Class: Phenothiazines
VA Class: CN701
Chemical Name: 2-[4-[3-(2-chloro-10H-phenothiazin-10-yl) propyl]piperazin-1-yl]ethanol
Molecular Formula: C21H26CIN3OS
CAS Number: 58-39-9
Special Alerts:
[Posted 02/22/2011] ISSUE: FDA notified healthcare professionals that the Pregnancy section of drug labels for the entire class of antipsychotic drugs has been updated. The new drug labels now contain more and consistent information about the potential risk for abnormal muscle movements (extrapyramidal signs or EPS) and withdrawal symptoms in newborns whose mothers were treated with these drugs during the third trimester of pregnancy.
The symptoms of EPS and withdrawal in newborns may include agitation, abnormally increased or decreased muscle tone, tremor, sleepiness, severe difficulty breathing, and difficulty in feeding. In some newborns, the symptoms subside within hours or days and do not require specific treatment; other newborns may require longer hospital stays.
BACKGROUND: Antipsychotic drugs are used to treat symptoms of psychiatric disorders such as schizophrenia and bipolar disorder.
RECOMMENDATION: Healthcare professionals should be aware of the effects of antipsychotic medications on newborns when the medications are used during pregnancy. Patients should not stop taking these medications if they become pregnant without talking to their healthcare professional, as abruptly stopping antipsychotic medications can cause significant complications for treatment. For more information visit the FDA website at: and .
Introduction
Propylpiperazine-derivative phenothiazine; conventional (prototypical, first-generation) antipsychotic agent.a b c d f g j
Uses for Perphenazine
Psychotic Disorders
Symptomatic management of psychotic disorders (i.e., schizophrenia).a b c d f j
Management of acute depressive episodes (in fixed combination with amitriptyline hydrochloride) in patients with schizophrenia.d
Anxiety and Depressive Disorders
Management of moderate to severe anxiety and/or agitation (in fixed combination with amitriptyline hydrochloride) in patients with depressed mood.d
Management of severe anxiety and/or agitation (in fixed combination with amitriptyline hydrochloride) in patients with depression.d
Management of depression and anxiety (in fixed combination with amitriptyline hydrochloride) in association with chronic physical disease.d
Nausea and Vomiting
Management of severe nausea and vomiting in adults.a b c f
Mental Retardation
Efficacy not established for the management of behavioral complications in patients with mental retardation.a b c f
Perphenazine Dosage and Administration
General
Adjust dosage carefully according to individual requirements and response; use the lowest possible effective dosage.a b c f
For symptomatic relief of psychotic disorders, initial therapeutic response to antipsychotic therapy usually occurs within 2–4 weeks and optimum therapeutic response occurs within 6 months or longer.c g
Periodically evaluate patients receiving long-term therapy to determine whether maintenance dosage can be decreased or drug therapy discontinued.b c
Fixed-ratio combination preparations generally should not be used as initial therapy.m First administer each drug separately.m If the optimum maintenance dosage corresponds to the ratio in a commercial combination preparation, a fixed-combination preparation may be used.m If dosage adjustment is necessary, administer the drugs separately.m Fixed-ratio combination preparations do not permit individual titration of dosages.n
Therapeutic response with combination therapy usually evident within days or weeks; may take longer in some patients.d
Administration
Oral Administration
Administered orally.a b c d f j Has been given parenterally† as perphenazine, perphenazine decanoate, and perphenazine enanthate, but a parenteral dosage form of the drug is no longer commercially available in the US.j k
Dosage
Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.
Available as perphenazine (alone and in fixed combination with amitriptyline hydrochloride); dosage expressed in terms of base.b d
Pediatric Patients
Psychotic Disorders
Monotherapy in Outpatients
Oral
Children ≥12 years of age: Initially, 4–8 mg 3 times daily.a b f Carefully adjust subsequent dosage according to the patient’s tolerance and therapeutic response.a b c f During maintenance therapy, keep dosage at the lowest effective level.a b c f
Prolonged administration of dosages >24 mg daily should be limited to hospitalized patients or patients under continuous observation.a b f
Monotherapy in Hospitalized Patients
Oral
Children ≥12 years of age: Initially, 8–16 mg 2–4 times daily.a b f Carefully adjust subsequent dosage according to the patient’s tolerance and therapeutic response.a b c f During maintenance therapy, keep dosage at the lowest effective level.a b c f
Prolonged administration of dosages >24 mg daily should be limited to hospitalized patients or patients under continuous observation.a b f
Perphenazine/Amitriptyline Combination Therapy
Oral
Adolescents: Initially, 4 mg (in fixed combination with 10 mg amitriptyline hydrochloride) 3 or 4 times daily; adjust as required.d (See Pediatric Use under Cautions.)
Maximum daily dosages of perphenazine and amitriptyline hydrochloride not to exceed 16 and 200 mg, respectively.d
Adults
Psychotic Disorders
Monotherapy in Outpatients
Oral
Initially, 4–8 mg 3 times daily.a b f Carefully adjust subsequent dosage according to the patient’s tolerance and therapeutic response.a b c f During maintenance therapy, keep dosage at the lowest effective level.a b c f
Prolonged administration of dosages >24 mg daily should be limited to hospitalized patients or patients under continuous observation.a b f
Monotherapy in Hospitalized Patients
Oral
Initially, 8–16 mg 2–4 times daily.a b f Carefully adjust subsequent dosage according to the patient’s tolerance and therapeutic response.a b c f During maintenance therapy, keep dosage at the lowest effective level.a b c f
Prolonged administration of dosages >24 mg daily should be limited to hospitalized patients or patients under continuous observation.a b f
Avoid dosages >64 mg daily.a b f g
Perphenazine/Amitriptyline Combination Therapy
Oral
Initially, 2 tablets of 4 mg (in fixed combination with 25 mg amitriptyline hydrochloride) 3 times daily.d If needed, a fourth dose may be given at bedtime.d
Carefully adjust subsequent dosage according to the patient’s tolerance and therapeutic response.d During maintenance therapy, keep dosage at the lowest effective level.d Perphenazine maintenance dosages usually range from 4–16 mg and amitriptyline hydrochloride maintenance dosages usually range from 50–100 mg daily.d
Maximum daily dosages of perphenazine and amitriptyline hydrochloride not to exceed 16 and 200 mg, respectively.d
Anxiety and Depressive Disorders
Perphenazine/Amitriptyline Combination Therapy
Oral
Initially, 2 mg (in fixed combination with 25 mg amitriptyline hydrochloride) or 4 mg (in fixed combination with 25 mg amitriptyline hydrochloride) 3 or 4 times daily. d Alternatively, 4 mg (in fixed combination with 50 mg amitriptyline hydrochloride) twice daily.d
Carefully adjust subsequent dosage according to the patient’s tolerance and therapeutic response.d During maintenance therapy, keep dosage at the lowest effective level.d Perphenazine maintenance dosages usually range from 4–16 mg and amitriptyline hydrochloride maintenance dosages usually range from 50–100 mg daily.d
Maximum daily dosages of perphenazine and amitriptyline hydrochloride not to exceed 16 and 200 mg, respectively.d
Nausea and Vomiting
Oral
Initially, 8–16 mg in divided doses.a b f Some patients may require dosages ≤24 mg daily; early dosage reduction desirable.a b f
Prolonged administration of dosages >24 mg daily should be used only in hospitalized patients or patients under continuous observation.a b f
Prescribing Limits
Pediatric Patients
Psychotic Disorders
Perphenazine/Amitriptyline Combination Therapy
Oral
Adolescents: Maximum 16 and 200 mg daily of perphenazine and amitriptyline hydrochloride, respectively.d
Adults
Psychotic Disorders
Monotherapy
Oral
Prolonged administration of dosages >24 mg daily limited to hospitalized patients or patients under continuous observation.a b f
Maximum 64 mg daily in hospitalized patients.a b f
Perphenazine/Amitriptyline Combination Therapy
Oral
Maximum 16 and 200 mg daily of perphenazine and amitriptyline hydrochloride, respectively.d
Anxiety and Depressive Disorders
Perphenazine/Amitriptyline Combination Therapy
Oral
Maximum 16 and 200 mg daily of perphenazine and amitriptyline hydrochloride, respectively.d
Special Populations
Geriatric Patients
No specific dosage recommendations for geriatric patients, but generally select dosage at the lower end of recommended range; increase dosage more gradually and monitor closely.a b e f May administer before bedtime.a f (See Geriatric Use under Cautions.)
Lower dosages for longer duration may be necessary for optimal therapeutic response.a f
Psychotic Disorders
When used in fixed combination with amitriptyline hydrochloride, an oral dosage of 4 mg of perphenazine and 10 mg of amitriptyline hydrochloride 3 or 4 times daily is recommended initially.d Subsequent dosage adjustments may be made as necessary.d
Cautions for Perphenazine
Contraindications
Comatose or greatly obtunded states or in the presence of large amounts of CNS depressants (e.g., alcohol, antihistamines, barbiturates, opiates). a c d f (See Specific Drugs and Laboratory Tests under Interactions.)
Bone marrow depression, blood dyscrasias, or liver damage.a c d f
Suspected or established subcortical brain damage, with or without hypothalamic damage.a c f
Known hypersensitivity to perphenazine, any component in the formulations, or other phenothiazine derivatives.a c d f
Warnings/Precautions
Warnings
Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.
Shares the toxic potentials of other phenothiazines; observe the usual precautions of phenothiazine therapy.a b c d f
Tardive Dyskinesia
Tardive dyskinesia, a syndrome of potentially irreversible, involuntary, dyskinetic movements, may develop in patients receiving antipsychotic agents, including perphenazine.a c d f Consider discontinuance.a c d f
Neuroleptic Malignant Syndrome
Neuroleptic malignant syndrome (NMS), a potentially fatal syndrome requiring immediate discontinuance of the drug and intensive symptomatic treatment, has been reported with antipsychotic agents, including perphenazine.a c f
Cardiovascular Effects
Possible hypotension (including orthostatic hypotension).a c f Patients with pheochromocytoma or mitral insufficiency may be especially prone to hypotensive effects.a c f Rebound hypertension may occur in pheochromocytoma patients.a f If severe hypotension occurs, may use norepinephrine or phenylephrine to treat; epinephrine or dopamine should not be used.a c f (See Specific Drugs and Laboratory Tests under Interactions.)
Seizures
May lower seizure threshold.a c f Use with caution in patients experiencing alcohol withdrawal, patients with seizure disorders, and in those receiving anticonvulsant agents.a c f (See Specific Drugs and Laboratory Tests under Interactions.)
CNS Depression
May impair mental and/or physical abilities, especially during the first few days of therapy; use caution with activities requiring alertness (e.g., operating vehicles or machinery).a c f
Because of CNS depressant effects, use with caution in patients with chronic respiratory disorders (e.g., severe asthma, emphysema, acute respiratory tract infections).a c f
Sensitivity Reactions
Possible sensitivity reactions (e.g., anaphylactoid reactions, cholestatic jaundice, blood dyscrasias, skin reactions).a c d f Use generally not recommended in patients who have previously demonstrated a hypersensitivity reaction (e.g., blood dyscrasias, jaundice) to a phenothiazine, unless potential benefits outweigh the possible risks.a c d f
Photosensitivity may occur; avoid excessive exposure to sun during therapy.a c f
Contact dermatitis reported.a c f
General Precautions
Hematologic Effects
Agranulocytosis, thrombocytopenia, anemia, and pancytopenia reported.a c f Perform hematologic evaluations periodically.a c f
If bone marrow suppression occurs during therapy, discontinue drug and institute appropriate therapy.a c f f g
Hepatic Effects
Cholestatic jaundice or liver damage reported.a c f
Periodically monitor liver function tests during therapy; if abnormal results occur, discontinue therapy.a c f g
Prolactin Secretion
Elevated prolactin concentrations reported; elevation persists during chronic administration.a c d f
Clinical importance unknown; consider that approximately one-third of human breast cancers are prolactin dependent when prescribed in patients with previously detected breast cancer.a d f
Galactorrhea, amenorrhea, gynecomastia, and impotence reported.a c d f
Ocular Effects
Consider possibility of pigmentary retinopathy and lenticular and corneal deposits in patients receiving prolonged therapy.a c f
Regulation of Body Temperature
Phenothiazines depress the hypothalamic mechanism for body temperature regulation; possible hyperthermia or hypothermia when exposed to temperature extremes.a c
Use with caution in patients exposed to extreme heat or cold.a c d f
Suicide
Attendant risk with depression; closely supervise high-risk patients.a d f Prescribe in the smallest quantity consistent with good patient management to reduce risk.a d f
Anticholinergic Effects
Possible anticholinergic effects (e.g., dry mouth, blurred vision, mydriasis, constipation, obstipation, nausea, adynamic ileus, atonic colon, urinary retention, decreased perspiration, and impotence).a c f
Use in Fixed Combination
When used in fixed combination with amitriptyline hydrochloride, consider the cautions, precautions, and contraindications associated with amitriptyline hydrochloride.d
Other Precautions
Periodically monitor renal function tests during long-term use; if BUN becomes abnormal, discontinue therapy.a c f g
Antiemetic effects may mask signs of overdosage of other drugs (e.g., antineoplastic agents) or obscure cause of vomiting in various disorders (e.g., intestinal obstruction, Reye’s syndrome, brain tumor).a c d f
Specific Populations
Pregnancy
Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.
Category C.e
Lactation
Distributed into milk.c e Caution if used in nursing women; carefully assess potential benefits and risks.a e f i
Pediatric Use
Safety and efficacy of amitriptyline hydrochloride not established in children <12 years of age.a b
Safety and efficacy of the perphenazine-amitriptyline hydrochloride fixed combination not established in pediatric patients.d
Geriatric Use
Geriatric patients appear to be particularly sensitive to adverse CNS (e.g., tardive dyskinesia, parkinsonian manifestations, akathisia, sedation), anticholinergic, and cardiovascular (e.g., orthostatic hypotension) effects of antipsychotic agents.a c f g Possible increased risk for falls and consequent hip fractures.f
Use with caution.f (See Geriatric Patients under Dosage and Administration.)
Hepatic Impairment
Contraindicated in patients with liver damage.a f
Renal Impairment
Use with caution.a c d f Monitor renal function periodically; if BUN becomes abnormal, discontinue therapy.a c f g
Common Adverse Effects
Extrapyramidal reactions (e.g., Parkinson-like symptoms, dystonia, akathisia, tardive dyskinesia), drowsiness, muscular weakness, dry mouth, blurred vision, weight gain, skin reactions, amenorrhea, galactorrhea.a c d f g
Interactions for Perphenazine
Drugs Affecting Hepatic Microsomal Enzymes
Potential pharmacokinetic interaction (increased plasma perphenazine concentrations) with concomitant use of CYP2D6 inhibitors; use with caution.a f
Specific Drugs and Laboratory Tests
Drug | Interaction | Comments |
|---|---|---|
Alcohol | Potential additive CNS effects; concomitant use with alcohol potentiates hypotension observed with perphenazinea c d f | Advise patients to avoid alcohola c d f |
Anticholinergic agents | Additive anticholinergic effectsa f | Use with cautiona f |
Anticonvulsants | Perphenazine may lower seizure thresholda c f | Dosage adjustments of anticonvulsants may be necessary a c d f |
Antidepressants, SSRIs (e.g., citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline) | Possible increased plasma concentrations of perphenazinea f | Observe patients closely for adverse effectsa f Dosage reduction of SSRI or perphenazine may be necessarya f |
Antidepressants, tricyclic (TCAs) | Possible increased plasma concentrations of perphenazinea f | Observe patients closely for adverse effectsa f Dosage reduction of TCA or perphenazine may be necessarya f |
CNS depressants (e.g., analgesics, antihistamines, barbiturates, general anesthetics, opiates) | Possible additive effects or potentiated action of other CNS depressantsa c f | Use concomitantly with caution to avoid excessive sedation or CNS depressiona c f |
Epinephrine or dopamine | Possible further lowering of BPa c f | Do not use epinephrine or dopamine for phenothiazine-induced hypotensiona c f (see Cardiovascular Effects under Cautions) |
Lithium | An acute encephalopathic syndrome reported occasionally, especially when high serum lithium concentrations presentc | Observe patients receiving combined therapy for evidence of adverse neurologic effects; promptly discontinue if such signs or symptoms appearc |
Test for phenylketonuria (PKU) | Potential false-positive test results may occur during phenothiazine usec |
Perphenazine Pharmacokinetics
Absorption
Bioavailability
Well absorbed after oral administrationc ; appears to undergo substantial first-pass metabolism.h j l Peak plasma concentrations generally attained within 1–3 hours.a c f h k
Distribution
Extent
Not fully characterized.c f Phenothiazines are widely distributed into most body tissues and fluids.c h
Crosses the placenta.c e Distributed into breast milk.c e
Plasma Protein Binding
Phenothiazines are highly bound to plasma proteins.c h
Elimination
Metabolism
Extensively metabolized in the liver by sulfoxidation, hydroxylation, dealkylation and glucuronidation.a f k Poor metabolizers of CYP2D6 metabolize the drug more slowly than normal metabolizers.a d f k
Elimination Route
Phenothiazines and their metabolites are excreted in urine and feces.c h
Unlikely to be removed by hemodialysis and peritoneal dialysis.a f k
Half-life
9–12 hours following oral administration.a f g k l
Stability
Storage
Oral
Tablets
Tight, light-resistant containers at 20–25°C (may be exposed to 15-30°C).a b f
Fixed-combination (with Amitriptyline Hydrochloride) Tablets
Tight, light-resistant containers at 20–25°C.d
ActionsActions
Precise mechanism(s) of antipsychotic action not determined, but may be principally related to antidopaminergic effects.a c d f
Exhibits moderate anticholinergic effects, weak to moderate sedative effects, and strong extrapyramidal effects; possesses strong antiemetic activity.b d g
Advice to Patients
Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.
Risk of drowsiness and impairment of mental and physical abilities required for driving a car or operating heavy machinery.a c f
Importance of avoiding alcohol during perphenazine therapy.a c d f
Importance of clinicians informing patients in whom chronic use is contemplated of risk of tardive dyskinesia, taking into account clinical circumstances and competency of patient to understand information provided.c f
Importance of clinicians informing patients of risk of extrapyramidal reactions and providing reassurance that these reactions usually can be controlled by administration of antiparkinsonian drugs (e.g., benztropine) and by subsequent dosage reduction.c
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as concomitant illnesses.a d
Importance of avoiding exposure to temperature extremes.a c d f
Importance of informing clinician if sore throat or other signs of infection occur.a c f
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.a d f i
Importance of informing patients of other important precautionary information.a d f (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Oral | Tablets | 2 mg* | Perphenazine Tablets | Sandoz, Teva, Vintage |
4 mg* | Perphenazine Tablets | Sandoz, Teva, Vintage | ||
8 mg* | Perphenazine Tablets | Sandoz, Teva, Vintage | ||
16 mg* | Perphenazine Tablets | Sandoz, Teva, Vintage |
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Oral | Tablets, film-coated | 2 mg Perphenazine and Amitriptyline Hydrochloride 10 mg* | Perphenazine and Amitriptyline Hydrochloride Tablets | Mylan, Sandoz, Watson |
2 mg Perphenazine and Amitriptyline Hydrochloride 25 mg* | Perphenazine and Amitriptyline Hydrochloride Tablets | Mylan, Sandoz, Watson | ||
4 mg Perphenazine and Amitriptyline Hydrochloride 10 mg* | Perphenazine and Amitriptyline Hydrochloride Tablets | Mylan, Sandoz, Watson | ||
4 mg Perphenazine and Amitriptyline Hydrochloride 25 mg* | Perphenazine and Amitriptyline Hydrochloride Tablets | Mylan, Sandoz, Watson | ||
4 mg Perphenazine and Amitriptyline Hydrochloride 50 mg* | Perphenazine and Amitriptyline Hydrochloride Tablets | Mylan |
Comparative Pricing
This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 04/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.
Perphenazine 16MG Tablets (SANDOZ): 60/$82.99 or 180/$229.98
Perphenazine 2MG Tablets (SANDOZ): 60/$41.99 or 120/$72.98
Perphenazine 4MG Tablets (SANDOZ): 60/$55.99 or 180/$155.96
Perphenazine 8MG Tablets (SANDOZ): 60/$59.99 or 180/$165.97
Disclaimer
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions March 15, 2011. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
References
HID. Trissel LA. Handbook on injectable drugs. 12th ed. Bethesda, MD: American Society of Health-System Pharmacists; 2003:622-3.
a. Sandoz, Inc. Perphenazine tablets prescribing information. Princeton, NJ; 2007 Jan.
b. AHFS drug information 2007. McEvoy GK, ed. Perphenazine. Bethesda, MD: American Society of Health-System Pharmacists; 2007:2454-55.
c. AHFS drug information 2007. McEvoy GK, ed. Phenothiazines general statement. Bethesda, MD: American Society of Health-System Pharmacists; 2007:2439-50.
d. Mylan Pharmaceuticals. Perphenazine and amitriptyline hydrochloride tablets prescribing information. Morgantown, WV; 2007 Aug.
e. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 7th ed. Baltimore, MD: Williams & Wilkins; 2005:1271-2.
f. Ivax Pharmaceuticals, Inc. Perphenazine tablets prescribing information. Miama, FL; 2003 Nov.
g. American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry. 2004; 161(Suppl):1-56.
h. DeVane CL. Brief comparison of the pharmacokinetics and pharmacodynamics of the traditional and newer antipsychotic drugs. Am J Health-Syst Pharm. 1995; 52(Suppl 1):S15-8. [PubMed 7538435]
i. Tenyi T, Csabi G, Trixler M. Antipsychotics and breast-feeding: a review of the literature. Paediatr Drugs. 2000; 2:23-8. [PubMed 10937456]
j. Hartung B, Wada M, Laux G et al. Perphenazine for schizophrenia. Cochrane Database Systematic Reviews. 2005; Issue 1:Article No.: CD003443. DOI: 10.1002/14651858.CD003443.pub2.
k. Schering Corporation. Trilafon (perphenazine) tablets and injection prescribing information. Kenilworth, NJ; 2002 Apr.
l. Eggert Hansen C, Rosted Christensen T, Elley J et al. Clinical pharmacokinetic studies of perphenazine. Br J Clin Pharmacol. 1976; 3:915-23. [PubMed 973987]
m. AHFS drug information 2008. McEvoy GK, ed. Amitriptyline hydrochloride. Bethesda, MD: American Society of Health-System Pharmacists; 2008:2415.
n. AHFS drug information 2008. McEvoy GK, ed. Antimuscarinics/antispasmodics general statement. Bethesda, MD: American Society of Health-System Pharmacists; 2008:1293-300.
More Perphenazine resources
- Perphenazine Side Effects (in more detail)
- Perphenazine Use in Pregnancy & Breastfeeding
- Drug Images
- Perphenazine Drug Interactions
- Perphenazine Support Group
- 5 Reviews for Perphenazine - Add your own review/rating
- Perphenazine Professional Patient Advice (Wolters Kluwer)
- Perphenazine MedFacts Consumer Leaflet (Wolters Kluwer)
- Perphenazine Prescribing Information (FDA)
- perphenazine Concise Consumer Information (Cerner Multum)
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