perphenazine (Trilafon - discontinued)

Perphenazine is an oral antipsychotic medication used for the management of schizophrenia. Perphenazine is one of the older, first-generation antipsychotic medications. Examples of other first-generation antipsychotics include:

• prochlorperazine (Compazine, Compro, Procomp)
• chlorpromazine (Promapar, Thorazine)
• trifluoperazine (Stelazine)
• thioridazine (Mellaril)

Although the exact mechanism of antipsychotics is unknown, scientists believe that they may work by blocking the action of dopamine in the brain. Dopamine is a neurotransmitter (chemical) that nerves use to communicate with one another. Perphenazine is used when patients do not respond to other antipsychotics.

What brand names are available for perphenazine?

N/A

Is perphenazine available as a generic drug?

Yes

Do I need a prescription for perphenazine?

Yes

Perphenazine causes extrapyramidal side effects such as:

• Abnormal muscle contractions
• Difficulty breathing and swallowing
• Neck spasms

Other side effects include:

• Low blood pressure
• Constipation
• Dry mouth
• Blurred vision
• Seizures
• Dizziness
• Drowsiness
• Urinary retention
• Worsening of glaucoma
• Increased or decreased blood glucose
• Tardive dyskinesia and neuroleptic malignant syndrome can result from perphenazine treatment. These side effects can be severe so patients must seek medical help.

• The recommended dose of perphenazine for treating schizophrenia is 4 to 16 mg every 6 to 12 hours. The maximum daily dose is 64 mg.
• The dose for treating nausea and vomiting is 8 to 16 mg daily in divided doses and given every 6 to 12 hours. The maximum dose is 24 mg daily.
• The dose for treating intractable hiccoughs is 8 to 16 mg daily in divided doses and given every 8 to 12 hours. The maximum dose is 24 mg daily.

Combining perphenazine with medications such as procainamide (Pronestyl), sotalol (Betapace), amiodarone (Cordarone), and dofetilide (Tikosyn) that affect heart rate and rhythm can cause abnormal heart beats.

Antidepressants such as fluoxetine (Prozac), sertraline (Zoloft) and tricyclic antidepressants may reduce the breakdown of perphenazine, leading to increased blood levels and side effects of perphenazine.

Perphenazine should be used with caution with medications that depress the central nervous system and cause sedation or drowsiness. Examples include alprazolam (Xanax), clonazepam (Klonopin), zolpidem (Ambien), codeine, morphine, and alcohol. Such combinations can cause excessive sedation, drowsiness, weakness, confusion, speech impairment, and in severe cases coma or death. Combining alcohol with perphenazine also increases the risk of low blood pressure.

Use of perphenazine during pregnancy has not been adequately studied. Neonates exposed to antipsychotics during the third trimester of pregnancy are at risk for extrapyramidal and withdrawal symptoms after birth. Symptoms reported included agitation, hypertonia, hypotonia, tremor, somnolence, depressed breathing, and feeding disorder.

Safe use of perphenazine by nursing mothers has not been established.

What preparations of perphenazine are available?

Tablets: 2, 4, 8 and 16 mg.

How should I keep perphenazine stored?

Perphenazine tablets should be stored between 2 C and 25 C (36 and 77 F).