Can you take Perphenazine with Valsartan?
1 drug interaction and 37 additional warnings found for the following 2 drugs:
- perphenazine
- valsartan
Drug interactions
Moderate drug interactions
Moderate:
perphenazine valsartan
Applies to: perphenazine and valsartan
Perphenazine and valsartan may have additive effects in lowering your blood pressure.
You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate.
These side effects are most likely to be seen:
- at the beginning of treatment
- following a dose increase
- when treatment is restarted after an interruption
Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome.
Avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
valsartan Food/Lifestyle
Applies to: valsartan
If you are taking valsartan you should avoid potassium-containing salt substitutes or over-the-counter potassium supplements without first talking to your doctor.
This can cause high levels of potassium in your blood.
High levels of potassium can cause:
- weakness
- irregular heartbeat
- confusion
- tingling of the extremities
- feelings of heaviness in the legs
Call your doctor at once if you have any of these symptoms.
Moderate:
perphenazine Alcohol (Ethanol)
Applies to: perphenazine
Ask your doctor before using perphenazine together with ethanol (alcohol).
This can cause:
- uncontrollable movements
- agitation
- seizures
- severe dizziness or fainting
- coma
- very deep sleep
- irregular heartbeats
- high or low body temperature
Use caution when driving, operating machinery, or performing other hazardous activities, these medicaions may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
35 potential interactions Applies to: 30 conditions, including High Blood Pressure, Heart Failure, Seizures, Arrhythmia, and Breast Cancer.
Acute Alcohol Intoxication
Major:
perphenazine
Perphenazine has a major potential interaction with Acute Alcohol Intoxication.
Phenothiazines are contraindicated in the presence of large amounts of central nervous system depressants such as alcohol. The risk of suicide and the danger of overdose may be increased in patients who use alcohol excessively. Phenothiazines should be used with caution in patients experiencing alcohol withdrawal.
Alcoholism
Major:
perphenazine
Perphenazine has a major potential interaction with Alcoholism.
Phenothiazines are contraindicated in the presence of large amounts of central nervous system depressants such as alcohol. The risk of suicide and the danger of overdose may be increased in patients who use alcohol excessively. Phenothiazines should be used with caution in patients experiencing alcohol withdrawal.
Altered Consciousness
Major:
perphenazine
Perphenazine has a major potential interaction with Altered Consciousness.
The use of phenothiazines is contraindicated in comatose patients and patients with severe central nervous system depression. Phenothiazines may potentiate the CNS and respiratory depression in these patients.
Angioedema
Major:
valsartan
Valsartan has a major potential interaction with Angioedema.
The use of these agents is contraindicated in patients with a history of angioedema related to previous angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) therapy or in patients with hereditary angioedema. Patients with a history of angioedema unrelated to these agents may be at increased risk of angioedema while receiving angiotensin II receptor (AR) antagonists. Patients should be advised to immediately report any signs or symptoms suggestive of angioedema (swelling of face, extremities, eyes, lips, or tongue, or difficulty swallowing or breathing) and to stop taking the medication until otherwise directed by their physician. Emergency therapy and/or measures to prevent airway obstruction are required for angioedema involving the tongue, glottis, or larynx. Treatment with angiotensin II receptor (AR) antagonists should be discontinued permanently if angioedema develops in association with therapy.
Arrhythmia
Major:
perphenazine
Perphenazine has a major potential interaction with Arrhythmia.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Biliary Obstruction
Moderate:
valsartan
Valsartan has a moderate potential interaction with Biliary Obstruction.
Valsartan is primarily eliminated by biliary excretion, and a minority is excreted in the urine. Dosage adjustments are not necessary in patients with renal impairment unless they are also volume-depleted, in which case therapy should be initiated under medical supervision. Likewise, patients with mild to moderate hepatic impairment or biliary obstruction generally do not require a dosage adjustment. The manufacturer recommends administering valsartan therapy with caution in patients with impaired renal and/or liver function, particularly if these conditions are severe.
Bone Marrow Depression/Low Blood Counts
Major:
perphenazine
Perphenazine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Phenothiazines may cause hematologic toxicity. In patients with preexisting blood dyscrasias, bone marrow suppression, or a history of drug-induced leukopenia or neutropenia, phenothiazines should not be used or are contraindicated. Complete blood counts should be regularly monitored in patients with risk factors for blood dyscrasias. If white blood cell counts indicate cellular depression, discontinue treatment and institute appropriate therapy.
Breast Cancer
Moderate:
perphenazine
Perphenazine has a moderate potential interaction with Breast Cancer.
The chronic use of phenothiazines is associated with persistent elevations in prolactin levels. The clinical significance in patients with a history of breast cancer is unknown and should be considered prior to therapy; approximately one-third of human breast cancers are thought to be prolactin-dependent. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in animal studies; however, evidence is inconclusive in humans.
Cardiovascular Conditions and Disorders
Major:
perphenazine
Perphenazine has a major potential interaction with Cardiovascular Conditions and Disorders.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Central Nervous System Disorders
Moderate:
perphenazine
Perphenazine has a moderate potential interaction with Central Nervous System Disorders.
Phenothiazines can lower the seizure threshold. Caution is recommended during administration in patients with a history of convulsive disorders or EEG abnormalities. Anticonvulsant therapy should be maintained or adequately adjusted during phenothiazine treatment.
Cerebrovascular Insufficiency
Major:
perphenazine
Perphenazine has a major potential interaction with Cerebrovascular Insufficiency.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Dehydration
Major:
valsartan
Valsartan has a major potential interaction with Dehydration.
Angiotensin II receptor (AR) antagonists can cause symptomatic hypotension in patients with an activated renin-angiotensin system, such as volume- and/or sodium-depleted patients. Therapy with AR antagonists should be administered cautiously in such patients and in those predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, especially if high doses were used or if recently instituted; those on dietary salt restriction; renal dialysis patients). Volume and/or sodium depletion should be corrected prior to initiating therapy with AR antagonists, and the patient should be hemodynamically stable. Ideally, patients at risk for excessive hypotension should initiate AR antagonist therapy under close medical supervision, preferably with a lower dose, and followed closely for the first 2 weeks of treatment and whenever the dosage of AR antagonist or diuretic is increased.
Dementia
Major:
perphenazine
Perphenazine has a major potential interaction with Dementia.
Antipsychotic drugs are not approved for the treatment of patients with dementia-related psychosis. Older patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; although the causes were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. A causal relationship with antipsychotic use has not been established. In controlled trials in older patients with dementia-related psychosis, patients randomized to risperidone, aripiprazole, and olanzapine had higher incidence of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, compared to patients treated with placebo.
Diabetes Mellitus
Major:
valsartan
Valsartan has a major potential interaction with Diabetes Mellitus.
The coadministration of some angiotensin II receptor blocker agents with aliskiren is contraindicated in patients with diabetes.
Head Injury
Major:
perphenazine
Perphenazine has a major potential interaction with Head Injury.
Perphenazine is contraindicated in patients with suspected or established subcortical brain damage, with or without hypothalamic involvement. Perphenazine can interfere with thermoregulatory mechanisms, and a hyperthermic reaction with temperatures in excess of 40C (104F) may occur in such patients, sometimes not until 14 to 16 hours after drug administration.
Heart Failure
Moderate:
valsartan
Valsartan has a moderate potential interaction with Heart Failure.
Angiotensin II receptor (AR) antagonists can cause renal impairment in patients whose renal function depends on the activity of the renin-angiotensin-aldosterone system. In addition, symptomatic hypotension can occur in susceptible individuals, which may compromise renal and myocardial perfusion. In patients with severe congestive heart failure (CHF), treatment with AR antagonists has been associated with oliguria and/or progressive azotemia and, rarely, renal failure, myocardial ischemia, and death. Therapy with AR antagonists should be initiated cautiously in patients with severe CHF, especially when accompanied by volume and/or sodium depletion. In patients who experience a decline in renal function, discontinuation of AR antagonist therapy is usually not required provided there is symptomatic improvement of the heart failure and renal deterioration is well-tolerated. Transient hypotension is also not a contraindication to further treatment with AR antagonists, since therapy can usually be reinstated without difficulty after blood pressure stabilizes.
Hemodialysis
Major:
valsartan
Valsartan has a major potential interaction with Hemodialysis.
Angiotensin II receptor (AR) antagonists can cause symptomatic hypotension in patients with an activated renin-angiotensin system, such as volume- and/or sodium-depleted patients. Therapy with AR antagonists should be administered cautiously in such patients and in those predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, especially if high doses were used or if recently instituted; those on dietary salt restriction; renal dialysis patients). Volume and/or sodium depletion should be corrected prior to initiating therapy with AR antagonists, and the patient should be hemodynamically stable. Ideally, patients at risk for excessive hypotension should initiate AR antagonist therapy under close medical supervision, preferably with a lower dose, and followed closely for the first 2 weeks of treatment and whenever the dosage of AR antagonist or diuretic is increased.
High Blood Pressure
Major:
perphenazine
Perphenazine has a major potential interaction with High Blood Pressure.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
History - Cerebrovascular Disease
Major:
perphenazine
Perphenazine has a major potential interaction with History - Cerebrovascular Disease.
Perphenazine is contraindicated in patients with suspected or established subcortical brain damage, with or without hypothalamic involvement. Perphenazine can interfere with thermoregulatory mechanisms, and a hyperthermic reaction with temperatures in excess of 40C (104F) may occur in such patients, sometimes not until 14 to 16 hours after drug administration.
Major:
perphenazine
Perphenazine has a major potential interaction with History - Cerebrovascular Disease.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
History - Myocardial Infarction
Major:
perphenazine
Perphenazine has a major potential interaction with History - Myocardial Infarction.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Hyperkalemia
Moderate:
valsartan
Valsartan has a moderate potential interaction with Hyperkalemia.
Drugs that inhibit the renin-angiotensin, such as angiotensin II receptor antagonist system can cause hyperkalemia. Concomitant use of these agents with drugs that increase potassium levels may increase the risk of hyperkalemia. Use caution when using these agents together and monitor serum potassium periodically.
Hyponatremia
Major:
valsartan
Valsartan has a major potential interaction with Hyponatremia.
Angiotensin II receptor (AR) antagonists can cause symptomatic hypotension in patients with an activated renin-angiotensin system, such as volume- and/or sodium-depleted patients. Therapy with AR antagonists should be administered cautiously in such patients and in those predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, especially if high doses were used or if recently instituted; those on dietary salt restriction; renal dialysis patients). Volume and/or sodium depletion should be corrected prior to initiating therapy with AR antagonists, and the patient should be hemodynamically stable. Ideally, patients at risk for excessive hypotension should initiate AR antagonist therapy under close medical supervision, preferably with a lower dose, and followed closely for the first 2 weeks of treatment and whenever the dosage of AR antagonist or diuretic is increased.
Hypotension
Major:
perphenazine
Perphenazine has a major potential interaction with Hypotension.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Liver Disease
Major:
perphenazine
Perphenazine has a major potential interaction with Liver Disease.
The manufacturer considers the use of perphenazine to be contraindicated in patients with preexisting liver damage. Phenothiazines are extensively metabolized by the liver and may accumulate in patients with hepatic impairment.
Major:
perphenazine
Perphenazine has a major potential interaction with Liver Disease.
Therapy with phenothiazines should be administered cautiously or are contraindicated in patients with preexisting liver disease or with a history of jaundice due to phenothiazine hypersensitivity. Patients with a history of hepatic encephalopathy due to cirrhosis may have increased sensitivity to the central nervous system effects of some phenothiazines (e.g., chlorpromazine). Treatment should be discontinued if jaundice occurs.
Moderate:
valsartan
Valsartan has a moderate potential interaction with Liver Disease.
Valsartan is primarily eliminated by biliary excretion, and a minority is excreted in the urine. Dosage adjustments are not necessary in patients with renal impairment unless they are also volume-depleted, in which case therapy should be initiated under medical supervision. Likewise, patients with mild to moderate hepatic impairment or biliary obstruction generally do not require a dosage adjustment. The manufacturer recommends administering valsartan therapy with caution in patients with impaired renal and/or liver function, particularly if these conditions are severe.
Neuroleptic Malignant Syndrome
Moderate:
perphenazine
Perphenazine has a moderate potential interaction with Neuroleptic Malignant Syndrome.
Therapy with phenothiazines may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). Treatment should not be initiated in patients with active NMS, and should be immediately discontinued if currently administered in such patients. In patients with a history of NMS, introduction or reintroduction of phenothiazines should be carefully considered, since NMS may recur.
Pheochromocytoma
Major:
perphenazine
Perphenazine has a major potential interaction with Pheochromocytoma.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Renal Dysfunction
Moderate:
perphenazine
Perphenazine has a moderate potential interaction with Renal Dysfunction.
Phenothiazines should be used with caution in patients with renal dysfunction. Patients with renal insufficiency may be more prone to hypotension. Periodic renal function tests are recommended for all patients during prolonged therapy.
Moderate:
valsartan
Valsartan has a moderate potential interaction with Renal Dysfunction.
Valsartan is primarily eliminated by biliary excretion, and a minority is excreted in the urine. Dosage adjustments are not necessary in patients with renal impairment unless they are also volume-depleted, in which case therapy should be initiated under medical supervision. Likewise, patients with mild to moderate hepatic impairment or biliary obstruction generally do not require a dosage adjustment. The manufacturer recommends administering valsartan therapy with caution in patients with impaired renal and/or liver function, particularly if these conditions are severe.
Moderate:
valsartan
Valsartan has a moderate potential interaction with Renal Dysfunction.
Changes in renal function including acute renal failure can be caused by drugs that inhibit the renin-angiotensin system and by diuretics. Patients whose renal function may depend in part on the activity of the renin-angiotensin system (e.g., patients with renal artery stenosis, chronic kidney disease, severe congestive heart failure, or volume depletion) may be at particular risk of developing acute renal failure with these agents. Monitor renal function periodically in these patients. Consider withholding or discontinuing therapy in patients who develop a clinically significant decrease in renal function with these agents.
Respiratory Arrest
Major:
perphenazine
Perphenazine has a major potential interaction with Respiratory Arrest.
The use of phenothiazines is contraindicated in comatose patients and patients with severe central nervous system depression. Phenothiazines may potentiate the CNS and respiratory depression in these patients.
Seizures
Moderate:
perphenazine
Perphenazine has a moderate potential interaction with Seizures.
Phenothiazines can lower the seizure threshold. Caution is recommended during administration in patients with a history of convulsive disorders or EEG abnormalities. Anticonvulsant therapy should be maintained or adequately adjusted during phenothiazine treatment.
Valvular Heart Disease
Major:
perphenazine
Perphenazine has a major potential interaction with Valvular Heart Disease.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
More resources
perphenazine
A total of 751 drugs are known to interact with perphenazine.
- Perphenazine is in the following drug classes: phenothiazine antiemetics, phenothiazine antipsychotics.
-
Perphenazine is used to treat the following conditions:
- Bipolar Disorder (off-label)
- Nausea/Vomiting
- Psychosis
valsartan
A total of 347 drugs are known to interact with valsartan.
- Valsartan is in the drug class angiotensin receptor blockers.
- Valsartan is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.