Primidone is a medication to relieve and control seizures. That way, patients can move normally and the risk of complications due to recurring seizures can be reduced. In addition, this drug can also be used in the treatment of tremors.

Primidone belongs to the class of barbiturate anticonvulsants . This drug will be metabolized to phenobarbital and phenylethylmalonamide (PEMA), which will affect electrical activity in the central nervous system. This way of working will help relieve seizures, including seizures during sleep .

Primidone trademarks: -

What is Primidone

class Prescription drug
Category Barbiturate  anticonvulsants
Benefit Relieves spasms  and treats  essential tremor
Consumed by Adults and children
Primidone for pregnant and lactating women Category D:  There is positive evidence of risk to the human fetus, but the benefits may outweigh the risks, for example in dealing with a life-threatening situation. Primidone may be absorbed into breast milk. If you are breastfeeding, do not take this drug before consulting a doctor.
Drug form Tablet

Precautions Before Taking Primidone

Primidone should not be used carelessly and must be in accordance with a doctor's prescription. The following things must be considered before taking primidone:

  • Do not take primidone if you are allergic to it or to phenobarbital . Tell your doctor about any history of allergies you have.
  • Tell your doctor if you have porphyria , adrenal gland disease , or a vitamin deficiency, such as folic acid  or vitamin K.
  • Tell your doctor if you have or have had liver disease , alcoholism, drug abuse , sleep apnea , COPD , kidney disease, certain mental disorders, such as depression .
  • Tell your doctor if you are taking certain medications, supplements or herbal products.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy.
  • Tell your doctor that you are taking primidone if you are planning to have certain laboratory tests or surgery.
  • Do not drive a vehicle or do activities that require alertness after taking primidone, because this drug can cause drowsiness  or dizziness .
  • Immediately see a doctor if you experience a drug allergic reaction , overdose, or serious side effects after taking primidone.

Dosage and Rules for Using Primidone

The doctor will determine the primidone dosage according to the age and condition of the patient. In general, the following is the primidone dosage according to its intended use:

Purpose:  Dealing with seizures

  • Adult
    Initial dose 100–125 mg, once daily, in the evening at bedtime. The dose may be increased by 125 mg, every 3 days, up to 500 mg per day. The maintenance dose is 750–1500 mg per day divided into 2 doses. The maximum dose is 1,500 mg per day.
  • Children
    The initial dose is 50 mg once daily, in the evening at bedtime, for the first 3 days. Followed by 50 mg, 2 times daily, for a further 3 days, and continued by 100 mg, until day 9. After day 9, the maintenance dose is 125–250 mg, 3 times daily.

Purpose:  Manage essential tremor

  • Adults
    The initial dose is 50 mg per day. Dosage may be increased gradually over 2–3 weeks. The maximum dose is 750 mg per day.

How to Take Primidone Properly

Take primidone as directed by your doctor  and read the directions for use on the package. Primidone can be taken before or after food. Swallow primidone tablets with a glass of water.

Make sure to take primidone at the same time each day so that the drug can work effectively. Do not stop using the drug suddenly because it can worsen the condition you are suffering from.

If you forget to take primidone, consume it immediately if the gap with the scheduled time for the next consumption is not too close. If it is close, ignore it and do not double the next dose.

While undergoing treatment with primidone, you will undergo a complete blood count, bone density test, folic acid level test, and monitoring for symptoms of depression. Follow the advice and examination schedule given by the doctor so that your condition can be monitored.

Store Primidone in a closed container in a cool dry place. Keep this drug out of reach of children.

Primidone Interactions with Other Drugs

The following are some of the effects of drug interactions that can occur if primidone is used with certain drugs:

  • Decreased levels of tricyclic antidepressants, beta blockers , carbamazepine, clozapine, corticosteroids , cyclophosphamide, ciclosporin , dicoumarin, digitoxin, doxycycline, ethosuximide, etoposide, granisetron, lamotrigine, losartan , methadone, mianserin, montelukast, nimodipine, birth control pills, oxcarbazepine, phenytoin , quinidine , rocuronium, tiagabine, topiramate , vecuronium, warfarin, or zonisamide in the body.
  • Increased blood levels of primidone when used with chloramphenicol , felbamate, nelfinavir, metronidazole , or sodium valproate.
  • Increased risk of liver damage when used with paracetamol
  • Increased risk of side effects when used with other opioid or barbiturate class drugs

Primidone Side Effects and Dangers

The side effects that can arise after consuming primidone are as follows:

  • Drowsiness
  • Dizziness  or headache
  • Nausea or vomiting
  • Lost appetite
  • Unusual fatigue or just the opposite looks too excited

Check with your doctor if the side effects above don't improve or get worse. Immediately consult a doctor if an allergic drug reaction  or more serious side effects occur, such as:

  • Visual disturbances, for example seeing certain objects in double numbers
  • Trouble walking, such as looking clumsy
  • Slow heart rate  or fast or slow breathing
  • Libido or decreased sexual desire
  • Mood disturbances, depression, or thoughts of self-harm and suicide
  • Faint
  • Easy bruising , pale skin, unusual tiredness and getting worse
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