Drug/Small Molecule:
primidone

PharmGKB contains no dosing guidelines for this drug/small molecule. To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.

PharmGKB has no annotated drug labels with pharmacogenomic information for this drug/small molecule. If you know of a drug label with PGx, send us a message.

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?
Spartan RX CYP2C19 System CYP2C19*17, CYP2C19*2, CYP2C19*3 , rs12248560 , rs4986893 , rs4244285

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

Gene ? Variant?
(138)
Alternate Names / Tag SNPs ? Drugs ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
VIP No VIP available No VIP available CYP2C19 *2A N/A N/A N/A
VIP No VIP available No VIP available CYP2C19 *3A N/A N/A N/A
rs4244285 24154G>A, 24154G>C, 47346080G>A, 47346080G>C, 681G>A, 681G>C, 96541616G>A, 96541616G>C, CYP2C19*2, CYP2C19:681G>A, CYP2C19:G681A, Pro227=
G > C
G > A
Synonymous
Pro227Pro
rs4986893 22948G>A, 47344874G>A, 636G>A, 96540410G>A, CYP2C19*3, CYP2C19:636G>A, CYP2C19:G636A, Trp212Ter
G > A
Stop Codon
Trp212null
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 138
2D structure from PubChem
provided by PubChem

Overview

Generic Names
Trade Names
  • Apo-Primidone
  • Cyral
  • Desoxyphenobarbitone
  • Hexadiona
  • Hexamidine
  • Lepimidin
  • Lepsiral
  • Liskantin
  • Majsolin
  • Medi-Pets
  • Midone
  • Milepsin
  • Misodine
  • Misolyne
  • Mizodin
  • Mizolin
  • Myidone
  • Mylepsin
  • Mylepsinum
  • Mysedon
  • Mysoline
  • Neurosyn
  • Pms Primidone
  • Prilepsin
  • Primacione
  • Primaclone
  • Primacone
  • Primakton
  • Primidon
  • Primidone Methanol Solution
  • Primoline
  • Prysoline
  • Pyrimidone "Medi-Pets"
  • Pyrimidone Medi-Pets
  • Resimatil
  • Sertan
Brand Mixture Names

PharmGKB Accession Id:
PA451105

Description

An antiepileptic agent related to the barbiturates; it is partly metabolized to phenobarbital in the body and owes some of its actions to this metabolite. Adverse effects are reported to be more frequent than with phenobarbital. (From Martindale, The Extra Pharmacopoeia, 30th ed, p309)

Source: Drug Bank

Indication

For the treatment of epilepsy

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Primidone is a GABA receptor agonist. The mechanism of Primidone's antiepileptic action is not known.

Source: Drug Bank

Pharmacology

Primidone is a barbiturate with anticonvulsant properties. Primidone, either alone or used concomitantly with other anticonvulsants, is indicated in the control of grand mal, psychomotor, and focal epileptic seizures. It may control grand mal seizures refractory to other anticonvulsant therapy. Primidone raises electro- or chemoshock seizure thresholds or alters seizure patterns in experimental animals. Primidone per se has anticonvulsant activity as do its two metabolites, phenobarbital and phenylethylmalonamide (PEMA). In addition to its anticonvulsant activity, Primidone potentiates that of phenobarbital in experimental animals.

Source: Drug Bank

Food Interaction

Avoid alcohol.|Avoid high doses of caffeine.|Take with food to reduce gastric irritation.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic

Source: Drug Bank

Protein Binding

70%

Source: Drug Bank

Absorption

90 to 100%

Source: Drug Bank

Half-Life

3-23 hours

Source: Drug Bank

Toxicity

Symptoms of an overdose typically include sluggishness, incoordination, difficulty in thinking, slowness of speech, faulty judgment, drowsiness or coma, shallow breathing, staggering, and in severe cases coma and death.

Source: Drug Bank

Chemical Properties

Chemical Formula

C12H14N2O2

Source: Drug Bank

Isomeric SMILES

CCC1(C(=O)NCNC1=O)c2ccccc2

Source: OpenEye

Canonical SMILES

CCC1(C(=O)NCNC1=O)C1=CC=CC=C1

Source: Drug Bank

Average Molecular Weight

218.2518

Source: Drug Bank

Monoisotopic Molecular Weight

218.105527702

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

EvidenceGene
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
CYP2C19

Drug Targets

Gene Description
CHRNA4 (source: Drug Bank)
CHRNA7 (source: Drug Bank)
GABRA1 (source: Drug Bank)
GABRA2 (source: Drug Bank)
GABRA3 (source: Drug Bank)
GABRA4 (source: Drug Bank)
GABRA5 (source: Drug Bank)
GABRA6 (source: Drug Bank)
GRIA2 (source: Drug Bank)
GRIK2 (source: Drug Bank)

Drug Interactions

Drug Description
primidone The barbiturate, primidone, decreases the effect of aminophylline. (source: Drug Bank)
primidone The barbiturate, primidone, may decrease the effect of the corticosteroid, betamethasone. (source: Drug Bank)
primidone The enzyme inducer decreases the effect of hormones (source: Drug Bank)
primidone The enzyme inducer, primidone, decreases the effect of the hormone agent, clomifene. (source: Drug Bank)
primidone The enzyme inducer, primidone, decreases the effect of the hormone agent, conjugated estrogens. (source: Drug Bank)
primidone The barbiturate increases the effect of cyclosporine (source: Drug Bank)
primidone The barbiturate, primidone, increases the effect of cyclosporine. (source: Drug Bank)
primidone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
primidone The barbiturate, primidone, may decrease the effect of the corticosteroid, dexamethasone. (source: Drug Bank)
primidone The enzyme inducer decreases the effect of hormones (source: Drug Bank)
primidone The enzyme inducer, primidone, decreases the effect of the hormone agent, diethylstilbestrol. (source: Drug Bank)
primidone Divalproex sodium increases the effect of the barbiturate, primidone. (source: Drug Bank)
primidone The anticonvulsant decreases the effect of doxycycline (source: Drug Bank)
primidone The anticonvulsant, primidone, decreases the effect of doxycycline. (source: Drug Bank)
primidone The enzyme inducer decreases the effect of hormones (source: Drug Bank)
primidone The enzyme inducer, primidone, decreases the effect of the hormone agent, estradiol. (source: Drug Bank)
primidone This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
primidone This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
primidone Felbamate increases the effect and toxicity of phenobarbital/primidone (source: Drug Bank)
primidone Felbamate increases the effect and toxicity of phenobarbital/primidone (source: Drug Bank)
primidone The barbiturate decreases the effect of felodipine (source: Drug Bank)
primidone The barbiturate, primidone, decreases the effect of felodipine. (source: Drug Bank)
primidone The barbiturate, primidone, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
primidone Folic acid decreases the effect of anticonvulsant (source: Drug Bank)
primidone Folic acid decreases the effect of anticonvulsant, primidone. (source: Drug Bank)
primidone This CYP3A4 inducer may reduce gefitinib concentrations and pharmacological effects (source: Drug Bank)
primidone The CYP3A4 inducer, primidone, may decrease the serum concentration and therapeutic effects of gefitinib. (source: Drug Bank)
primidone The barbiturate decreases the effect of griseofulvin (source: Drug Bank)
primidone The barbiturate, primidone, decreases the effect of griseofulvin. (source: Drug Bank)
primidone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
primidone The barbiturate, primidone, may decrease the effect of the corticosteroid, hydrocortisone. (source: Drug Bank)
primidone Phenobarbital decreases the effect of levonorgestrel (source: Drug Bank)
primidone Phenobarbital decreases the effect of levonorgestrel (source: Drug Bank)
primidone The enzyme inducer decreases the effect of hormones (source: Drug Bank)
primidone The enzyme inducer, primidone, decreases the effect of the hormone agent, medroxyprogesterone. (source: Drug Bank)
primidone The enzyme inducer decreases the effect of hormones (source: Drug Bank)
primidone The enzyme inducer, primidone, decreases the effect of the hormone agent, megestrol. (source: Drug Bank)
primidone The barbiturate decreases the effect of methadone (source: Drug Bank)
primidone The barbiturate, primidone, decreases the effect of methadone. (source: Drug Bank)
primidone The barbiturate decreases the effect of metabolized beta-blocker (source: Drug Bank)
primidone The barbiturate decreases the effect of metabolized beta-blocker (source: Drug Bank)
primidone The barbiturate decreases the effect of metronidazole (source: Drug Bank)
primidone The barbiturate, primidone, decreases the effect of metronidazole. (source: Drug Bank)
primidone The barbiturate decreases the effect of the calcium channel blocker (source: Drug Bank)
primidone The barbiturate, primidone, decreases the effect of the calcium channel blocker, nifedipine. (source: Drug Bank)
primidone This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
primidone This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
primidone The barbiturate, primidone, decreases the effect of oxtriphylline. (source: Drug Bank)
primidone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
primidone The barbiturate, primidone, may decrease the effect of the corticosteroid, prednisolone. (source: Drug Bank)
primidone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
primidone The barbiturate, primidone, may decrease the effect of the corticosteroid, prednisone. (source: Drug Bank)
acenocoumarol The barbiturate decreases the anticoagulant effect (source: Drug Bank)
acenocoumarol The barbiturate, primidone, decreases the anticoagulant effect of acenocoumarol. (source: Drug Bank)
aminophylline The barbiturate, primidone, decreases the effect of aminophylline. (source: Drug Bank)
anisindione The barbiturate, primidone, decreases the anticoagulant effect of anisindione. (source: Drug Bank)
betamethasone The barbiturate, primidone, may decrease the effect of the corticosteroid, betamethasone. (source: Drug Bank)
chlorotrianisene The enzyme inducer, primidone, decreases the effect of the hormone agent, chlorotrianisene. (source: Drug Bank)
clomifene The enzyme inducer decreases the effect of hormones (source: Drug Bank)
clomifene The enzyme inducer, primidone, decreases the effect of the hormone agent, clomifene. (source: Drug Bank)
conjugated estrogens The enzyme inducer, primidone, decreases the effect of the hormone agent, conjugated estrogens. (source: Drug Bank)
cortisone acetate The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
cyclosporine The barbiturate increases the effect of cyclosporine (source: Drug Bank)
cyclosporine The barbiturate, primidone, increases the effect of cyclosporine. (source: Drug Bank)
dexamethasone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
dexamethasone The barbiturate, primidone, may decrease the effect of the corticosteroid, dexamethasone. (source: Drug Bank)
dicumarol The barbiturate decreases the anticoagulant effect (source: Drug Bank)
dicumarol The barbiturate, primidone, decreases the anticoagulant effect, dicumarol. (source: Drug Bank)
diethylstilbestrol The enzyme inducer decreases the effect of hormones (source: Drug Bank)
diethylstilbestrol The enzyme inducer, primidone, decreases the effect of the hormone agent, diethylstilbestrol (source: Drug Bank)
doxycycline The anticonvulsant decreases the effect of doxycycline (source: Drug Bank)
doxycycline The anticonvulsant, primidone, decreases the effect of doxycycline. (source: Drug Bank)
dyphylline The barbiturate, primidone, decreases the effect of dyphylline. (source: Drug Bank)
estradiol The enzyme inducer decreases the effect of hormones (source: Drug Bank)
estriol The enzyme inducer, primidone, decreases the effect of the hormone agent, estriol. (source: Drug Bank)
estrone The enzyme inducer decreases the effect of hormones (source: Drug Bank)
estrone The enzyme inducer, primidone, decreases the effect of the hormone agent, estrone. (source: Drug Bank)
ethinyl estradiol This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
felbamate Felbamate increases the effect and toxicity of primidone (source: Drug Bank)
felbamate Felbamate increases the effect and toxicity of primidone (source: Drug Bank)
felodipine The barbiturate decreases the effect of felodipine (source: Drug Bank)
felodipine The barbiturate, primidone, decreases the effect of felodipine. (source: Drug Bank)
fludrocortisone The barbiturate, primidone, may decrease the effect of the corticosteroid, fludrocortisone. (source: Drug Bank)
folic acid Folic acid decreases the effect of anticonvulsant (source: Drug Bank)
gefitinib This CYP3A4 inducer may reduce gefitinib plasma concentrations and pharmacological effects (source: Drug Bank)
gefitinib The CYP3A4 inducer, primidone, may decrease the serum concentration and therapeutic effects of gefitinib. (source: Drug Bank)
griseofulvin The barbiturate decreases the effect of griseofulvine (source: Drug Bank)
griseofulvin The barbiturate, primidone, decreases the effect of griseofulvin. (source: Drug Bank)
hydrocortisone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
hydrocortisone The barbiturate, primidone, may decrease the effect of the corticosteroid, hydrocortisone. (source: Drug Bank)
levonorgestrel Phenobarbital decreases the effect of levonorgestrel (source: Drug Bank)
levonorgestrel Phenobarbital decreases the effect of levonorgestrel (source: Drug Bank)
medroxyprogesterone The enzyme inducer decreases the effect of hormones (source: Drug Bank)
medroxyprogesterone The enzyme inducer, primidone, decreases the effect of the hormone, medroxyprogesterone. (source: Drug Bank)
megestrol The enzyme inducer decreases the effect of hormones (source: Drug Bank)
megestrol The enzyme inducer, primidone, decreases the effect of the hormone, megestrol. (source: Drug Bank)
mestranol This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
mestranol This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
methadone The barbiturate decreases the effect of methadone (source: Drug Bank)
methadone The barbiturate, primidone, decreases the effect of methadone. (source: Drug Bank)
methoxyflurane The barbiturate increases the renal toxicity of methoxyflurane (source: Drug Bank)
methoxyflurane The barbiturate, primidone, increases the renal toxicity of methoxyflurane. (source: Drug Bank)
methylprednisolone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
methylprednisolone The barbiturate, primidone, may decrease the effect of the corticosteroid, methylprednisolone. (source: Drug Bank)
metoprolol The barbiturate decreases the effect of metabolized beta-blocker (source: Drug Bank)
metoprolol The barbiturate decreases the effect of metabolized beta-blocker (source: Drug Bank)
metronidazole The barbiturate decreases the effect of metronidazole (source: Drug Bank)
metronidazole The barbiturate, primidone, decreases the effect of metronidazole. (source: Drug Bank)
nifedipine The barbiturate decreases the effect of the calcium channel blocker (source: Drug Bank)
nifedipine The barbiturate, primidone, decreases the effect of the calcium channel blocker, nifedipine. (source: Drug Bank)
norethindrone This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
norethindrone This product may cause a slight decrease of contraceptive effect (source: Drug Bank)
oxtriphylline The barbiturate, primidone, decreases the effect of oxtriphylline. (source: Drug Bank)
paramethasone The barbiturate, primidone, may decrease the effect of the corticosteroid, paramethasone. (source: Drug Bank)
prednisolone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
prednisolone The barbiturate, primidone, may decrease the effect of the corticosteroid, prednisolone. (source: Drug Bank)
prednisone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
prednisone The barbiturate, primidone, may decrease the effect of the corticosteroid, prednisone. (source: Drug Bank)
propranolol The barbiturate decreases the effect of metabolized beta-blocker (source: Drug Bank)
propranolol The barbiturate decreases the effect of metabolized beta-blocker (source: Drug Bank)
quinestrol The enzyme inducer, primidone, decreases the effect of the hormone agent, quinestrol. (source: Drug Bank)
quinidine The anticonvulsant decreases the effect of quinidine (source: Drug Bank)
quinidine The anticonvulsant, primidone, decreases the effect of quinidine. (source: Drug Bank)
sodium Divalproex sodium increases the effect of the barbiturate, primidone. (source: Drug Bank)
theophylline The barbiturate decreases the effect of theophylline (source: Drug Bank)
theophylline The barbiturate, primidone, decreases the effect of theophylline. (source: Drug Bank)
triamcinolone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
triamcinolone The barbiturate, primidone, may decrease the effect of the corticosteroid, triamcinolone. (source: Drug Bank)
verapamil The barbiturate decreases the effect of the calcium channel blocker (source: Drug Bank)
verapamil The barbiturate, primidone, decreases the effect of the calcium channel blocker, verapamil. (source: Drug Bank)
voriconazole The barbiturate decreases the effect of voriconazole (source: Drug Bank)
voriconazole The barbiturate, primidone, decreases the effect of voriconazole. (source: Drug Bank)
warfarin The barbiturate decreases the anticoagulant effect (source: Drug Bank)
warfarin The barbiturate, primidone, decreases the anticoagulant effect of warfarin. (source: Drug Bank)
primidone The barbiturate decreases the effect of metabolized beta-blocker (source: Drug Bank)
primidone The barbiturate decreases the effect of metabolized beta-blocker (source: Drug Bank)
primidone The anticonvulsant decreases the effect of quinidine (source: Drug Bank)
primidone The anticonvulsant, primidone, decreases the effect of quinidine. (source: Drug Bank)
primidone Primidone may decrease the plasma concentration of Telithromycin. Consider alternate therapy. (source: Drug Bank)
primidone Primidone may increase the metabolism of Temsirolimus decreasing its efficacy. Concomitant therapy should be avoided. (source: Drug Bank)
primidone The barbiturate decreases the effect of theophylline (source: Drug Bank)
primidone The barbiturate, primidone, decreases the effect of theophylline. (source: Drug Bank)
primidone Primidone may decrease the effect of Tramadol by increasing Tramadol metabolism and clearance. (source: Drug Bank)
primidone The CYP3A4 inducer, Primidone, may decrease Trazodone efficacy by increasing Trazodone metabolism and clearance. Monitor for changes in Trazodone efficacy/toxicity if Primidone is initiated, discontinued or dose changed. (source: Drug Bank)
primidone The CYP3A4 inducer, Primidone, may decrease Trazodone efficacy by increasing Trazodone metabolism and clearance. Monitor for changes in Trazodone efficacy/toxicity if Primidone is initiated, discontinued or dose changed. (source: Drug Bank)
primidone The strong CYP2C8 inducer, Primidone, may increase the metabolism and clearance of oral Tretinoin. Consider alternate therapy to avoid failure of Tretinoin therapy or monitor for changes in Tretinoin effectiveness and adverse/toxic effects if Primidone is initiated, discontinued or dose changed. (source: Drug Bank)
primidone The barbiturate decreases the effect of the corticosteroid (source: Drug Bank)
primidone The barbiturate, primidone, may decrease the effect of the corticosteroid, triamcinolone. (source: Drug Bank)
primidone The CNS depressants, Triprolidine and Primidone, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)
primidone The CNS depressants, Triprolidine and Primidone, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to primidone: 2

No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Lack of association between ABCC2 gene variants and treatment response in epilepsy. Pharmacogenomics. 2012. Hilger Eva, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
PharmGKB summary: very important pharmacogene information for cytochrome P450, family 2, subfamily C, polypeptide 19. Pharmacogenetics and genomics. 2011. Scott Stuart A, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0527-1301-01
DrugBank:
DB00794
KEGG Compound:
C07371
KEGG Drug:
D00474
PubChem Compound:
4909
PubChem Substance:
173378
46507775
Drugs Product Database (DPD):
396761
ChemSpider:
4740
Therapeutic Targets Database:
DAP000678
FDA Drug Label at DailyMed:
a1a817f7-c190-4825-94eb-442f477187e3

Clinical Trials

These are trials that mention primidone and are related to either pharmacogenetics or pharmacogenomics.

Common Searches

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.