{"id":4633,"date":"2025-03-31T18:12:14","date_gmt":"2025-03-31T18:12:14","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/primidone-txt\/"},"modified":"2025-03-31T18:12:14","modified_gmt":"2025-03-31T18:12:14","slug":"primidone-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/primidone-txt\/","title":{"rendered":"primidone.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nAnti-epileptic agent Also used for essential tremor

DOSE IN NORMAL RENAL FUNCTION <\/H3>Epilepsy: 500 mg\u20131.5 g daily in 2 divided dosesEssential tremor: 62.5\u2013750 mg daily

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :218.3<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :20<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 40<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.4\u20131<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :10\u201315\/Unchanged

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function, but avoid very large doses
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Reduce dose by 25\u201350% initially, and avoid very large single doses

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • HDF\/high flux &nbsp :Dialysed. Dose as in GFR
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antibacterials: reduced concentrations of chloramphenicol, doxycycline, metronidazole and telithromycin\n
  • Anticoagulants: increased metabolism of coumarins (reduced effect)\n
  • Antidepressants: antagonise anticonvulsant effect; reduces concentration of paroxetine, mianserin and tricyclics; St John\u2019s wort reduces active primidone metabolite concentration \u2013 avoid concomitant use\n
  • Anti-epileptics: reduces concentration of carbamazepine; carbamazepine reduces primidone concentration but increases metabolite concentration; possibly reduces concentration of ethosuximide; reduces concentration of lamotrigine and tiagabine; primidone concentration possibly reduced by phenytoin, but active metabolite increased and concentration of phenytoin may be altered; primidone concentration possibly increased by valproate, valproate concentration reduced; concentration of primidone possibly reduced by vigabatrin\n
  • Antifungals: possibly reduces concentration of posaconazole and voriconazole \u2013 avoid concomitant use; reduces absorption of griseofulvin (reduced effect)\n
  • Antimalarials: possibly increased risk of convulsions with chloroquine and hydroxychloroquine; anticonvulsant effect antagonised by mefloquine\n
  • Antipsychotics: anticonvulsant effect antagonised; metabolism of haloperidol accelerated; possibly reduces aripiprazole concentration \u2013 increase aripiprazole dose\n
  • Antivirals: concentration of indinavir, lopinavir, nelfinavir and saquinavir possibly reduced\n
  • Calcium-channel blockers: effect of felodipine, isradipine and probably other dihydropyridines, diltiazem and verapamil reduced\n
  • Ciclosporin: reduces ciclosporin blood levelsCorticosteroids: metabolism of corticosteroids accelerated, reduced effectOestrogens and progestogens: metabolism accelerated, reduced contraceptive effect

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>\u2013.PriMidonE 605

    OTHER INFORMATION <\/H4>Plasma concentrations of 5\u201312 mcg\/L (23\u2013 55 \u00b5mol\/L) have been loosely correlated with optimum responsePartially converted to phenobarbital and phenylethylmalonamide with long half-lives (metabolites may accumulate in renal impairment)May cause excessive sedation and osteomalacia.
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Anti-epileptic agent Also used for essential tremor DOSE<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4633","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4633","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4633"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4633\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4633"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4633"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4633"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}