Drug interactions
Primidone + Tofacitinib
Severity: Moderate
Primidone and Tofacitinib: 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, which induces CYP3A4 and may lower tofacitinib exposure. This could result in reduced efficacy.
What this interaction means in plain words
Primidone and Tofacitinib 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; Tofacitinib belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 by primidone and its phenobarbital metabolite increases tofacitinib clearance.
What to do
Monitor for loss of response to tofacitinib; consider an alternative therapy if disease control worsens.
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 Tofacitinib
- Baricitinib + Tofacitinib Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Tofacitinib + Upadacitinib Contraindicated
- Abatacept + Tofacitinib Major
- Anti-thymocyte + Tofacitinib Major
- Antithymocyte globulin equine + Tofacitinib 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 Tofacitinib?
MediHelp rates the interaction as moderate. Primidone and Tofacitinib 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, which induces CYP3A4 and may lower tofacitinib exposure. This could result in reduced efficacy.
How serious is the interaction between Primidone and Tofacitinib?
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 for loss of response to tofacitinib; consider an alternative therapy if disease control worsens.
What other medicines interact with Tofacitinib?
MediHelp also lists interactions of Tofacitinib with, for example, Baricitinib, Cladribine, Upadacitinib. The full list is on the Tofacitinib page.
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