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Liskantin

Manufacturer: Desitin Arzneimittel GmbH
Active ingredient: primidone
Dosage form: tablet

prescription only

effect

Liskantin contains the active ingredient primidone.

Primidon can be used in a variety of ways in epilepsy. Types of epilepsy such as:
  • Seizures that affect only part of the brain (partial or focal seizures), such as Jackson fits, adversive convulsions, or psychomotor seizures
  • Myoclonic seizures in adolescence with brief, sudden, shock-like muscle twitches
  • complex focal seizures such as temporal lobe seizures
  • Seizures that initially only affect part of the brain but then spread to the entire brain (secondary generalized seizures)
  • Seizures that affect the entire brain from the outset (primarily generalized seizures), such as the so-called grand mal in various forms
Primidon is used for grand mal prevention in children who have absenteeism or other epilepsy with certain EEG signs.

For the following areas of application of Primidon more detailed information is available:

You can also read the information on the antiepileptic active ingredient group to which the active ingredient primidone belongs.

Areas of application according to the manufacturer's information

  • certain types of epileptic seizures (grand mal, partial seizures such as Jackson seizures, adversive seizures, psychomotor seizures, impulsive petit mal, grand mal prophylaxis in petit mal epilepsies)

Video: epilepsy


dosage

The dosage of the drug must be increased slowly in stages until the effective concentration is reached.

One generally starts with daily doses of 60 to 125 milligrams
and increases the dose by 125 milligrams in stages. The average daily dose in the long term (maintenance dose) is 20 milligrams per kilogram of body weight for children and 15 milligrams per kilogram of body weight for adults. That corresponds to a daily dose of 250 to 500 milligrams for children up to two years of age, 500 to 750 milligrams for children from two to five years of age, 750 to 1000 milligrams for children from six to nine years or 750 to 1500 milligrams for children from nine years of age as well for adults. In elderly patients, in poor general condition, or in impaired liver or respiratory function, lower doses are usually required.

The tablets should be chewed whole, if possible during or after
Food can be taken with a little liquid (preferably water). The daily dose is divided into two to three individual doses. It is possible, if the seizure frequency is increased, at a certain time (for example at night)
then give a higher or even the full dose (for example in the evening).

A specialist (neurologist, neuropediatrician) decides on the setting, duration of treatment and discontinuation. Long-term therapy is generally required for epilepsy. Usually, the drug can only be stopped after two to three years of seizure freedom. The dose is to be reduced gradually ("tapering off").

Other ingredients

The medication contains the following non-medicinally active ingredients:

  • Cornstarch
  • gelatin
  • Magnesium stearate
  • methylated silica
  • Poly (O-carboxymethyl) starch sodium salt
  • Silicon dioxide

Side effects

Very common side effects:
Balance disorders

Frequent side effects:
Double vision, trembling eyes, fixed gaze, headache, loss of appetite, weight loss, indifference, tiredness, impaired perception, impaired consciousness, diarrhea, indigestion, nausea and vomiting, coordination disorders, memory disorders, convulsions, dizziness, increased excitability, tremors, speech disorders, drowsiness , prolonged reaction time, short-term memory loss.

Uncommon side effects:
Skin rash (maculopapular exanthema), anemia, decreased blood calcium concentration, increased liver enzymes (alkaline phosphatase, gamma-GT), decreased thyroid hormone.

Rare side effects:
Shoulder problems, severe bone changes, bone deformities, loss of bone mass (osteoporosis, rickets antiepileptic).

Very rare and occasional side effects:
Gum growths, skin changes such as exanthema, increase in pigmentation, changes in hairiness, shortening of the muscles in the bend of the finger (Dupuytren's contracture), cardiac arrhythmia (triggering of ventricular fibrillation), muscle fatigue, severe allergic reactions such as skin inflammation with large-leaved scaling such as changes in the lymphatic glands, changes in the lymphatic glands, hemorrhagic changes, fever , Leukopenia, anemia, thrombocytopenia or pancytopenia, blood formation disorders such as megaloblastic anemia or acute porphyria attacks, liver dysfunction.

Side effects without frequency information:
Slowing of the heartbeat, intensification of cardiac arrhythmias up to cardiac arrest, drop in blood pressure, shock, hypersensitivity reactions such as allergic skin rashes or light-sensitive skin reactions.

Particularities:
Especially in children and elderly patients, there may be increased restlessness, aggressiveness, confusion and disgruntlement.

Apparently taking the drug increases suicidal tendencies, so patients should be carefully monitored.

Long-term treatment with anti-epileptic drugs such as primidone increases the risk of osteoporosis. If this disease already exists or if hydrocortisone or other glucocorticoids are taken at the same time, a doctor should be consulted.

Interactions

Simultaneous use of sleeping pills, tranquilizers, agents against depression (antidepressants such as lithium) and agents against psychoses and states of excitement (neuroleptics) can lead to a mutual reinforcement of the effects. The same applies to the simultaneous use of other anti-epileptic drugs, AT1 receptor antagonists (antihistamines) and opioid pain relievers or alcohol consumption.

Primidone accelerates the breakdown and thereby reduces the effect of beta blockers (for heart relief and lowering blood pressure), cardiac glycosides such as digitoxin, blood coagulation inhibitors (anticoagulants), doxycycline and chloramphenicol (antibiotics) and of cytostatics (cancer drugs).

The effect of griseofulvin (mushroom remedy for internal use), glucocorticoids and female sex hormones (progestins, estrogens, hormonal contraceptives such as the "pill") is reduced.

Valproic acid (anti-epileptic) increases the effect of primidone, MAO-inhibitors (antidepressants) extend its effect.

Antiepileptics such as phenobarbital, carbamazepine, phenytoin, clonazepam, diazepam are broken down to a greater extent by primidone and therefore have a shorter effect.

The toxicity and side effects of methotrexate (anticancer medicine) can be increased by primidone.

Contraindications

The active ingredient must not be used in the event of hypersensitivity to primidone or other barbiturates, as well as acute poisoning with alcohol or central depressant agents such as sleeping pills, antidepressants, neuroleptics or opioid painkillers.

Primidon must also not be used for severe liver or kidney dysfunction, severe heart muscle weakness (severe myocardial damage), severe respiratory dysfunction in the form of asthma (status asthmaticus), certain blood formation disorders such as acute hepatic porphyria and cardiovascular shock or anaphylactic shock.

Particularly careful medical supervision is required in patients with a poor general condition, cardiac arrhythmias, severe septic diseases (caused by contamination or infection with pathogens), severe metabolic diseases, severe anemia (severe anemia), impaired liver or kidney function and breathing disorders such as diseases of the bronchi with shortness of breath, bronchial asthma or cor pulmonale.

Since the excretion of primidone can be considerably delayed in chronic kidney disease, a reduction in the primidone dose by the doctor is necessary here.

What should I watch for pregnancy and breastfeeding?

Primidone and one of its main metabolic products reach the unborn child via the placenta. They can accumulate there, which can lead to overdoses in the child, resulting in malformations and mental impairments. With long-term treatment in the last trimester of pregnancy, in particular, withdrawal symptoms such as breathing difficulties, slack muscles, low body temperature and poor drinking can occur in the newborn. Therefore, primidone should only be used during pregnancy if the doctor deems it absolutely necessary.

If treatment is required during pregnancy, it should be given at the lowest therapeutically effective dose and not in combination with other anti-epileptic drugs. This is especially important between the 20th and 40th day of pregnancy. The daily dose should be divided into several small doses.

If primidone is used during pregnancy, administration of folic acid before the start of and during pregnancy can be useful. In the last few weeks of pregnancy, it is recommended to give vitamin K1 to the mother or to the newborn after the birth.

Primidone passes into breast milk. This can lead to increased sleepiness in the infant. Long-term treatment of the mother with primidone during breastfeeding can lead to addiction in the newborn. In the event of sudden weaning, the infant must therefore be specially monitored by a doctor.

What to consider with children

Primidon can be used for the treatment of epilepsy in infants in a correspondingly low dose. It should be noted, however, that primidone is not effective in febrile convulsions in children.

Warning notices

  • The ability to react can be so limited that participation in road traffic or driving machines is impaired. This is especially true when drinking alcohol at the same time.
  • During the entire treatment, you may experience increased tiredness or even drowsiness.
  • Regular medical check-ups of the blood count and liver enzyme values ​​are recommended (especially in the initial phase).
  • The effectiveness of oral contraceptives ("pill") may be impaired. Therefore, additional contraceptive measures should be used.
  • Prolonged treatment with the drug can lead to habituation or dependence.
  • The drug should not be stopped suddenly, but the dose should be reduced gradually over several weeks. Sudden termination of therapy can lead to withdrawal symptoms and seizures of the brain.
  • It appears that taking the drug increases suicidal tendencies, so patients should be carefully monitored by the doctor and their relatives.
  • The drug increases the risk of osteoporosis with long-term treatment. This is especially true if the disease is pre-existing or if you are taking cortisone at the same time.
  • Dupuytren's contracture can occur very rarely.

Medicines can cause allergic reactions. Signs of this can be: reddening of the skin, runny nose, itching, swelling of the mucous membranes, itching and reddening of the eyes, narrowing of the airways (asthma). In rare cases, allergic shock with unconsciousness can occur.

If you notice any signs of an allergic reaction, inform a doctor immediately.

Pack sizes

Pack size and dosage form
Active ingredient content (dosage per tablet)

Comparable drugs

The following table gives an overview of Liskantin as well as other drugs with the active ingredient Primidon (possibly also generics). The dosage, pack size and price of the comparable drugs are listed.
(Please also note our information on price and additional payment information)


Swell:
The content of the medication guide was created by the editorial team on the basis of the following sources, among others:

  • Onmeda: Medicine and Health (www.onmeda.de). gofeminin.de GmbH, Cologne
  • ROTE LISTE® Online: Pharmaceutical Directory for Germany (www.rote-liste.de). Rote Liste® Service GmbH, Frankfurt am Main
  • FachInfo-Service: Fachinformationsverzeichnis Deutschland (www.fachinfo.de). Rote Liste® Service GmbH, Frankfurt am Main
  • Online information from the German Institute for Medical Documentation and Information (DIMDI) (www.dimdi.de), Cologne
  • Deutsche Apothekerzeitung, Deutscher Apotheker Verlag, Dr. Roland Schmiedel GmbH & Co., Stuttgart
  • Rote-Hand-Briefe, Drugs Commission of the German Medical Association (www.akdae.de), Berlin
  • Mutschler, E., Geisslinger, G., Kroemer, H.K., Ruth, P., Schäfer-Korting, M .: drug effects. Wissenschaftliche Verlagsges., Current edition
  • Active ingredient dossiers from the manufacturers
  • www.pharmazie.com - International drug information for healthcare professionals, DACON GmbH
  • Aktories, K., Förstermann, U., Hofmann, F., Forth, W .: General and special pharmacology and toxicology. Urban & Fischer, current edition
  • Dietel, M, Suttorp, N., Zeitz, M., Harrison, T.R .: Harrison's Internal Medicine. ABW Wissenschaftsverlag, current edition
  • Siegenthaler, W .: Siegenthaler's differential diagnosis of internal diseases. Thieme, current edition

Disclaimer:
Please note: The information on the effects, side effects and interactions as well as on contraindications and warnings generally relate to the active ingredient of the drug and may therefore differ from the manufacturer's information on your drug. If in doubt, please ask your doctor or pharmacist or refer to the package insert for your medication.