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Perphenazine Dosage

Medically reviewed on September 26, 2016.

Applies to the following strengths: 5 mg/mL; 16 mg; 8 mg; 16 mg/5 mL; 2 mg; 4 mg

Usual Adult Dose for Psychosis

Moderately disturbed, nonhospitalized patients:
-Recommended dose: 4 to 8 mg orally 3 times a day, with a dose reduction to the minimum effective dose as soon as possible
-Maximum dose: 24 mg/day

Hospitalized patients:
-Recommended dose: 8 to 16 mg orally 2 to 4 times a day
-Maximum dose: 64 mg/day

Comment:
-Nonhospitalized patients should be limited to a daily dose of 24 mg; maximum doses of 64 mg should be used in hospitalized patients.

Use: Treatment of schizophrenia

Usual Adult Dose for Nausea/Vomiting

Recommended dose: 8 to 16 mg orally, in divided doses
Maximum dose: 24 mg/day, in divided doses

Comment:
-The dose should be reduced as early as possible.

Use: Severe nausea and vomiting

Usual Pediatric Dose for Psychosis

12 years and older:
Moderately disturbed, nonhospitalized patients:
-Recommended dose: 4 to 8 mg orally 3 times a day, with a dose reduction to the minimum effective dose as soon as possible
-Maximum dose: 24 mg/day

Hospitalized patients:
-Recommended dose: 8 to 16 mg orally 2 to 4 times a day
-Maximum dose: 64 mg/day

Comments:
-Nonhospitalized patients should be limited to a daily dose of 24 mg; maximum doses of 64 mg should be used in hospitalized patients.

Use: Treatment of schizophrenia

Usual Pediatric Dose for Nausea/Vomiting

12 years and older:
-Recommended dose: 8 to 16 mg orally, in divided doses
-Maximum dose: 24 mg/day, in divided doses

Comment:
-The dose should be reduced as early as possible.

Use: Severe nausea and vomiting

Renal Dose Adjustments

Use with caution.

Liver Dose Adjustments

Patients with liver damage: Contraindicated

Dose Adjustments

Abnormalities in hepatic tests, BUN, and/or signs/symptoms of blood dyscrasias:
-Discontinue treatment and monitor appropriately.

Elderly patients: Lower initial doses are recommended. Clinical benefit may require lower doses for longer periods of time.

Precautions

US BOXED WARNING:
-INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS: This drug has an increased risk of mortality when administered to elderly patients with dementia-related psychosis. Elderly patients with dementia-related psychosis treated with antipsychotic drugs have an increased risk of death. This drug is not approved for use in patients with dementia-related psychosis.

Safety and efficacy have not been established in patients younger than 12 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-For some patients, this drug may be given before bed.

Storage requirements:
-See manufacturer product information.

General:
-All patients on prolonged treatment should be reassessed regularly.
-Patients receiving long-term treatment may have a higher risk of developing liver damage, corneal/lenticular deposits, and/or irreversible dyskinesia.
-Treatment has not been effective for the management of behavioral complications in patients with mental impairments.

Monitoring:
-ECG monitoring for patients at risk of QT prolongation
-Periodic WBC with differential tests, especially in patients with signs/symptoms of infection/sore throat, at increased risk of blood dyscrasias, and/or with a history of low WBCs or drug-induced neutropenia/leukopenia
-Periodic liver function tests
-Blood pressure, especially in patients with impaired cardiovascular systems
-Eye examinations, especially in patients on prolonged treatment
-Heart rate, especially in patients with arrhythmias and/or taking QT prolonging drugs concurrently
-Periodic renal function tests, especially in patients on prolonged treatment

Patient advice:
-Patients should be warned to avoid abrupt discontinuation of this drug.
-Patients should be instructed to immediately report any signs/symptoms of neutropenia/leukopenia, neuroleptic malignant syndrome, or tardive dyskinesia.
-Inform patients that this drug may cause or impair mental/physical abilities, and they should avoid driving or operating machinery until the full effects of the drug are seen.
-Patients should be advised to speak to a healthcare provider if they are pregnant, intend to become pregnant, or are breastfeeding.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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