Microplastics and Misinformation: What Science Really Says
November 12, 2025
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Brand Name :
Trilafon
Synonyms :
perphenazine
Class :
Antipsychotics, Phenothiazines, Antipsychotics, First Generation
Brand Name :
Trilafon
Synonyms :
perphenazine
Class :
Antipsychotics, Phenothiazines, Antipsychotics, First Generation
Dosage Forms & StrengthsÂ
TabletÂ
2mgÂ
4mgÂ
8mgÂ
16mgÂ
Indicated for Schizophrenia
In hospitalization patients: 8-16 mg orally two-four times in a day
Should not exceed 64 mg in a day divided two-four times in a day
Out patients:4-8 mg orally three times in a day, decrease the dose to minimum effective dose
Nausea or vomiting
8-16 mg orally every day divided two-four times in a day
Should not exceed 24 mg
Intractable Hiccoughs as off-label
8-16 mg orally every day in divided two-three times in a day
Should not exceed 24 mg
Dosage Forms & StrengthsÂ
TabletÂ
2mgÂ
4mgÂ
8mgÂ
16mgÂ
Indicated for Schizophrenia
Age >12 years
In hospitalization patients: 8-16 mg orally two-four times in a day
Should not exceed 64 mg in a day divided two-four times in a day
Out patients:4-8 mg orally three times in a day, decrease the dose to minimum effective dose
Age <12 years
Safety and efficacy not established
Intractable Hiccoughs as off-label
Age >12 years
8-16 mg orally every day in divided two-three times in a day
Should not exceed 24 mg
Age <12 years
Safety and efficacy not established
Refer to adult dosingÂ
may reduce the therapeutic effect of antiparkinson drugs
may reduce the therapeutic effect of antiparkinson drugs
may reduce the therapeutic effect of antiparkinson drugs
may reduce the therapeutic effect of antiparkinson drugs
may affect the absorption of drugs when combined
may affect the absorption of drugs when combined
may affect the absorption of drugs when combined
may affect the absorption of drugs when combined
may affect the absorption of drugs when combined
may enhance the risk of hypertension when combined
may enhance the risk of hypertension when combined
may enhance the risk of hypertension when combined
may enhance the risk of hypertension when combined
may enhance the risk of hypertension when combined
may increase the CNS depressant effect
may increase the CNS depressant effect
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
may decrease the therapeutic effect when combined with antipsychotic agents
may have an increased CNS depressive effect when combined with CNS depressants
CNS depressants may have an increased CNS depressive effect when combined with flunitrazepam
may have an increased CNS depressant effect when combined with dexmedetomidine
may have an increased CNS depressant effect when combined with CNS depressants
may increase the CNS depressant effect of CNS depressants
may decrease the therapeutic effect when combined with antipsychotic agents
hydroxyzine: they may increase the CNS depressant effect of CNS Depressants
lemborexant: they may increase the CNS depressant effect of CNS Depressants
nalmefene: they may decrease the therapeutic effect of Opioid Agonists
It may enhance toxicity when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
may increase the CNS depressant effect of CNS Depressants
may increase the CNS depressant effect of Buprenorphine
aluminum hydroxide/magnesium carbonateÂ
may diminish the absorption of Antacids
may decrease the therapeutic effect of each other when combined
oxolamine: they may increase the CNS depressant effect of CNS Depressants
amisulpride: they may increase the CNS depressant effect of CNS Depressants
ramosetron: they may increase the CNS depressant effect of CNS Depressants
linezolid: they may increase the CNS depressant effect of CNS Depressants
secretin: they may increase the CNS depressant effect of CNS Depressants
abciximab: it may decrease the excretion rate of abacavir CNS depressant
benoxaprofen: it may increase the risk of CNS depression
alpelisib: it may increase the risk of CNS depression
alogliptin: it may increase the risk of CNS depression
alosetron: it may increase the risk of CNS depression
albendazole: it may increase the risk of CNS depression
agomelatin: it may increase the risk of CNS depression
acyclovir: it may increase the risk of CNS depression
benzphetamine: it may increase the risk of CNS depression
benzydamine: it may increase the risk of CNS depression
cannabidiol: it may increase the risk of CNS depression
capsaicin: it may increase the risk of CNS depression
captopril: it may increase the risk of CNS depression
carbinoxamine: it may increase the risk of CNS depression
azelastine/fluticasone intranasalÂ
may increase the CNS depressant effect
may decrease the therapeutic effect of cabergoline
may have an increased CNS depressant effect when combined with CNS depressants
may have an increased CNS depressive effect when combined with CNS depressants
it increases the effect of CNS depressants
CNS depressants increase the effect of orphenadrine
it increases the effect of CNS depressants
CNS depressants increase the effect of paraldehyde
it increases the effect of CNS depressants
may have an increased CNS depressant effect when combined with CNS depressants
may have an increased CNS depressant effect when combined with flunarizine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
may have an increasingly adverse effect when combined with antipsychotic agents
metoclopramide increases the toxicity of antipsychotic agents
levosalbutamol: they may increase the CNS depressant effect of CNS Depressants
furosemide: it may increase the CNS depressant effect of CNS Depressants
aclidinium: they may increase the CNS depressant effect of CNS Depressants
mequitazine: they may increase the CNS depressant effect of CNS Depressants
cimetropium: they may increase the CNS depressant effect of CNS Depressants
potassium citrate: they may increase the CNS depressant effect of CNS Depressants
pitolisant: they may increase the CNS depressant effect of CNS Depressants
may diminish the therapeutic efficacy of each other when combined
may diminish the therapeutic efficacy of each other when combined
may diminish the therapeutic efficacy of each other when combined
may diminish the therapeutic efficacy of each other when combined
may diminish the therapeutic efficacy of each other when combined
may increase the harmful effects of CNS depressants
may increase the harmful effects of CNS depressants
may increase the harmful effects of CNS depressants
may increase the harmful effects of CNS depressants
may increase the harmful effects of CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may enhance the CNS depressant effect of Opioid Agonists
may enhance the CNS depressant effect of Opioid Agonists
may enhance the CNS depressant effect of Opioid Agonists
may enhance the CNS depressant effect of Opioid Agonists
may enhance the adverse/toxic effect of amphetamines
may enhance the adverse/toxic effect of amphetamines
may enhance the adverse/toxic effect of amphetamines
may enhance the adverse/toxic effect of amphetamines
may enhance the adverse/toxic effect of amphetamines
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may enhance the hypotensive effect of beta-blockers
may reduce the therapeutic effect of anti-Parkinson drugs
may reduce the therapeutic effect of anti-Parkinson drugs
may reduce the therapeutic effect of anti-Parkinson drugs
may reduce the therapeutic effect of anti-Parkinson drugs
may reduce the therapeutic effect of anti-Parkinson drugs
may increase the effect of beta-blockers
may increase the effect of beta-blockers
may increase the effect of beta-blockers
may increase the effect of beta-blockers
may increase the effect of beta-blockers
may increase the adverse effect of amphetamines
may increase the adverse effect of amphetamines
may increase the adverse effect of amphetamines
may increase the adverse effect of amphetamines
may increase the adverse effect of amphetamines
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may have an increased neurotoxic effect when combined with antipsychotic agents
may have an increased neurotoxic effect when combined with antipsychotic agents
may have an increased effect of CNS depressant when combined with cannabinoid products
may have an increased effect of CNS depressant when combined with cannabinoid products
they decrease the effect of each other by pharmacodynamic antagonism
they decrease the effect of each other by pharmacodynamic antagonism
they decrease the effect of each other by pharmacodynamic antagonism
they decrease the effect of each other by pharmacodynamic antagonism
they decrease the effect of each other by pharmacodynamic antagonism
may have an increased hypotensive effect when combined with beta-blockers
may have an increased hypotensive effect when combined with beta-blockers
may have an increased hypotensive effect when combined with beta-blockers
When encainide is used together with perphenazine, this leads to a reduction in the encainide’s metabolism
may diminish the therapeutic effect of the drug
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may increase the hypotensive effect of antipsychotic agents
may have an increased Effect of CNS depressant when combined with alcohol
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased serotonergic effect when combined with serotonergic agents
perphenazine: it may increase the risk of methemoglobinemia associated agents
perphenazine: it may increase the risk of methemoglobinemia associated agents
perphenazine: it may increase the risk of methemoglobinemia associated agents
perphenazine: it may increase the risk of methemoglobinemia associated agents
perphenazine: it may increase the risk of methemoglobinemia associated agents
when both drugs are combined, there may be an increase in the serum concentration of perphenazine 
It may increase the neurotoxic effect of Antipsychotic Agents
seizure lowering agents increase the toxic or adverse effects of other antipsychotic agents
it may increase the risk of adverse effect of amphetamines
serotonergic agents may enhance the adverse/toxic effect of anti-psychotic agents
CNS Depressants may enhance the CNS depressant effect of brexanolone
lisuride may enhance the CNS depressant effect of CNS Depressants
may enhance the neurotoxic (central) effect of antipsychotic agents
may enhance the neurotoxic (central) effect of antipsychotic agents
may enhance the neurotoxic (central) effect of antipsychotic agents
may enhance the neurotoxic (central) effect of antipsychotic agents
may enhance the neurotoxic (central) effect of antipsychotic agents
it increases the effect of CNS depressants
it increases the effect of CNS depressants
antacids reduce the systemic absorption of phenothiazine derivatives
antacids reduce the systemic absorption of phenothiazine derivatives
antacids reduce the systemic absorption of phenothiazine derivatives
antacids reduce the systemic absorption of phenothiazine derivatives
antacids reduce the systemic absorption of phenothiazine derivatives
may increase the hypotensive effect of beta-blockersÂ
may increase the hypotensive effect of beta-blockersÂ
may increase the hypotensive effect of beta-blockersÂ
may increase the hypotensive effect of beta-blockersÂ
may increase the hypotensive effect of beta-blockersÂ
may enhance the adverse/toxic effect of other CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may enhance the adverse/toxic effect of other CNS depressants
may decrease the absorption of antipsychotic agents
may decrease the absorption of antipsychotic agents
may decrease the absorption of antipsychotic agents
may decrease the absorption of antipsychotic agents
may decrease the absorption of antipsychotic agents
may enhance the hypotensive effects
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may enhance the neurotoxic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may diminish the therapeutic effect of antipsychotic agents
may decrease the absorption of antipsychotic agents
may decrease the absorption of antipsychotic agents
may decrease the absorption of antipsychotic agents
may decrease the absorption of antipsychotic agents
may decrease the absorption of antipsychotic agents
may enhance the hypotensive effect of antipsychotic agents
may enhance the hypotensive effect of antipsychotic agents
may enhance the hypotensive effect of antipsychotic agents
may enhance the hypotensive effect of antipsychotic agents
may enhance the hypotensive effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may enhance the adverse effect of antipsychotic agents
may increase the hypotensive effect of beta blockers
may increase the hypotensive effect of beta blockers
may increase the toxic effect of amphetamines
may increase the hypotensive effect of blood pressure-lowering agents
may have an increased CNS depressant effect when combined with brexanolone
may have an increased CNS depressive effect when combined with CNS depressants
may have an increased CNS depressive effect when combined with CNS depressants
may have an increased CNS depressive effect when combined with CNS depressants
it increases the effect of CNS depressants
CNS depressants increase the efficacy of cannabinoid-containing products
CNS depressants increase the efficacy of cannabinoid-containing products
it increases the effect of CNS depressants
it increases the effect of CNS depressants
may increase the effect of antipsychotic agents
may increase the effect of antipsychotic agents
may increase the effect of antipsychotic agents
may increase the effect of antipsychotic agents
may increase the effect of antipsychotic agents
may increase the toxic effect of CNS depressants
may increase the toxic effect of seizure threshold-lowering potential agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may increase the hypotensive effect of Blood Pressure Lowering Agents
may increase the risk of adverse effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may enhance the hypotensive effect
may increase the hypotensive effect of Blood Pressure Lowering Agents
lofexidine: they may increase the CNS depressant effect of CNS Depressants
pramipexole: they may increase the sedative effect of CNS Depressants
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
may increase the neurotoxic effect
It may enhance sedation when combined with perphenazine
It may enhance sedation when combined with perphenazine
It may enhance sedation when combined with perphenazine
It may enhance sedation when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
It may enhance sedation when combined with perphenazine
It may enhance QTc interval when combined with perphenazine
may increase the risk of adverse effects
may increase the risk of adverse effects
may increase the risk of adverse effects
may increase the risk of adverse effects
may increase the risk of adverse effects
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may have an increased Effect of a CNS depressant when combined with methotrimeprazine
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increasingly adverse effect when combined with antipsychotic agent
may decrease the therapeutic effect when combined with guanethidine
they decrease the absorption of antipsychotic agents
they decrease the absorption of antipsychotic agents
antipsychotic agents increase the effect of beta-blockers
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
may increase the QTc-prolonging effect
The sedative effect of metyrosine might be intensified by CNS depressants
Could potentially amplify the toxicity of antipsychotic agents
The efficacy of guanethidine could be reduced by the presence of antipsychotic agents
Could potentially amplify the toxicity of antipsychotic agents
may have an increased neurotoxic effect when combined with antipsychotic agents
may have an increased neurotoxic effect when combined with antipsychotic agents
chloroprocaine: they may increase the CNS depressant effect of CNS Depressants
ixabepilone: they may increase the CNS depressant effect of CNS Depressants
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
may have an increased hypotensive effect when combined with antipsychotic agents
benzyl alcohol: they may increase the CNS depressant effect of CNS Depressants
bromopride: they may increase the CNS depressant effect of CNS Depressants
dimethindene: they may increase the CNS depressant effect of CNS Depressants
kava: they may increase the CNS depressant effect of CNS Depressants
cimetidine: they may decrease the therapeutic effect of antipsychotics
topiramate: they may decrease the therapeutic effect of antipsychotics
barbiturates: they may decrease the therapeutic effect of antipsychotics
barbiturates: they may decrease the therapeutic effect of antipsychotics
barbiturates: they may decrease the therapeutic effect of antipsychotics
barbiturates: they may decrease the therapeutic effect of antipsychotics
barbiturates: they may decrease the therapeutic effect of antipsychotics
flecainide: they may increase the CNS depressant effect of CNS Depressants
glucagon: they may increase the CNS depressant effect of CNS Depressants
hyaluronidase: they may increase the CNS depressant effect of CNS Depressants
tedizolid: they may increase the CNS depressant effect of CNS Depressants
alfuzosin: they may increase the CNS depressant effect of CNS Depressants
dexketoprofen: they may increase the CNS depressant effect of CNS Depressants
aprotinin: they may increase the CNS depressant effect of CNS Depressants
may increase the CNS depressant effect of CNS depressants
may have an increased neurotoxic effect when combined with antipsychotic agents
abacavir: it may decrease the excretion rate of abacavir CNS depressant
abatacept: it may decrease the excretion rate of abacavir CNS depressant
alvimopan: it may increase the risk or severity of CNS depression
carmustine: it may increase the risk or severity of CNS depression
carprofen: it may increase the risk or severity of CNS depression
carvedilol: it may increase the risk or severity of CNS depression
dalfampridine: it may increase the risk or severity of CNS depression
cariprazine: it may increase the risk or severity of CNS depression
cetirizine: it may increase the risk or severity of CNS depression
celiprolol: it may increase the risk or severity of CNS depression
ajmaline: it may increase the risk or severity of CNS depression
apomorphine: it may increase the risk or severity of CNS depression
arformoterol: it may decreased the serum concentration of CNS depressants
oxybuprocaine: it may increase the metabolism of CNS depressants
axitinib: it may increase the metabolism of CNS depressants
may have an increased CNS depressive effect when combined with CNS depressants
may have an increased CNS depressive effect when combined with CNS depressants
may have an increased CNS depressive effect when combined with CNS depressants
may have an increased CNS depressive effect when combined with CNS depressants
may have an increased CNS depressive effect when combined with CNS depressants
When perphenazine is used together in combination with profenamine, this leads to reduction in therapeutic effectiveness of profenamine
it increases the effect of CNS depressants
CNS depressants increase the effect of zolpidem
it increases the effect of CNS depressants
CNS depressants increase the effect of oxycodone
CNS depressants increase the effect of opioid agonists serotonergic opioids
CNS depressants increase the effect of opioid agonists serotonergic opioids
CNS depressants increase the effect of opioid agonists serotonergic opioids
CNS depressants increase the effect of opioid agonists serotonergic opioids
it increases the toxicity of muscle relaxants
Actions and Spectrum:Â
perphenazine is a typical antipsychotic medication used to treat symptoms of schizophrenia and other psychotic disorders. Its action is not fully understood. Still, it is believed to work by blocking dopamine, serotonin receptors in the brain, which helps reduce the activity of specific nerve pathways responsible for causing hallucinations, delusions, and other psychotic symptoms.Â
perphenazine belongs to the phenothiazine class of antipsychotics, and its spectrum of activity includes treating positive symptoms of schizophrenia, like hallucinations, delusions, and disordered thinking. It may also effectively treat negative symptoms of schizophrenia, such as lack of motivation and emotional flatness. However, it is generally less effective for these symptoms than some other antipsychotic medications.Â
Frequency definedÂ
>10%Â
Akathisia (60%)Â
Frequency not definedÂ
Diminished gag reflexÂ
ConfusionÂ
EPSÂ
Tardive dyskinesiaÂ
DystoniaÂ
Neuroleptic malignant syndromeÂ
Muscle stiffnessÂ
Akathisia (60%)Â
ParkinsonismÂ
RareÂ
PriapismÂ
SeizureÂ
Cholestatic jaundiceÂ
CommonÂ
Anticholinergic effectsÂ
SedationÂ
Erectile dysfunctionÂ
Weight gainÂ
OligomenorrheaÂ
AmenorrheaÂ
Less CommonÂ
Lens opacitiesÂ
Orthostatic hypotensionÂ
AnorexiaÂ
ConstipationÂ
DyspepsiaÂ
IleusÂ
TachycardiaÂ
WeaknessÂ
AnxietyÂ
RestlessÂ
cerebral edemaÂ
insomniaÂ
depressionÂ
headacheÂ
UncommonÂ
PhotosensitivityÂ
PruritisÂ
Ejaculatory disorderÂ
Blood dyscrasiaÂ
ECG changesÂ
GalactorrheaÂ
DiarrheaÂ
Black Box Warning:Â
perphenazine has a black box warning for increased mortality in elderly patients with dementia-related psychosis. Older patients with dementia treated with antipsychotic medications, including perphenazine, are at an increased risk of death, especially during the first few months of treatment.
perphenazine is not approved for treating dementia-related psychosis, and its use in this population is associated with an increased risk of stroke, falls, and other adverse events. Physicians are advised to use caution when prescribing perphenazine to elderly patients with dementia-related psychosis and to carefully weigh the treatment’s potential benefits and risks before initiating therapy.Â
Contraindication/Caution:Â
ContraindicationÂ
perphenazine is contraindicated in patients with hypersensitivity to perphenazine or other phenothiazines. It is generally not to use in patients with history of blood disorders, such as bone marrow depression, leukopenia, or agranulocytosis. Additionally, it should not generally be used in patients with a history of CNS (central nervous system) depression, comatose states, or in those who are in a state of acute alcohol intoxication or taking CNS depressants.Â
perphenazine should be generally used with caution in patients with a previous history of seizures, liver or kidney disease, cardiovascular disease, or glaucoma. It should not be used during pregnancy condition or while breastfeeding unless the benefits outweigh the risks to the fetus or infant.Â
As with all medications, healthcare professionals should carefully consider each patient’s unique medical history and medications before prescribing perphenazine to ensure that it is safe and appropriate for the patient.Â
CautionÂ
perphenazine should be generally used cautiously in patients with a history of seizures, kidney or liver disease, cardiovascular disease, or glaucoma. It may also cause drowsiness or dizziness, impairing a patient’s ability to perform tasks that need mental alertness/coordination, such as driving or operating machinery.Â
perphenazine may also increase the risk of developing a movement disorder typically known as tardive dyskinesia, which causes involuntary movements of the face and tongue. The risk of developing tardive dyskinesia may increase with long-term use of perphenazine, and the condition may not improve even after the medication is discontinued.Â
perphenazine may also lower the seizure threshold and should be generally used cautiously in patients with a previous history of seizures or epilepsy. It might also interact with other medications, such as antihistamines, barbiturates, and benzodiazepines, to increase the risk of respiratory depression or sedation.Â
Lastly, perphenazine may cause various side effects, including constipation, blurred vision, and urinary retention. These side effects may be managed with appropriate medical management and by adjusting the dose of the medication as needed.Â
As with all medications, healthcare professionals should carefully consider each patient’s unique medical history and medications before prescribing perphenazine to ensure that it is safe and appropriate for the patient.Â
Pregnancy consideration:Â Â
US FDA pregnancy category: Not assignedÂ
Lactation:  Â
Excreted into human milk: YesÂ
Pregnancy category:Â
Pharmacology:Â
perphenazine is a typical antipsychotic medication that blocks the dopamine receptors in the brain. Dopamine is a neurotransmitter that regulates motivation, mood, and movement. By blocking dopamine receptors, perphenazine reduces the activity of dopamine in certain regions of brain, which can help to diminish the symptoms of psychosis.Â
perphenazine also antagonizes other neurotransmitters, including serotonin, histamine, and acetylcholine, which may contribute to its therapeutic effects.Â
Pharmacodynamics:Â
Mechanism of action: The antipsychotic medication obstructs the postsynaptic mesolimbic dopaminergic receptor in the brain. It exhibits moderate anticholinergic properties and weak-moderate sedative effects. The medication also produces powerful extrapyramidal effects while demonstrating potent antiemetic activity.Â
Pharmacokinetics:Â
AbsorptionÂ
perphenazine is well-absorbed after oral administration, and peak plasma concentrations are reached within 2-4 hours. The bioavailability of perphenazine is approximately 50% due to extensive first-pass metabolism in the liver.Â
DistributionÂ
perphenazine is highly protein-bound (approximately 90%) and has a large volume of distribution, which allows it to rapidly distribute throughout the body, including the central nervous system.Â
MetabolismÂ
perphenazine is extensively metabolized in the liver by the cytochrome P450 system, primarily via the CYP2D6 and CYP3A4 enzymes, to form several active and inactive metabolites. The primary active metabolite, called 7-hydroxyperphenazine, has similar pharmacological properties to perphenazine and may contribute to the overall therapeutic effects of the medication.Â
Elimination and ExcretionÂ
The elimination half-life of perphenazine is approximately 10-20 hours, and the duration of action may be prolonged with repeated dosing due to the accumulation of the medication in the body. Most perphenazine and its metabolites are excreted in the urine, with only a tiny percentage in the feces.Â
Administration:Â
Oral administrationÂ
perphenazine is available in various formulations, including tablets, capsules, injectable solutions, and orally disintegrating tablets. The dose, duration of treatment will be based on the individual patient’s condition and response to treatment and should be determined by a healthcare professional.Â
perphenazine tablets and capsules should be generally taken with a full glass of water, with/without food, as directed by the healthcare professional. The tablets should not be crushed/chewed, as this may affect the release of the medication.Â
A healthcare professional should administer the injectable solution and be given deep intramuscularly into the upper outer quadrant of the buttock. The dose of the injectable solution may be adjusted based on the patient’s response to treatment and any adverse effects.Â
The orally disintegrating tablets should be placed on the tongue and allowed to dissolve totally before swallowing. These tablets should not be chewed, crushed, or swallowed whole.Â
Taking perphenazine as the healthcare professional prescribes is crucial, even if the patient feels better. Abruptly stopping the medication might cause withdrawal symptoms, and patients should only discontinue perphenazine under the supervision of their healthcare provider.Â
If a dose is missed, it is normally recommended to take as early as possible. However, if the next scheduled dose is missed, it should be skipped and the following dose should be taken at the appropriate time. It is important to avoid taking a double dose of the medication to compensate for the missed dose.
Patient information leafletÂ
Generic Name: perphenazineÂ
Pronounced: [ per-FEN-a-zeen ]Â
Why do we use perphenazine?Â
perphenazine is a typical antipsychotic medication primarily used to treat symptoms of schizophrenia and psychotic disorders. It effectively reduces positive symptoms of schizophrenia, such as hallucinations, delusions, and disordered thinking.Â
In addition to schizophrenia, perphenazine may be used to treat psychiatric disorders, like bipolar disorder and severe anxiety. It may be adjunctive therapy with other medications, such as antidepressants, to treat mood disorders.Â
perphenazine is sometimes used to manage severe nausea and vomiting, particularly when other medications have been ineffective. It might also be used as an off-label to treat certain conditions, such as agitation and aggression, in patients with dementia.Â
As with all medications, perphenazine should be used only under the guidance of physician with experience treating psychiatric disorders. The healthcare professional will carefully consider perphenazine’s potential benefits and risks before prescribing it to a patient.Â
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