Primidone
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| Clinical data | |
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| Trade names | Lepsiral, Mysoline, Resimatil, Primaclone |
| AHFS/Drugs.com | Monograph |
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| Dependence liability |
Moderate-high |
| Routes of administration |
Oral |
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| Pharmacokinetic data | |
| Bioavailability | ~100% |
| Protein binding | 25% |
| Metabolism | Hepatic |
| Biological half-life | Primidone: 5-18 h, Phenobarbital: 75-120 h, PEMA: 16 h Time to reach steady state: Primidone: 2-3 days, Phenobarbital&PEMA 1-4weeks |
| Excretion | Renal |
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| Synonyms | desoxyphenobarbital, desoxyphenobarbitone |
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| ChEMBL | |
| ECHA InfoCard | 100.004.307 |
| Chemical and physical data | |
| Formula | C12H14N2O2 |
| Molar mass | 218.252 g/mol |
| 3D model (Jmol) | |
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Primidone (INN, BAN, USP) is an anticonvulsant of the barbiturate class. It is a structural analog of phenobarbital and related to barbiturate-derivative anticonvulsants. The active metabolites, phenobarbital, p-hydroxyphenobarbital, and phenylethylmalonamide, are also anticonvulsants. Primidone was once a mainstay anticonvulsant in the treatment of partial and generalized seizures and was the treatment of choice for secondarily generalized seizures originating in the temporal lobes, especially when combined with phenytoin, but by the early 1980s, carbamazepine had surpassed it in popularity due to the latter's lower incidence of sedation. As time passed and more and more anticonvulsants came on the market, primidone was pushed further and further away from its former place of prominence, and major Western pharmaceutical corporations became less and less interested in manufacturing and selling it. It has largely fallen into disuse in the developed world as more and more anticonvulsants entered the market, and it has been withdrawn from various markets around the world.
Licensed for generalized tonic-clonic and complex partial seizures in the United Kingdom. In the United States, primidone is approved for adjunctive (in combination with other drugs) and monotherapy (by itself) use in generalized tonic-clonic seizures, simple partial seizures, and complex partimple partial seizures, and myoclonic seizures. In juvenile myoclonic epilepsy (JME), it is a second-line therapy, reserved for when the valproates and/or lamotrigine do not work and when other second-line therapies—acetazolamid work either.
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