Drug Index

Primidone

 
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Mechanism :

It is a precursor of phenobarbitone and is used as an antiepileptic agent. It is a GABAergic agent. It is used in the treatment of generalized and partial tonic clonic seizures.


Indication :

• Seizure disorder (generalized tonic clonic seizures, complex partial, simple partial seizures)


Contraindications :

Hypersensitivity to drug/class/component, Porphyria, Avoid abrupt withdrawal.


Dosing :

Neonates: 12-20 mg/kg/day PO divided bid-qid. Start with low dose and increase gradually.

<8 years: 10-25 mg/kg/day PO divided tid-qid. (Max: 2 g/day) Start with low dose and increase gradually.

>8 years: 250 mg PO tid-qid. (Max: 2 g/day) Start with low dose and increase gradually.


Adverse Effect :

Respiratory depression, hypotension, paradoxical excitement, hepatitis, mental confusion and impaired performance, hypersensitivity and severe hematological reaction. It is contraindicated in children with porphyria.


Interaction :

Ethosuximide, Valproic Acid, Griseofulvin: It may decrease levels serum concentrations.
phenytoin: May decrease primidone serum concentrations.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function, but avoid very large doses
<10Reduce dose by 25–50% initially, and avoid very large single doses

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnknown dialysability. Dose as in GFR<10 mL/min
HDDialysed. Dose as in GFR<10 mL/ min
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDDialysed. Dose as in GFR=10– 20 mL/min

Hepatic Dose :

Dose adjustment guidelines are not available. Dose adjustment may be required. In severe impairment use drug with caution, monitor closely, side effect risk is increased.
08/05/2020 08:08:18 Primidone
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