Medication·Interactions & depletion·Reviewed June 9, 2026
Primidone interactions.
Primidone has 4 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Vitamin D, Calcium, and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Primidone at a glance.
A quick, data-grounded summary. The full tables are below.
Primidone has 4 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Vitamin D, Calcium, and Folate. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with primidone.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Ginkgo Biloba | Conflict | Ginkgo may lower seizure threshold and is undesirable with anticonvulsant therapy. |
| Ashwagandha | Caution | Ashwagandha may add to primidone-related sedation or dizziness. |
| Melatonin | Caution | Melatonin can add to primidone and phenobarbital-metabolite sedation. |
| St. John's Wort | Caution | St. John's Wort adds enzyme induction to primidone's enzyme-inducing metabolite burden and can reduce exposure to many co-medications. |
What primidone can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Vitamin D | Significant | Primidone's phenobarbital metabolite and enzyme-inducing effects accelerate vitamin D catabolism. | Vitamin D3 | Serum 25-hydroxyvitamin D |
| Calcium | Moderate | Lower vitamin D activity reduces intestinal calcium absorption and can contribute to bone loss. | Calcium | Serum calcium, parathyroid hormone, and bone density when indicated |
| Folate | Moderate | Chronic older anticonvulsant therapy can lower folate status and contribute to megaloblastic anemia. | Methylfolate | CBC, serum folate, red blood cell folate, and homocysteine |
The full primidone profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common primidone questions.
Quick answers drawn from the tables above.
What interacts with Primidone?
In the NutriStack database, Primidone has 4 documented interactions. The most notable include Ginkgo Biloba, Ashwagandha, Melatonin, and St. John's Wort. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Primidone?
Primidone is flagged against 1 substance in the database, including Ginkgo Biloba. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Does Primidone deplete any nutrients?
Primidone is associated with lowering Vitamin D, Calcium, and Folate with prolonged use. Useful biomarkers to monitor include Serum 25-hydroxyvitamin D, Serum calcium, parathyroid hormone, and bone density when indicated, and CBC, serum folate, red blood cell folate, and homocysteine. Ask your prescriber before adding any replacement supplement.
Is it safe to take Ginkgo Biloba with Primidone?
NutriStack classifies the Ginkgo Biloba and Primidone pairing as conflict: Ginkgo may lower seizure threshold and is undesirable with anticonvulsant therapy. Avoid ginkgo if primidone is used for seizure prevention. Always confirm with your prescriber.
Check your whole stack
See how primidone fits your supplements.
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