There may be a slightly increased risk of serious, possibly fatal side effects (such as heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.Who should not take perphenazine?
This medication is used to treat certain mental/mood disorders (e.g., schizophrenia, manic phase of bipolar disorder, schizoaffective disorder). This medicine helps you to think more clearly, feel less nervous, and take part in everyday life. It can reduce aggressive behavior and the desire to hurt yourself/others. It may also help to decrease hallucinations (e.g., hearing/seeing things that are not there). Perphenazine is a psychiatric medication (antipsychotic-type) that works by helping to restore the balance of certain natural substances (e.g., dopamine) in the brain.
Take this medication by mouth, usually 1-3 times a day with or without food or as directed by your doctor.
Dosage is based on your medical condition and response to therapy. Your doctor may direct you to take a low dose at first, gradually increasing the dose to lower the chance of side effects such as muscle spasms. Follow your doctor's directions carefully.
When you begin treatment, frequent visits to your doctor may be needed to find the best dose for you. Keep all medical/lab appointments.
Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.
Although you may notice some medication effects soon after starting, it may take as much as 4-6 weeks of regular use to see the full benefit. Do not stop taking this medication without consulting your doctor. Your condition may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.
Tell your doctor if your condition does not improve or if it worsens.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Some people using this medication do not have serious side effects.
This drug may cause muscle/nervous system problems (extrapyramidal symptoms-EPS). Your doctor may prescribe another medication to decrease these side effects. Therefore, tell your doctor immediately if you notice any of the following side effects: increased anxiety, drooling/trouble swallowing, restlessness/constant need to move, shaking (tremor), shuffling walk, stiff muscles.
Tell your doctor immediately if any of these unlikely but serious side effects occur: difficulty urinating.
This medication may cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor immediately if you develop any involuntary/repetitive muscle movements such as lip smacking/puckering, tongue thrusting, chewing, or finger/toe movements.
In rare cases, perphenazine may increase your level of a certain chemical made by the body (prolactin). For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor immediately.
Tell your doctor immediately if any of these rare but very serious side effects occur: easy bruising/bleeding, slow heartbeat, signs of infection (e.g., sore throat), severe muscle spasm/cramping (e.g., twisting neck, arching back, eyes rolling up), persistent nausea, seizures, stomach/abdominal pain, yellowing eyes/skin.
This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, change in the amount of urine.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Before taking perphenazine, tell your doctor or pharmacist if you are allergic to it, or to other phenothiazines (e.g., chlorpromazine, fluphenazine), or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: decreased bone marrow function, serious head injury, severe liver problems, severe nervous system problem (e.g., coma, drug/alcohol overdose, shock), Parkinson's disease.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: history of alcohol/substance abuse, low blood pressure, breathing problems (e.g., asthma, emphysema), breast cancer, fast/slow/irregular heartbeat, heart valve problems, a certain adrenal gland tumor (pheochromocytoma), restless legs syndrome, seizure disorder, a certain severe reaction to other medications (neuroleptic malignant syndrome), difficulty urinating (e.g., due to prostate problems).
This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.
To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.
Before having surgery, tell your doctor or dentist that you are taking this medication.
Caution is advised during hot weather because perphenazine can reduce sweating, increasing your risk for a severe reaction to too much heat (heatstroke). Drink plenty of fluids. Avoid strenuous exercise in hot weather. If you become overheated, promptly seek cooler shelter and/or stop exercising. Seek immediate medical attention if your body temperature is above normal or if you have mental/mood changes, headache, or dizziness.
Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially dizziness and muscle/nervous system problems such as extrapyramidal symptoms and tardive dyskinesia (see Side Effects).
During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may infrequently develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.
Since untreated mental/mood problems (such as schizophrenia, bipolar disorder, schizoaffective disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.
Perphenazine passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: certain drugs used for Parkinson's (e.g., bromocriptine, levodopa, pergolide), certain anticholinergic medications (e.g., dicyclomine, scopolamine), drugs affecting liver enzymes that remove perphenazine from your body (e.g., amiodarone, duloxetine, fluoxetine, paroxetine, ritonavir).
Also report the use of the following drugs, which might increase your risk of a seizure when combined with perphenazine, such as isoniazid (INH), other antipsychotic medications (e.g., haloperidol, quetiapine), lithium, tramadol, tricyclic antidepressants (e.g., amitriptyline), and alcohol, among others. Consult your doctor or pharmacist for details.
Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone).
Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow/shallow breathing, inability to wake up (coma).
Do not share this medication with others.
Laboratory and/or medical tests (e.g., complete blood count, liver function, eye exams) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.
Information last revised March 2015. Copyright(c) 2015 First Databank, Inc.
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