Drug interactions
Nevirapine + Primidone
Severity: Major
Nevirapine and Primidone: major 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 can lower nevirapine concentrations. This may lead to loss of HIV suppression and development of resistance.
What this interaction means in plain words
Nevirapine and Primidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Nevirapine belongs to Anti Virals; Primidone belongs to Central Nervous System.
Why it happens
Primidone and its metabolite phenobarbital induce CYP3A4 and CYP2B6, increasing nevirapine clearance.
What to do
Prefer a non-inducing anticonvulsant such as levetiracetam. If the combination is used, monitor viral load and nevirapine trough levels.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine 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 Nevirapine with Primidone?
MediHelp rates the interaction as major. Nevirapine and Primidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Primidone is metabolized to phenobarbital, an enzyme inducer, and can lower nevirapine concentrations. This may lead to loss of HIV suppression and development of resistance.
How serious is the interaction between Nevirapine and Primidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-inducing anticonvulsant such as levetiracetam. If the combination is used, monitor viral load and nevirapine trough levels.
What other medicines interact with Nevirapine?
MediHelp also lists interactions of Nevirapine with, for example, Elbasvir / grazoprevir, Ranolazine, St john's wort. The full list is on the Nevirapine page.
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