Drug interactions
Primidone + Rolapitant
Severity: Major
Primidone and Rolapitant: 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 metabolised to phenobarbital, a CYP3A4 inducer, and may lower rolapitant levels. Antiemetic efficacy may be reduced.
What this interaction means in plain words
Primidone and Rolapitant 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 belongs to Central Nervous System; Rolapitant belongs to Gastrointestinal Tract.
Why it happens
Primidone and its phenobarbital metabolite induce CYP3A4, accelerating rolapitant metabolism.
What to do
Avoid combining where possible and use an alternative antiemetic approach. If unavoidable, monitor for breakthrough nausea and vomiting.
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 Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant 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 Primidone with Rolapitant?
MediHelp rates the interaction as major. Primidone and Rolapitant 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 metabolised to phenobarbital, a CYP3A4 inducer, and may lower rolapitant levels. Antiemetic efficacy may be reduced.
How serious is the interaction between Primidone and Rolapitant?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining where possible and use an alternative antiemetic approach. If unavoidable, monitor for breakthrough nausea and vomiting.
What other medicines interact with Rolapitant?
MediHelp also lists interactions of Rolapitant with, for example, Pimozide, Thioridazine, Atomoxetine. The full list is on the Rolapitant page.
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