How does this medication work? What will it do for me?

This medication is used to manage psychotic disorders such as agitated depression and schizophrenia. It also is used to manage severe nausea and vomiting. It works by affecting the balance of certain chemicals in the brain.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

2 mg
Each round, white, biconvex, film-coated tablet, identified "2", contains perphenazine 2 mg. Nonmedicinal ingredients: carnauba wax, cornstarch, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), and titanium dioxide.

4 mg
Each round, white, biconvex, film-coated tablet, identified "4", contains perphenazine 4 mg. Nonmedicinal ingredients: carnauba wax, cornstarch, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), and titanium dioxide.

8 mg
Each round, white, biconvex, film-coated tablet, identified "8", contains perphenazine 8 mg. Nonmedicinal ingredients: carnauba wax, cornstarch, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), and titanium dioxide.

16 mg
Each round, white, biconvex, film-coated tablet, identified "16", contains perphenazine 16 mg. Nonmedicinal ingredients: carnauba wax, cornstarch, hydroxypropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), and titanium dioxide.

How should I use this medication?

The recommended dose varies widely up to a maximum of 24 mg daily, depending on the condition being treated and the circumstances.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Perphenazine should not be taken by anyone who:

  • is allergic to perphenazine or to any of the ingredients of the medication
  • is comatose or non-functional
  • is receiving large doses of central nervous system depressants (e.g., barbiturates, alcohol, analgesics, or antihistamines)
  • has severe depression
  • has severely impaired blood circulation
  • has bone marrow depression
  • has liver damage
  • has decreased kidney function
  • has a pheochromocytoma (a tumour of the adrenal glands)
  • has or may have subcortical brain damage

Do not give this medication to children who are undergoing surgery.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • blurred vision
  • changes in menstrual cycles
  • changed interest in sexual activity
  • dizziness upon rising from a sitting or lying down position
  • drowsiness (usually during the first 2 weeks)
  • dry mouth
  • headache
  • nasal congestion
  • nausea
  • new or worsening constipation
  • sweating
  • urinary incontinence (unable to hold urine)
  • vomiting
  • weight changes

A significant rise in body temperature, not otherwise explained, may suggest intolerance to perphenazine, in which case use of the medication should be discontinued.

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blood pressure changes (high or low)
  • breast enlargement and milk production (men and women)
  • fast, slow, or pounding heartbeat
  • a feeling of restlessness; inability to sit still
  • movement difficulties, exaggerated reflexes
  • muscle stiffness
  • signs of a blood clot in the arm or leg (tenderness, pain, swelling, warmth, or redness in the arm or leg) or lungs (difficulty breathing, sharp chest pain that is worst when breathing in, coughing, coughing up blood, sweating, or passing out)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • symptoms of increased blood sugar (e.g., increased frequency of urination, thirst, hunger, fruity smell to breath)
  • symptoms of a respiratory tract infection (e.g., fever, flu-like symptoms, cough, difficult or fast breathing)
  • uncontrollable movements or twitching of the body, face, or eyes
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • long lasting (more than 4 hours) and painful erection
  • seizures
  • signs of neuroleptic malignant syndrome (e.g., confusion, reduced consciousness, high fever, or muscle stiffness)
  • symptoms of an allergic reaction (shortness of breath or difficulty breathing; hives; swelling of the eyes, mouth, lips, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol and other medications that cause drowsiness: Do not combine this medication with alcohol or other medications  that cause drowsiness (e.g., antidepressants, sleeping pills, anxiety medications) since additive drowsiness can occur and be dangerous.

Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Drowsiness/reduced alertness: Perphenazine may impair the mental or physical abilities required to perform certain tasks, such as driving a car or operating machinery.

Glaucoma: This medication may cause the symptoms of glaucoma (increased pressure in the eye) to become worse. If you have glaucoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Report any changes in vision to your doctor as soon as possible while you are taking this medication.

Heart Problems: If you have a history of heart problems, including irregular heartbeat, angina or blood clots, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Neuroleptic malignant syndrome (NMS): Like other antipsychotic medications, perphenazine can cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.

Seizures: Perphenazine can lower the seizure threshold in certain people. People in alcohol withdrawal or with seizure disorders should be monitored by their doctor.

Sun: People being treated with phenothiazines such as perphenazine should avoid undue exposure to sunlight.

Tardive dyskinesia: Tardive dyskinesia is characterized by involuntary movements that may develop in people treated with antipsychotic medications such as perphenazine. Although this seems to be most frequent among the elderly, especially elderly women, this cannot be used to predict who will develop this syndrome. Both the risk of developing tardive dyskinesia and the likelihood that it will become irreversible are believed to increase as the length of treatment and the total dose of perphenazine increases. If signs and symptoms of tardive dyskinesia appear, speak to your doctor about stopping the medication. However, some people may require treatment despite the presence of the syndrome.

Urinary Problems: This medication can affect urinary tract function.  If you have a history of urinary retention or benign prostatic hypertrophy, or other prostate problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor.

Breast-feeding: Perphenazine is excreted rapidly in breast milk and could cause serious side effects in the breast-fed infant. Breast-feeding mothers should make a decision with their doctor whether to stop taking the medication or stop breast-feeding.

Children: The safety and effectiveness of perphenazine have not been established for use by children under 12 years of age.

Seniors: Seniors with dementia who take perphenazine or other similar medications are at an increased risk of dying. There may be a higher risk of liver, kidney, and heart problems, and a higher risk of drug interactions for seniors. Talk to your doctor about the risks and benefits of using this medication.

What other drugs could interact with this medication?

There may be an interaction between perphenazine and any of the following:

  • abiraterone
  • aclidinium
  • amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
  • antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
  • antihistamines (e.g., azelastine, cetirizine, chlorpheniramine, desloratadine, diphenhydramine, fexofenadine, hydroxyzine, loratadine)
  • anti-Parkinson medications (e.g., amantadine, apomorphine, cabergoline, levodopa, pramipexole, rotigotine)
  • other anti-psychotics (e.g., aripiprazole, chlorpromazine, methotrimeprazine, olanzapine, quetiapine, risperidone)
  • alcohol
  • atropine
  • barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
  • benzodiazepines (e.g., clonazepam, diazepam, lorazepam)
  • benztropine
  • beta-adrenergic blockers (e.g., acebutolol, carvedilol, metoprolol, propranolol)
  • botulinum toxin
  • brimonidine
  • bromocriptine
  • buprenorphine
  • bupropion
  • cannabis
  • chloral hydrate
  • clidinium
  • clonidine
  • dantrolene
  • darifenacin
  • dexmethylphenidate
  • dimenhydrinate
  • diphenoxylate
  • disopyramide
  • diuretics (water pills; e.g., hydrochlorothiazide, indapamide)
  • domperidone
  • donepezil
  • doxepin
  • efavirenz
  • eluxadoline
  • epinephrine
  • esketamine
  • fesoterodine
  • gabapentin
  • galantamine
  • glucagon
  • glycopyrrolate
  • guanfacine
  • HIV protease inhibitors (e.g., darunavir, saquinavir, tipranavir)
  • ipratropium
  • lamotrigine
  • lemborexant
  • linezolid
  • methadone
  • methylphenidate
  • metoclopramide
  • mirtazapine
  • monoamine oxidase inhibitors (MAOIs; e.g., maprotiline, moclobemide, phenelzine, tranylcypromine)
  • muscle relaxants (e.g., baclofen, cyclobenzaprine, orphenadrine)
  • nabilone
  • narcotic pain relievers (e.g., codeine, fentanyl, hydrocodone, morphine, oxycodone, tapentadol, tramadol)
  • oxybutynin
  • pizotifen
  • pomalidomide
  • potassium chloride
  • pregabalin
  • quinidine
  • rivastigmine
  • scopolamine
  • selective serotonin reuptake inhibitors (e.g., citalopram, escitalopram, fluoxetine, paroxetine, sertraline)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
  • sodium bicarbonate
  • sodium oxybate
  • tetrabenazine
  • thalidomide
  • tiotropium
  • tizanidine
  • tolterodine
  • topiramate
  • trazodone
  • tricyclic antidepressants (e.g., clomipramine, desipramine, imipramine)
  • trospium
  • tryptophan
  • umeclidinium
  • valerian
  • zolpidem
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Perphenazine