Drug interactions
Primidone + Quinine
Severity: Moderate
Primidone and Quinine: 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 partly converted to phenobarbital, which induces CYP3A4 and lowers quinine exposure. The result may be subtherapeutic quinine levels and treatment failure.
What this interaction means in plain words
Primidone and Quinine 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 belongs to Central Nervous System; Quinine belongs to Anti Parasitic.
Why it happens
Primidone and its metabolite phenobarbital induce CYP3A4, accelerating quinine metabolism.
What to do
Monitor treatment response closely and consider an alternative antimalarial. Reassess quinine dosing if the anticonvulsant is started 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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
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 Primidone with Quinine?
MediHelp rates the interaction as moderate. Primidone and Quinine 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 partly converted to phenobarbital, which induces CYP3A4 and lowers quinine exposure. The result may be subtherapeutic quinine levels and treatment failure.
How serious is the interaction between Primidone and Quinine?
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 treatment response closely and consider an alternative antimalarial. Reassess quinine dosing if the anticonvulsant is started or stopped.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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