Antiepileptic drug Primidone: indications, instructions, reviews

Primidone is an antiepileptic drug that belongs to the barbiturate group.

The chemical structure of the drug is very close to Phenobarbital, but it has a more pronounced anticonvulsant effect.

It is used for various types of epileptic seizures and convulsive conditions.

Has a large number of adverse reactions.

opinion and form

Form release and composition

The drug is available in the form of flat-cylindricaltablets( 250 mg in 1 pc.) in a blister pack and in cardboard packs. It consists of:

• primidone( active ingredient);
• calcium stearate;
• potato starch;
• Povidone;
• sodium carboxymethyl starch.

Pharmacological profile

Primidone has an anticonvulsant effect. It is able to cause a mild hypnotic effect. Under the influence of the drug, the activity of neurons in the epileptogenic center is reduced. With accumulation of blood in the amount of 12 μg / ml, epileptic seizures become rare. The drug does not have an overwhelming effect on the central nervous system.

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The drug is rapidly and completely absorbed from the gastrointestinal tract. The greatest of its saturation in the blood is observed three hours after admission. Has insignificant ability to connect with plasma proteins( 20%).Biological availability is 90-100%.The time for which the constituents of the drug is half withdrawn from the blood, is 8-14 hours. About 64% of the drug excreted by the kidneys in the form of primidone, and 12% in the form of major metabolites.

As a result of the process of metabolization, the drug is partially transformed into phenylethylmalonamide and phenobarbital. These metabolites show pronounced antiepileptic activity. To achieve therapeutic effect in other types of epilepsy( polymorphic, non-convulsive, etc.), the drug is prescribed as part of systemic treatment.

The mechanism of action of the drug is to achieve an antiepileptic effect, by influencing the active component on the chloride channels, and then extending the inhibitory potential of the GABA action.

Scope and contraindications

Indications for use of primidone:

• therapy of generalized tonic-clonic and partial seizures( assigned mono or polytherapy);
• akinetic attacks, tonic and myoclonic seizures;
• Jacksonian and partial epilepsy;
• psychomotor epilepsy and large convulsive seizures.

Contraindications to prescribing:

• presence of anemia and leukopenia;
• children under three years;
• pregnancy;
• high sensitivity to the components of the drug;
• intermittent porphyria in acute form;
• lactation period;
• renal and hepatic impairment;

With special care, the drug is prescribed for weakened and mature patients. If the kidneys and liver work incorrectly, the dose should be reduced.

Instruction for use

The course of therapy is prescribed for each patient individually. This is due to the fact that in some cases, the therapeutic effect is sufficient monotherapy, and in others, there is a need for combined anticonvulsant therapy.

Treatment begins with a dose of 125 mg( sex tablets) with a frequency of intake once a day( before bedtime).At the end of every three days, the amount of the drug should be increased by 125 mg.

At a dose of 500 mg per day( two tablets), the dose should be increased by another 250 mg every three days( children from 3 to 9 years of age, the dose increases by 125 mg).

Overdose and Adverse Reactions

In case of a drug overdose, the following symptoms appear:

• nausea and ataxia;
• suppression of CNS functions( loss of consciousness, respiratory depression and coma).

Crystalluria is often manifested, which in turn is the main diagnostic symptom of an overdose of Primidone. To eliminate all of the above symptoms, it is necessary to conduct symptomatic therapy in the form of gastric lavage and intake of activated charcoal.

Among the side effects are the following symptoms:

• central and peripheral nervous system - a manifestation of psychotic reactions, ataxia and apathy, loss of vision;
• musculoskeletal system - osteomalacia and arthralgia, in rare cases Dupuytren's contracture is observed;
• Gastrointestinal tract - nausea and vomiting;
• skin and subcutaneous tissues - allergic reactions with the appearance of scarlet fever and korepodobnogo rashes, much less frequent occurrence of severe reactions, including lupus and toxic epidermal necrolysis;
• liver and biliary tract - increased activity of hepatic enzymes and alkaline phosphatase.

Among the common adverse reactions most often manifested headache, lethargy and dizziness.

Special instructions

The drug may be prescribed as part of complex anticonvulsant therapy. The abolition of the medication and its replacement with another medication should be carried out gradually. It is not recommended to prescribe in children up to three years.

Components of the drug component can reduce reactions when driving by transport and controlling other mechanisms.

With prolonged use, there is a risk of megaloblastic anemia. In case of this disease, it is necessary to cancel the drug and start therapy with folic acid and vitamin B12.

Alcohol is not recommended throughout the course of treatment. If the kidneys and liver work improperly, the medication is contraindicated. The same applies to the period of pregnancy and lactation.

During treatment with Primidone, all patients should be under constant supervision, as the drug increases the likelihood of suicidal thoughts.

Interaction with other drugs

With simultaneous administration of drugs with a major depressive effect, the overwhelming effect on the central nervous system increases.

The use of carbonic anhydrase inhibitors provokes osteogenesis disorders. Use in conjunction with drugs for general anesthesia( Halothane, Enflurane and Methoxyflurane) increases the toxic effect on the liver.

Primidon enhances the effects of hypnotic drugs and urea sulfonyl derivatives. Reduces the absorption of Griseofulvin, as a result of which its antifungal activity is suppressed.

Is the opinion of

Reviews of doctors and patients who have taken or are taking Primidone.

In my opinion, this is a rather dangerous drug. I prefer to appoint it if necessary and to comply with all the recommendations for admission, since the drug is able to cause drug dependence.

Galina Petrovna, doctor neurologist

I often prescribe primidon in case of epilepsy and with serious convulsive seizures. In all cases the treatment had a favorable outcome, with the presence of minimal adverse reactions. The main thing is for the patient to be under the constant supervision of the doctor and adhere to the exact dosage.

Vladimir Evgenievich, doctor, psychotherapist

My brother was treated with this remedy, because he had epilepsy. The result was visible, but after the withdrawal of the drug, he again began( although very rarely) to manifest epileptic seizures.

Irina

I also took Primidone from epilepsy. I was initially assigned a pill, then two tablets, and I finished the therapeutic course with a dose of three tablets per day. I want to say that I did not have any addiction to the medicine, but just a little nauseated at the beginning.

Vladislav

Practice shows that Primidone is a strong remedy that can be addictive. Its use should be strictly controlled by doctors.

Purchase and analogues

Primidone is available in the form of tablets intended for internal use, the average price per pack is 290 rubles.

The medication should be stored in a dark room, at a temperature of not more than 25 degrees. The maximum useful life of the medicinal product is thirty-six months.

The drug is dispensed in pharmacies strictly according to the prescription.

Primidone analogues that can be purchased at pharmacies:

• Hexamidine( tablets);
• Misolin( tablets).