Primidone

Aka: Primidone, Mysoline

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II. Indications

  1. Seizure Disorder
    1. Grand Mal Seizure
    2. Psychomotor Seizure
    3. Focal Seizure
  2. Essential Tremor

III. Contraindications

  1. Porphyria
  2. Phenobarbital Hypersensitivity

IV. Mechanism

  1. Barbiturate with 2 active metabolites
    1. Phenobarbital
    2. Phenylethylmalonamide (PEMA)
  2. Raises Seizure threshold

V. Dosing: adults and children over age 8 years

  1. Titration to maintenance dose
    1. Days 1 to 3: Take 100-125 mg PO qhs
    2. Days 4 to 6: Take 100-125 mg PO bid
    3. Days 7 to 9: Take 100-125 mg PO tid
    4. Days >10: Take 250 mg PO tid
  2. Maintenance dosing
    1. Standard dosing: 250 mg PO tid-qid
    2. Maximum dosing: 500 mg PO qid (do not exceed)

VI. Monitoring: Labs every 6 months

  1. Complete Blood Count
  2. Chemistry panel (SMA-12)

VII. Adverse effects

  1. Common
    1. Ataxia
    2. Vertigo
  2. Occasional
    1. Nausea, Vomiting or Anorexia
    2. Fatigue or drowsiness
    3. Hyperirritability or other emotional disturbance
    4. Sexual Impotence
    5. Diplopia or Nystagmus
    6. Morbilliform skin rash
  3. Rare
    1. Megaloblastic Anemia responsive to Folate

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Cost: Medications

primidone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PRIMIDONE 250 MG TABLET Generic $0.29 each
PRIMIDONE 50 MG TABLET Generic $0.15 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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