Carbamazepine and Primidone interaction

Carbamazepine and Primidone: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Carbamazepine (EQUETRO) label · effective 2025-08-19

Major

CNS Depressants The concomitant use of EQUETRO and other CNS depressants can increase the risk of respiratory depression, profound sedation, hypotension, and syncope.

Drug interactionsby drug classView label on DailyMed
Moderate

EQUETRO increases the plasma levels of the following drugs by inhibition of their metabolism : Clomipramine, P henytoin, and P rimidone EQUETRO can increase the concentrations of clomipramine, phenytoin, and primidone.

Drug interactionsnames PrimidoneView label on DailyMed
Moderate

Limited evidence suggests that HLA-B*1502 may be a risk factor for the development of SJS/TEN in patients of Chinese ancestry taking other anti-epileptic drugs associated with SJS/TEN, including phenytoin.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Consider reducing the dose of CNS depressants or EQUETRO when using these drugs concomitantly.

Drug interactionsby drug classView label on DailyMed
Minor

Hypersensitivity Hypersensitivity reactions to carbamazepine have been reported in patients who previously experienced this reaction to anticonvulsants including phenytoin, primidone, and phenobarbital.

Warnings and precautionsnames PrimidoneView label on DailyMed

From the Primidone (Mysoline) label · effective 2020-07-06

Minor

Neonatal hemorrhage, with a coagulation defect resembling vitamin K deficiency, has been described in newborns whose mothers were taking primidone and other anticonvulsants.

Warningsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.