Drug interactions
Metoprolol + Primidone
Severity: Moderate
Metoprolol 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 partly to phenobarbital and induces hepatic enzymes, which can lower metoprolol levels. Loss of beta-blocker effect may appear over several weeks.
What this interaction means in plain words
Metoprolol 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.
Metoprolol belongs to Cardiovascular; Primidone belongs to Central Nervous System.
Why it happens
Enzyme induction by primidone and its metabolite phenobarbital increases metoprolol clearance.
What to do
Monitor heart rate and blood pressure and increase metoprolol dosage if control is inadequate. Reassess when primidone is changed 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 Metoprolol
- Metoprolol + Thioridazine Contraindicated
- Amifostine + Metoprolol Major
- Amiodarone + Metoprolol Major
- Atenolol-chlorthalidone + Metoprolol Major
- Atenolol + Metoprolol Major
- Betaxolol + Metoprolol 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 Metoprolol with Primidone?
MediHelp rates the interaction as moderate. Metoprolol 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 partly to phenobarbital and induces hepatic enzymes, which can lower metoprolol levels. Loss of beta-blocker effect may appear over several weeks.
How serious is the interaction between Metoprolol 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 heart rate and blood pressure and increase metoprolol dosage if control is inadequate. Reassess when primidone is changed or stopped.
What other medicines interact with Metoprolol?
MediHelp also lists interactions of Metoprolol with, for example, Thioridazine, Amifostine, Amiodarone. The full list is on the Metoprolol page.
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