Perphenazine Side Effects
For the Consumer
Applies to perphenazine: oral fixed-combination tablets, oral tablets
Side effects include:
Extrapyramidal reactions (e.g., Parkinson-like symptoms, dystonia, akathisia, tardive dyskinesia), drowsiness, muscular weakness, dry mouth, blurred vision, weight gain, skin reactions, amenorrhea, galactorrhea.
For Healthcare Professionals
Applies to perphenazine: compounding powder, injectable solution, oral concentrate, oral tablet
Frequency not reported: Extrapyramidal symptoms, opisthotonos, motor restlessness, hyperreflexia, dystonia, slurred speech, akathisia, dyskinesia, parkinsonism, ataxia, drowsiness, sedation, hypnosis, lethargy, cerebral edema, convulsive seizures, hyperactivity
Postmarketing reports: Headaches, choreiform movements of the extremities, orofacial dyskinesia, tardive dyskinesia, disturbances in consciousness, somnolence, stupor, dizziness, tremor, epileptic fits, neuroleptic malignant syndrome (NMS), severe extrapyramidal dysfunction, coma, autonomic disturbances, cerebrospinal fluid protein abnormalities[Ref]
Convulsive seizures occurred most frequently in patients with EEG abnormalities and/or patients with a history of convulsive seizures.
Drowsiness usually occurred within the first 1 to 2 weeks, with gradual disappearance thereafter.
NMS occurred in patients who took neuroleptic drugs, and was fatal in some cases. NMS was characterized by severe extrapyramidal dysfunction, rigidity, stupor, coma, hyperthermia, and/or autonomic disturbances.
Significant autonomic effects were infrequently reported in patients who received less than 24 mg/day.[Ref]
Frequency not reported: Pallor, hypertension, change in pulse rate, circulatory collapse, postural hypotension, bradycardia, peripheral edema, shock-like condition (hypotensive effect), reversible and nonspecific ECG changes
Postmarketing reports: Tachycardia, QT prolongation, ventricular arrhythmias, ventricular tachycardia/fibrillation, edema, cardiovascular effects (related to neuroleptic malignant syndrome), hypotension, venous thromboembolism, deep vein thrombosis, cardiac arrest and Torsades de pointes[Ref]
Tachycardia occurred more commonly with sudden, marked increases in dose.[Ref]
Frequency not reported: Perspiration, urticaria, erythema, eczema, exfoliative dermatitis, photosensitivity, angioneurotic edema, contact dermatitis, skin pigmentation (in exposed areas)
Postmarketing reports: Photosensitivity, rashes/pruritus, hyperhidrosis[Ref]
Contact dermatitis occurred in nursing personnel who handled the drug.[Ref]
Frequency not reported: Nausea, dysphagia, vomiting, diarrhea, obstipation, fecal impaction, parotid swelling, protrusion/discoloration/aching and rounding of tongue,
Postmarketing reports: Oral dryness and altered saliva, adynamic ileus, constipation, other gastrointestinal atonic and hypomotility disorders[Ref]
Frequency not reported: Trismus, torticollis, retrocollis, aching and numbness of limbs, tonic spasm of masticatory muscles, muscle weakness, prolonged abnormal contractions of muscle groups
Postmarketing reports: Systemic lupus erythematosus (SLE)/SLE-like syndrome, rigidity[Ref]
Frequency not reported: Oculogyric crisis, myosis, mydriasis, glaucoma, photophobia, epithelial keratopathies
Postmarketing reports: Visual disorders, blurred vision, pigmented/pigmentary retinopathy, star-shaped lenticular opacities, fine particulate matter deposits in the cornea and lens[Ref]
Frequency not reported: Exacerbation of psychotic symptoms, catatonia/catatonic-like states, paranoid reactions, nocturnal confusion, bizarre dreams, libido changes,
Postmarketing reports: Confusion, agitation, excitement, insomnia[Ref]
Frequency not reported: Fever/hyperpyrexia, reversed epinephrine effect
Postmarketing reports: Fatigue, body temperature dysregulation, hyperthermia, sudden unexplained death, neonatal drug withdrawal syndrome[Ref]
Frequency not reported: Syndrome of inappropriate antidiuretic hormone (ADH) secretion, protein bound iodine (PBI) increase not attributable to an increase in thyroxine
Postmarketing reports: Hyperprolactinemia, gynecomastia (males), false positive pregnancy tests[Ref]
Frequency not reported: Anaphylactoid reactions[Ref]
Frequency not reported: Glycosuria[Ref]
Postmarketing reports: Urinary hesitancy/retention/incontinence, amenorrhea, erectile dysfunction, impaired ejaculation, lactation, galactorrhea, moderate breast enlargement (females), bladder paralysis, polyuria, menstruation with decreased bleeding or disturbances in the menstrual cycle[Ref]
Postmarketing reports: Antinuclear antibodies[Ref]
1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
2. "Product Information. Trilafon (perphenazine)" Schering Corporation, Kenilworth, NJ.
Some side effects of perphenazine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
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- Drug class: phenothiazine antiemetics
Other brands: Trilafon
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