perphenazine

Generic Name: perphenazine (per FEN a zeen)

Brand Names: Trilafon

What is perphenazine?

Perphenazine is an anti-psychotic medication in a group of drugs called phenothiazines (FEEN-oh-THYE-a-zeens). It works by changing the actions of chemicals in your brain.

Perphenazine is used to treat psychotic disorders such as schizophrenia. It is also used to control severe nausea and vomiting.

Perphenazine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about perphenazine?

Stop using this medication and call your doctor at once if you have twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs. These could be early signs of dangerous side effects. Perphenazine is not for use in psychotic conditions related to dementia. Perphenazine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. Do not use perphenazine if you have liver disease, brain damage, bone marrow depression, a blood cell disorder, or if you are also using large amounts of alcohol or medicines that make you sleepy. Do not use if you are allergic to perphenazine or other phenothiazines.

Before you take perphenazine, tell your doctor if you have severe depression, heart disease or high blood pressure, liver or kidney disease, severe asthma or breathing problems, history of seizures, Parkinson's disease, past or present breast cancer, adrenal gland tumor, enlarged prostate or urination problems, glaucoma, low levels of calcium in your blood, or if you have ever had serious side effects while using chlorpromazine or similar medicines.

Before taking perphenazine, tell your doctor about all other medications you use.

What should I discuss with my healthcare provider before taking perphenazine?

Perphenazine is not for use in psychotic conditions related to dementia. Perphenazine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. You should not use perphenazine if you have liver disease, brain damage, bone marrow depression, a blood cell disorder (such as low platelets or low red or white blood cell counts), or if you are also using large amounts of alcohol or medicines that make you sleepy. You also should not use this medication if you are allergic to perphenazine or other phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Permitil), prochlorperazine (Compazine, Compro), promethazine (Adgan, Pentazine, Phenergan), thioridazine (Mellaril), or trifluoperazine (Stelazine).

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take perphenazine, tell your doctor if you have:

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  severe or untreated depression;

  
  


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  heart disease or high blood pressure;

  
  


• liver or kidney disease;


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  severe asthma, emphysema, or other breathing problem;

  
  


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  a history of seizures;

  
  


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  Parkinson's disease;

  
  


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  past or present breast cancer;

  
  


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  adrenal gland tumor (pheochromocytoma);

  
  


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  enlarged prostate or urination problems;

  
  


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  low levels of calcium in your blood (hypocalcemia);

  
  


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  glaucoma; or

  
  


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  if you have ever had a serious side effect while using perphenazine or another phenothiazine.

  
  

Tell your doctor if you will be exposed to extreme heat or cold, or to insecticide poisons while you are taking perphenazine.

Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking perphenazine, do not stop taking it without your doctor's advice. Perphenazine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication.

How should I take perphenazine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

To be sure this medication is not causing harmful effects, your kidney and liver function may need to be tested. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are taking pherphenazine. Do not stop using perphenazine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using perphenazine. Store at room temperature away from moisture, heat, and light.

See also: Perphenazine dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include dry mouth, constipation, bloating or stomach cramps, extreme drowsiness, dizziness, fast or pounding heartbeat; uncontrollable muscle movements, fainting, and seizure (convulsions).

What should I avoid while taking perphenazine?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Avoid drinking alcohol. It can increase some of the side effects of perphenazine. Avoid exposure to sunlight or tanning beds. Perphenazine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Perphenazine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using perphenazine and call your doctor at once if you have a serious side effect such as:

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  twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;

  
  


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  tremor (uncontrolled shaking), drooling, trouble swallowing, problems with balance or walking;

  
  


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  feeling restless, jittery, or agitated;

  
  


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  confusion, unusual thoughts or behavior;

  
  


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  feeling like you might pass out;

  
  


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  seizure (convulsions);

  
  


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  decreased night vision, tunnel vision, watery eyes, increased sensitivity to light;

  
  


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  nausea and stomach pain, skin rash, and jaundice (yellowing of the skin or eyes);

  
  


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  high fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing;

  
  


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  pale skin, easy bruising or bleeding, fever, sore throat, flu symptoms;

  
  


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  urinating less than usual or not at all;

  
  


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  joint pain or swelling with fever, swollen glands, muscle aches, chest pain, vomiting, unusual thoughts or behavior, and patchy skin color; or

  
  


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  slow heart rate, weak pulse, fainting, slow breathing (breathing may stop).

  
  

Less serious side effects may include:

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  dizziness, drowsiness, anxiety;

  
  


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  blurred vision, headache;

  
  


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  sleep problems (insomnia), strange dreams;

  
  


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  constipation;

  
  


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  dry mouth or stuffy nose;

  
  


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  breast swelling or discharge;

  
  


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  changes in your menstrual periods;

  
  


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  weight gain, swelling in your hands or feet;

  
  


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  impotence, trouble having an orgasm; or

  
  


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  mild itching or skin rash.

  
  

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Perphenazine Dosing Information

Usual Adult Dose for Psychosis:

For moderately disturbed, nonhospitalized patients:
Tablets: 4 to 8 mg three times daily. The dose should be reduced as soon as possible to the minimum effective dose.

For hospitalized psychotic patients:
Tablets: 8 to 16 mg two to three times daily. Avoid dosages in excess of 64 mg daily.
Concentrate: 8 to 16 mg two to four times daily. Avoid dosages in excess of 64 mg daily.
Prolonged administration of doses exceeding 24 mg daily should be reserved for hospitalized patients or patients under continued observation for early detection and management of adverse reactions.

For patients requiring prompt control or in whom oral administration is not feasible:
5 mg by deep IM injection. May repeat every six hours, not to exceed a daily dosage of 15 mg in ambulatory patients or 30 mg in hospitalized patients. If necessary, an initial 10 mg IM dose may be administered for symptoms of severe psychosis.

Usual Adult Dose for Nausea/Vomiting:

For severe nausea and vomiting:
Tablets: 8 to 16 mg daily in divided doses, up to 24 mg if necessary. Early dose reduction is desirable.
Prolonged administration of doses exceeding 24 mg daily should be reserved for hospitalized patients or patients under continued observation for early detection and management of adverse reactions.

For patients requiring prompt control or in whom oral administration is not feasible:
5 mg by deep IM injection, may repeat every six hours. If necessary, an initial 10 mg IM dose may be administered for severe symptoms. In general, higher dosages should only be given to hospitalized patients.

Usual Pediatric Dose for Psychosis:

>12 years:
For moderately disturbed, nonhospitalized patients:
Tablets: 4 mg three times daily. The dose should be reduced as soon as possible to the minimum effective dose.

For hospitalized psychotic patients:
Tablets: 8 mg two times daily.

For patients requiring prompt control or in whom oral administration is not feasible:
5 mg by deep IM injection.. May repeat every six hours.

Usual Pediatric Dose for Nausea/Vomiting:

>12 years:
For severe nausea and vomiting:
Tablets: 8 mg daily in divided doses. Early dose reduction is desirable.

For patients requiring prompt control or in whom oral administration is not feasible:
5 mg by deep IM injection. May repeat every six hours.

What other drugs will affect perphenazine?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by perphenazine. Tell your doctor if you regularly use any of these medicines, or any other antipsychotic medicine.

Also tell your doctor if you are taking any of the following medicines:

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  atropine (Atreza, Sal-Tropine);

  
  


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  lithium (Eskalith, Lithobid);

  
  


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  gefitinib (Iressa), imatinib (Gleevec), or nilotinib (Tasigna);

  
  


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  an antibiotic;

  
  


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  birth control pills or hormone replacement estrogens;

  
  


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  blood pressure medication;

  
  


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  a blood thinner such as warfarin (Coumadin, Jantoven);

  
  


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  certain asthma medications or bronchodilators;

  
  


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  heart rhythm medication;

  
  


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  HIV or AIDS medications;

  
  


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  incontinence medications;

  
  


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  insulin or diabetes medications you take by mouth;

  
  


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  medication for nausea, vomiting, or motion sickness;

  
  


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  medications to treat or prevent malaria;

  
  


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  medications used for general anesthesia;

  
  


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  medicines used to prevent organ transplant rejection;

  
  


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  numbing medicine such as lidocaine or Novocain;

  
  


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  a stimulant or ADHD medication;

  
  


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  ulcer or irritable bowel medications; or

  
  


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  medicines to treat Parkinson's disease, restless leg syndrome, or pituitary gland tumor (prolactinoma).

  
  

This list is not complete and there are many other medicines that can interact with perphenazine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

More perphenazine resources

• Perphenazine Side Effects (in more detail)
• Perphenazine Dosage
• Perphenazine Use in Pregnancy & Breastfeeding
• Drug Images
• Perphenazine Drug Interactions
• Perphenazine Support Group
• 5 Reviews for Perphenazine - Add your own review/rating

• Perphenazine Prescribing Information (FDA)


• Perphenazine Professional Patient Advice (Wolters Kluwer)


• Perphenazine Monograph (AHFS DI)


• Perphenazine MedFacts Consumer Leaflet (Wolters Kluwer)

Compare perphenazine with other medications

• Bipolar Disorder
• Nausea/Vomiting
• Psychosis

Where can I get more information?

• Your pharmacist can provide more information about perphenazine.

See also: perphenazine side effects (in more detail)