Drug interactions
Primidone + Ramelteon
Severity: Moderate
Primidone and Ramelteon: 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 and induces hepatic enzymes, which may lower ramelteon levels and reduce its effect. Both drugs are sedating, so additive drowsiness may also occur.
What this interaction means in plain words
Primidone and Ramelteon 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; Ramelteon belongs to Central Nervous System.
Why it happens
Enzyme induction increases ramelteon clearance, plus additive CNS depression.
What to do
Monitor sleep response and daytime sedation, and reassess ramelteon if it appears ineffective.
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 Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
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 Ramelteon?
MediHelp rates the interaction as moderate. Primidone and Ramelteon 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 and induces hepatic enzymes, which may lower ramelteon levels and reduce its effect. Both drugs are sedating, so additive drowsiness may also occur.
How serious is the interaction between Primidone and Ramelteon?
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 sleep response and daytime sedation, and reassess ramelteon if it appears ineffective.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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