Drug Interaction Report
1 drug interaction and 29 additional warnings found for the following 2 drugs:
- bimekizumab
- perphenazine
Drug interactions
Moderate drug interactions
Moderate:perphenazine bimekizumab
Applies to: perphenazine, bimekizumab
Bimekizumab may alter the blood levels and effects of perphenazine.
Your doctor may need to monitor you more closely and/or adjust the dosing of your medication(s).
For example, a dose adjustment may be needed if you have been receiving perphenazine and are starting treatment with bimekizumab. Likewise, if you have been receiving both medications, the dose of perphenazine may need to be adjusted when bimekizumab is discontinued.
Contact your doctor if your condition changes or you experience increased side effects.
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:Alcohol (Ethanol) perphenazine
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
28 potential interactionsApplies to: 25 conditions, including High Blood Pressure, Depression, 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.
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.
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.
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.
Depression
Moderate:bimekizumab
Bimekizumab has a moderate potential interaction with Depression.
Patients with a history of suicidal ideation or behavior reported a higher rate of new onset of suicidal ideation when treated with bimekizumab. Patients with a history of severe depression are also susceptible to suicidal ideation or behavior when treated with bimekizumab.
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.
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.
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.
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.
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.
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.
Infection
Moderate:bimekizumab
Bimekizumab has a moderate potential interaction with Infection.
Bimekizumab may increase the risk of infections, including tuberculosis (TB). Patients should be evaluated for any active infection before and during treatment with bimekizumab, and administration should be avoided if infection is detected. Evaluate patients for TB before treatment and avoid therapy in patients with active TB. Anti-TB therapy should be considered for patients with a history of latent or active TB.
Inflammatory Bowel Disease
Moderate:bimekizumab
Bimekizumab has a moderate potential interaction with Inflammatory Bowel Disease.
Cases of Inflammatory Bowel Disease (IBD) have been reported in patients treated with bimekizumab. Treatment with bimekizumab should be avoided in patients with active IBD.
Liver Disease
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.
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.
Moderate:bimekizumab
Bimekizumab has a moderate potential interaction with Liver Disease.
Bimekizumab can cause increased levels of liver enzymes and bilirubin. Treatment with bimekizumab should be avoided in patients with acute liver disease or cirrhosis as they may be at increased risk for severe hepatic injury.
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.
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.
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. |
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Further information
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