Primidone, commonly known as Mysoline, is a barbiturate anticonvulsant medication primarily used to treat epileptic seizures. While it is effective for managing certain conditions, it's important to understand its potential side effects and how to use it safely.
What is Primidone Used For?
Primidone is primarily prescribed as an antiepileptic medication to treat certain types of epileptic seizures. It works to control seizures by calming brain activity. Primidone has also been found to be very effective in the treatment of essential tremors, at doses between 50mg and 1000mg per day. It may also be used for purposes not listed in this medication guide.
Off-Label Uses
Often, anticonvulsant drugs are prescribed to treat bipolar disorder, as a mood stabilizer. Primidone also impacts the function of ion channels and neurotransmitters, which has effects on mood and behavior, acting as a mood stabilizer.
Dosage and Administration
For adults, the initial dosage is typically 100mg per day, which can then be increased up to 1g per day, divided into 3-4 doses. For children, the initial dose is generally 50mg per day, which can be increased up to 750mg per day, divided into 3-4 doses.
Important Instructions
This medication should be taken exactly as prescribed, without missing a dose. If a dose is missed, take the medication as soon as possible, or if it is close to the next dosage time, skip the missed dose. Do not suddenly stop taking primidone, even if you feel better, as this can have serious impacts on your physical and mental health and can cause a reoccurrence of seizures. If you have been taking primidone regularly for several weeks, you should not suddenly stop taking it without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping completely.
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Potential Side Effects
When you begin a new medication, you may experience some common side effects. Severe side effects of primidone are less common but may still occur.
Common Side Effects
The most common side effects of primidone are:
- Trouble with balance or coordination
- Feeling dizzy or like you are spinning
Tell your healthcare provider if you have any of these side effects that bother you.
Serious Side Effects
While less common, the most serious side effects of primidone are described below, along with what to do if they happen.
- Severe Allergic Reactions: Primidone may cause allergic reactions, which can be serious. Stop taking primidone and get help right away if you have any of the following symptoms of a serious allergic reaction:
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
- Suicidal Thoughts and Actions: Primidone can cause suicidal thoughts, particularly at the beginning of your treatment. Primidone may cause suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms:
- New or increased thoughts of suicide or death
- Suicide attempt
- New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior
- Sleepiness: Primidone can make you very sleepy, especially when you first start taking it. Do not drive or do other activities that require alertness or coordination until you know how primidone affects you. Primidone may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Even if taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.
- Blood Disorders: Primidone can cause blood disorders, such as low levels of certain types of white blood cells, known as granulocytopenia and agranulocytosis, and low levels of red blood cells, which can cause anemia. Stop taking primidone and get help right away if you have any of the following symptoms of blood disorders:
- Fever
- Shortness of breath
- Pale or yellowish skin
- Easy bruising or bleeding
- Frequent infection
- Unusual weakness or tiredness
- Dizziness, lightheadedness, or feeling like you are about to pass out
- Headache
- Fast or abnormal heartbeat
There may be other side effects of primidone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
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Weight Loss
The user specifically asked about weight loss, but this article does not mention weight loss. Note: Medication side effects may be underreported. Further information Primidone side effects can vary depending on the individual.
Warnings and Precautions
Contraindications
People who are allergic to any of the following should not take primidone:
- Primidone
- Mysoline
- Phenobarbital
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific primidone products they stock.
Primidone should not be used if you have porphyria, a genetic disorder that most often affects your skin. Tell your healthcare provider if you have porphyria.
General Precautions
Do not take primidone unless it has been prescribed to you by a healthcare provider. Take it as prescribed. Do not share primidone with other people, even if they have the same condition as you. It may harm them. Keep primidone out of the reach of children. Primidone is a controlled substance because it can be misused or lead to dependence. Store primidone in a safe place to protect it from theft. It is illegal to sell or give away this medicine.
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Important Considerations Before Starting Primidone
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are taking. This will help them determine if primidone is right for you.
In particular, make sure that you discuss any of the following:
- Current and Past Health Conditions: Tell your healthcare provider if you have any of the following:
- Mental health conditions, such as depression or mood problems
- Suicidal thoughts or actions
- Pregnancy: Primidone may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take primidone while you are pregnant or trying to get pregnant. If you become pregnant while taking primidone, you can register for the North American Antiepileptic Drug Pregnancy Registry by calling 888-233-2334 or at www.aedpregnancyregistry.org. This registry collects safety information about the use of medicines to control seizures during pregnancy. Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away. Your doctor may want you to join a pregnancy registry for patients taking a seizure medicine.
- Breastfeeding: Primidone passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take primidone while breastfeeding. Along with its needed effects, primidone may cause some unwanted effects. Some side effects of primidone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine.
Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (such as the metyrapone and phentolamine tests) may be affected by this medicine. Before having any kind of surgery, dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine. This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine. Oral contraceptives (birth control pills) containing estrogen may not work properly if you take them while you are taking primidone. Unplanned pregnancies may occur. You should use a different or additional means of birth control while you are taking primidone.
This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor or your child's doctor right away.
Drug Interactions
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are taking.
In particular, make sure that you discuss if you are taking any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety before taking primidone.
Alcohol
It is likely best to avoid drinking alcohol while taking primidone. It is unknown if drinking alcohol will affect primidone. The risk of dizziness or sleepiness may be increased if you drink alcohol while taking primidone.
This may not be a complete list of medicines that can interact with primidone. Always check with your healthcare provider.
Storage
Primidone should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store away from direct sunlight in a tightly closed bottle, in a cool, dry place.