needed.
What other medicines interact with Isosorbide dinitrate?
MediHelp also lists interactions of Isosorbide dinitrate with, for example, Avanafil, Riociguat, Sildenafil. The full list is on the Isosorbide dinitrate page.
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