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amitriptyline and perphenazine

Generic Name: amitriptyline and perphenazine (a mee TRIP ti leen and per FEN a zeen)
Brand Name: Etrafon Forte, Triavil, Etrafon 2-10, Etrafon 2-25

What is amitriptyline and perphenazine?

Amitriptyline is a tricyclic antidepressant. Perphenazine is a phenothiazine (feen-oh-THYE-a-zeen). These medicines affect chemicals in the brain that may be unbalanced in people with depression or mental illness.

Amitriptyline and perphenazine is a combination medicine used to treat depression, anxiety, and agitation.

Amitriptyline and perphenazine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about amitriptyline and perphenazine?

You should not take this medicine if you have liver damage, a weak immune system, a blood cell disorder (such as anemia), or if you recently had a heart attack. Amitriptyline and perphenazine is not approved for use in psychotic conditions related to dementia.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Call your doctor at once if you have twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs. These could be early signs of dangerous side effects.

What should I discuss with my healthcare provider before taking amitriptyline and perphenazine?

You should not use this medicine if you are allergic to amitriptyline or perphenazine, or if:

  • you have recently had a heart attack;

  • you have a weak immune system (bone marrow depression); or

  • you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.

This medicine is not approved for use in psychotic conditions related to dementia. Perphenazine may increase the risk of death in older adults with dementia-related conditions.

Do not use amitriptyline and perphenazine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure this medicine is safe for you, tell your doctor if you have:

  • kidney or liver disease;

  • heart disease, or a history of heart attack or stroke;

  • pheochromocytoma (adrenal gland tumor);

  • epilepsy or other seizure disorder;

  • a thyroid disorder;

  • asthma, emphysema, or other breathing disorder;

  • glaucoma;

  • urination problems;

  • bipolar disorder (manic-depression), schizophrenia or other mental illness;

  • a history of drug or alcohol addiction;

  • a history of suicidal thoughts or behavior; or

  • a history of breast cancer.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking amitriptyline and perphenazine, do not stop taking it without your doctor's advice.

Amitriptyline and perphenazine may pass into breast milk and could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone under 18 years old without medical advice.

How should I take amitriptyline and perphenazine?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

Do not take this medicine in larger amounts than recommended, or for longer than prescribed. High doses or long-term use of perphenazine can cause a serious muscle movement disorder that may not be reversible. The longer you take perphenazine, the more likely you are to develop a serious movement disorder. The risk of this side effect is higher in older adults, especially women.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

While using this medicine, you may need frequent blood tests. Your kidney or liver function may also need to be checked.

If you need surgery, tell the surgeon ahead of time that you are using amitriptyline and perphenazine. You may need to stop using the medicine for a short time.

Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using amitriptyline and perphenazine.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amitriptyline and perphenazine can be fatal.

Overdose symptoms may include uneven heartbeats, extreme drowsiness, confusion, agitation, hallucinations, vomiting, feeling hot or cold, muscle stiffness, fainting, seizure (convulsions), or coma.

What should I avoid while taking amitriptyline and perphenazine?

Do not drink alcohol. Dangerous side effects or death can could occur.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid exposure to sunlight or tanning beds. Perphenazine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Amitriptyline and perphenazine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these signs of a serious movement disorder:

  • tremors or shaking in your arms or legs;

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement); or

  • any new or unusual muscle movements you cannot control.

Also call your doctor at once if you have:

  • severe constipation;

  • a light-headed feeling, like you might pass out;

  • fast, slow, or uneven heart rate;

  • chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

  • sudden numbness or weakness, slurred speech, problems with vision or balance;

  • sudden ill feeling, fever, chills, sore throat, easy bruising, unusual bleeding, pale skin;

  • dark urine, jaundice (yellowing of the skin or eyes);

  • urinating more or less than usual;

  • a seizure (convulsions); or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects may include:

  • drowsiness, headache;

  • strange dreams or nightmares;

  • sleep problems (insomnia);

  • blurred vision;

  • dry mouth, loss of appetite;

  • nausea, vomiting, diarrhea, constipation;

  • breast changes; or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect amitriptyline and perphenazine?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • cimetidine;

  • guanethidine;

  • heart rhythm medicine such as flecainide, propafenone, quinidine, and others;

  • other antidepressants or medicine to treat mental illness; or

  • seizure medication.

This list is not complete and other drugs may interact with amitriptyline and perphenazine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about amitriptyline and perphenazine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.01. Revision Date: 2016-07-20, 2:57:41 PM.

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