Drug interactions
Lidocaine + Primidone
Severity: Moderate
Lidocaine 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 enzyme inducer, and may increase lidocaine clearance and reduce its effect. Additive sedation is also possible.
What this interaction means in plain words
Lidocaine 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.
Lidocaine belongs to Cardiovascular; Primidone belongs to Central Nervous System.
Why it happens
Primidone and its metabolite phenobarbital induce hepatic CYP enzymes that metabolize lidocaine.
What to do
Titrate systemic lidocaine to response and ECG, and consider measuring plasma concentrations. Monitor for additive sedation.
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 Lidocaine
- Bupivacaine liposome + Lidocaine Major
- Disopyramide + Lidocaine Major
- Ex vivo expanded autologous human corneal epithelial cells containing stem cells + Lidocaine Major
- Lidocaine + Nirmatrelvir / ritonavir Major
- Lidocaine + Ombitasvir / paritaprevir / ritonavir and dasabuvir Major
- Lidocaine + Pimozide 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 Lidocaine with Primidone?
MediHelp rates the interaction as moderate. Lidocaine 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 enzyme inducer, and may increase lidocaine clearance and reduce its effect. Additive sedation is also possible.
How serious is the interaction between Lidocaine 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: Titrate systemic lidocaine to response and ECG, and consider measuring plasma concentrations. Monitor for additive sedation.
What other medicines interact with Lidocaine?
MediHelp also lists interactions of Lidocaine with, for example, Bupivacaine liposome, Disopyramide, Ex vivo expanded autologous human corneal epithelial cells containing stem cells. The full list is on the Lidocaine page.
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