Skip to main content
PMC home page
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1990 Oct;30(4):607–611. doi: 10.1111/j.1365-2125.1990.tb03820.x

The disposition of primidone in elderly patients.

C Martines 1, G Gatti 1, E Sasso 1, S Calzetti 1, E Perucca 1
PMCID: PMC1368252  PMID: 2291873

Abstract

1. The pharmacokinetics and metabolism of primidone at steady-state were studied in 10 elderly patients aged 70-81 years and eight control subjects aged 18-26 years. 2. Primidone half-lives and clearance values (mean +/- s.d.) were similar in the elderly and in the young (12.1 +/- 4.6 vs 14.7 +/- 3.5 h and 34.8 +/- 9.0 vs 33.2 +/- 7.2 ml h-1 kg-1 respectively. 3. The serum concentrations of the metabolites phenylethylmalonamide (PEMA) and phenobarbitone relative to those of parent drug were higher in the elderly than in the young, the difference being significant (P less than 0.01) in the case of PEMA. 4. The renal clearances of primidone, phenobarbitone and PEMA were moderately decreased in the elderly but this reduction was statistically significant only for PEMA. Elderly patients excreted a reduced proportion of unchanged primidone and an increased proportion of PEMA in urine. 5. Ageing is associated with a greater accumulation of PEMA, which is unlikely to have a major clinical significance.

Full text

PDF
609

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Calzetti S., Findley L. J., Pisani F., Richens A. Phenylethylmalonamide in essential tremor. A double-blind controlled study. J Neurol Neurosurg Psychiatry. 1981 Oct;44(10):932–934. doi: 10.1136/jnnp.44.10.932. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cloyd J. C., Miller K. W., Leppik I. E. Primidone kinetics: effects of concurrent drugs and duration of therapy. Clin Pharmacol Ther. 1981 Mar;29(3):402–407. doi: 10.1038/clpt.1981.55. [DOI] [PubMed] [Google Scholar]
  3. Cottrell P. R., Streete J. M., Berry D. J., Schäfer H., Pisani F., Perucca E., Richens A. Pharmacokinetics of phenylethylmalonamide (PEMA) in normal subjects and in patients treated with antiepileptic drugs. Epilepsia. 1982 Jun;23(3):307–313. doi: 10.1111/j.1528-1157.1982.tb06196.x. [DOI] [PubMed] [Google Scholar]
  4. Dietrichson P., Espen E. Primidone and propranolol in essential tremor: a study based on quantitative tremor recording and plasma anticonvulsant levels. Acta Neurol Scand. 1987 May;75(5):332–340. doi: 10.1111/j.1600-0404.1987.tb05455.x. [DOI] [PubMed] [Google Scholar]
  5. Gorman W. P., Cooper R., Pocock P., Campbell M. J. A comparison of primidone, propranolol, and placebo in essential tremor, using quantitative analysis. J Neurol Neurosurg Psychiatry. 1986 Jan;49(1):64–68. doi: 10.1136/jnnp.49.1.64. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Heipertz R., Guthoff A., Bernhardt W. Primidone metabolism in renal insufficiency and acute intoxication. J Neurol. 1979 Aug;221(2):101–104. doi: 10.1007/BF00313107. [DOI] [PubMed] [Google Scholar]
  7. Kauffman R. E., Habersang R., Lansky L. Kinetics of primidone metabolism and excretion in children. Clin Pharmacol Ther. 1977 Aug;22(2):200–205. doi: 10.1002/cpt1977222200. [DOI] [PubMed] [Google Scholar]
  8. Kunze H. E., Hooper W. D., Eadie M. J. High performance liquid chromatographic assay of methylphenobarbital metabolites in urine. Ther Drug Monit. 1981;3(1):45–49. [PubMed] [Google Scholar]
  9. Nau H., Rating D., Häuser I., Jäger E., Koch S., Helge H. Placental transfer and pharmacokinetics of primidone and its metabolites phenobarbital, PEMA and hydroxyphenobarbital in neonates and infants of epileptic mothers. Eur J Clin Pharmacol. 1980 Jul;18(1):31–42. doi: 10.1007/BF00561476. [DOI] [PubMed] [Google Scholar]
  10. Perucca E. Pharmacokinetic interactions with antiepileptic drugs. Clin Pharmacokinet. 1982 Jan-Feb;7(1):57–84. doi: 10.2165/00003088-198207010-00004. [DOI] [PubMed] [Google Scholar]
  11. Pisani F., Perucca E., Primerano G., D'Agostino A. A., Petrelli R. M., Fazio A., Oteri G., Di Perri R. Single-dose kinetics of primidone in acute viral hepatitis. Eur J Clin Pharmacol. 1984;27(4):465–469. doi: 10.1007/BF00549596. [DOI] [PubMed] [Google Scholar]
  12. Sasso E., Perucca E., Calzetti S. Double-blind comparison of primidone and phenobarbital in essential tremor. Neurology. 1988 May;38(5):808–810. doi: 10.1212/wnl.38.5.808. [DOI] [PubMed] [Google Scholar]
  13. Stern E. L. Possible phenylethylmalondiamide (PEMA) intoxication. Ann Neurol. 1977 Oct;2(4):356–357. doi: 10.1002/ana.410020418. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES