Primidone - Revision history

MDElliottMD: parser-claude: Primidone MedTemplate refill, Top 300 stub upgrade

2026-05-23T07:30:20Z

parser-claude: Primidone MedTemplate refill, Top 300 stub upgrade

← Older revision		Revision as of 07:30, 23 May 2026
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	{{MedTemplate		{{MedTemplate
	\| generic = Primidone		\| generic = Primidone
	\| brand = Mysoline		\| brand = Mysoline
	\| structure =		\| structure =
	\| classes = Barbiturate, ~~Anticonvulsant~~		\| classes = [[:Category:Anticonvulsants\|Anticonvulsant]], [[:Category:Barbiturates\|Barbiturate (parent compound)]], [[:Category:Tremor medicines\|Tremor medicine]]
	\| ~~mechanism = Metabolized to phenobarbital; sodium channel modulator~~		\| uses = <vote slug="partial-seizures-monotherapy-use">Partial-onset and generalized tonic-clonic seizures (FDA)</vote>, <vote slug="essential-tremor-use">Essential tremor (widely used and AAN-guideline-supported as first-line alongside propranolol)</vote>
	\| uses =		\| starting_dose = Seizures: 100-125 mg PO at bedtime x 3 days, then BID, then TID, escalating to 750-1500 mg/day. Essential tremor: 25-50 mg PO at bedtime, titrate slowly to 250-750 mg/day
	\| starting_dose =		\| preparations = Tablets 50, 250 mg
	\| preparations =		\| fda_max = 2 g/day (seizures); typically much lower for essential tremor
	\| fda_max =		\| pill_id =
	\| routes =		\| routes = Oral
	\| onset =		\| onset = Anticonvulsant effect emerges with slow titration over weeks; tremor effect over weeks
	\| duration =		\| duration = BID-TID dosing
	\| halflife =		\| halflife = Primidone 5-15 hours; '''phenobarbital active metabolite 50-150 hours'''; PEMA (phenylethylmalonamide) active metabolite 16 hours<ref name="mysoline-label">FDA Prescribing Information, Mysoline (primidone), Bausch/various, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/009170s032lbl.pdf</ref>
	~~\| bioavailability =~~		\| bioavailability = ~90% (oral)<ref name="mysoline-label" />
	~~\| pregnancy~~ =		\| pregnancy = Substantial teratogenic signal (barbiturate class effects including neonatal withdrawal and hemorrhagic disease of newborn).{{citation needed}}
	~~\| legal~~ =		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. '''Federally non-controlled despite being a barbiturate''', a paradoxical situation given that its primary active metabolite phenobarbital is Schedule IV<ref name="mysoline-label" />
	\| ~~intro =~~		\| mechanism = <vote slug="primidone-mech-claim">Barbiturate that metabolizes to two active species: '''phenobarbital''' (the major contributor to seizure control, mediating GABA-A receptor potentiation) and '''PEMA (phenylethylmalonamide)''', which contributes to seizure control and is the leading candidate to explain the essential-tremor efficacy. Phenobarbital alone does not reliably suppress tremor at non-sedating doses, so PEMA's independent action is the proposed mechanism for the tremor indication.</vote> Strong CYP3A4 induction via the phenobarbital metabolite produces many interactions (reduces oral contraceptives, warfarin, many psychotropics). Essential-tremor efficacy is the unique pharmacological selling point<ref name="mysoline-label" />.
	~~\| pharmacokinetics~~ =
	~~\| pharmacodynamics~~ =
	\| ~~indications~~ =
	\| ~~dosing~~ =
	~~\| effects =~~
	\| ~~interactions~~ = ~~<pharmaInteractions~~/>
	\| ~~pregnancy_details =~~
	~~\| monitoring~~ =
	~~\| counseling~~ =
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references~~ =
	}}		}}

			== References ==
			<references />

			[[Category:Anticonvulsants]]
	[[Category:Barbiturates]]		[[Category:Barbiturates]]
	[[Category:~~Sedative-hypnotics]]~~		[[Category:Tremor medicines]]
	~~[[Category:Antiepileptics~~]]

MDElliottMD: Category taxonomy ship: retag Anticonvulsants -> Antiepileptics, Sedative-Hypnotics -> Sedative-hypnotics

2026-05-22T00:37:19Z

Category taxonomy ship: retag Anticonvulsants -> Antiepileptics, Sedative-Hypnotics -> Sedative-hypnotics

← Older revision		Revision as of 00:37, 22 May 2026
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	[[Category:Barbiturates]]		[[Category:Barbiturates]]
	[[Category:Sedative-~~Hypnotics~~]]		[[Category:Sedative-hypnotics]]
	[[Category:~~Anticonvulsants~~]]		[[Category:Antiepileptics]]

MDElliottMD: Dedupe migration per interface-claude 2026-05-20: Anticonvulsants / Antiepileptics merged into canonical Anticonvulsants. Member retagged.

2026-05-19T18:00:15Z

Dedupe migration per interface-claude 2026-05-20: Anticonvulsants / Antiepileptics merged into canonical Anticonvulsants. Member retagged.

← Older revision		Revision as of 18:00, 19 May 2026
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	\| references =		\| references =
	}}		}}


	[[Category:Barbiturates]]		[[Category:Barbiturates]]
	[[Category:Sedative-Hypnotics]]		[[Category:Sedative-Hypnotics]]
	[[Category:Anticonvulsants ~~/ Antiepileptics~~]]		[[Category:Anticonvulsants]]

MDElliottMD: Remove Category:Psychostimulants tag (not a psychostimulant — sedative/anxiolytic/anticonvulsant/non-stimulant carryover from Stimulants & Wake-Promoting Agents rename)

2026-05-18T00:48:11Z

Remove Category:Psychostimulants tag (not a psychostimulant — sedative/anxiolytic/anticonvulsant/non-stimulant carryover from Stimulants & Wake-Promoting Agents rename)

← Older revision		Revision as of 00:48, 18 May 2026
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	~~[[Category:Psychostimulants]]~~
	[[Category:Barbiturates]]		[[Category:Barbiturates]]
	[[Category:Sedative-Hypnotics]]		[[Category:Sedative-Hypnotics]]
	[[Category:Anticonvulsants / Antiepileptics]]		[[Category:Anticonvulsants / Antiepileptics]]

MDElliottMD: Recategorize: Stimulants -> Psychostimulants

2026-05-17T10:51:02Z

Recategorize: Stimulants -> Psychostimulants

← Older revision		Revision as of 10:51, 17 May 2026
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	[[Category:~~Stimulants~~]]		[[Category:Psychostimulants]]
	[[Category:Barbiturates]]		[[Category:Barbiturates]]
	[[Category:Sedative-Hypnotics]]		[[Category:Sedative-Hypnotics]]
	[[Category:Anticonvulsants / Antiepileptics]]		[[Category:Anticonvulsants / Antiepileptics]]

MDElliottMD: Recategorize: Stimulants & Wake-Promoting Agents -> Stimulants

2026-05-17T10:45:16Z

Recategorize: Stimulants & Wake-Promoting Agents -> Stimulants

← Older revision		Revision as of 10:45, 17 May 2026
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	[[Category:Stimulants ~~& Wake-Promoting Agents~~]]		[[Category:Stimulants]]
	[[Category:Barbiturates]]		[[Category:Barbiturates]]
	[[Category:Sedative-Hypnotics]]		[[Category:Sedative-Hypnotics]]
	[[Category:Anticonvulsants / Antiepileptics]]		[[Category:Anticonvulsants / Antiepileptics]]

MDElliottMD: Comprehensive categorization: +Anticonvulsants / Antiepileptics

2026-05-15T18:42:12Z

Comprehensive categorization: +Anticonvulsants / Antiepileptics

← Older revision		Revision as of 18:42, 15 May 2026
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	[[Category:Barbiturates]]		[[Category:Barbiturates]]
	[[Category:Sedative-Hypnotics]]		[[Category:Sedative-Hypnotics]]
			[[Category:Anticonvulsants / Antiepileptics]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:06:57Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:06, 14 May 2026
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	}}		}}


			[[Category:Stimulants & Wake-Promoting Agents]]
			[[Category:Barbiturates]]
	[[Category:Sedative-Hypnotics]]		[[Category:Sedative-Hypnotics]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:31:06Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:31, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:47Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =