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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

Nervous system

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]

Cardiovascular

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]

Dermatologic

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]

Gastrointestinal

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]

Musculoskeletal

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]

Ocular

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]

Psychiatric

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]

Hematologic

Frequency not reported: Blood dyscrasias, eosinophilia, leukopenia, hemolytic anemia, thrombocytopenic purpura, pancytopenia
Postmarketing reports: Agranulocytosis, transient leukopenia[Ref]

Metabolic

Frequency not reported: Anorexia, hypoglycemia, polyphagia, increased appetite
Postmarketing reports: Weight gain, hyperglycemia, increased serum cholesterol[Ref]

Respiratory

Frequency not reported: Throat tightness, asthma, laryngeal edema
Postmarketing reports: Nasal stuffiness, pulmonary embolism[Ref]

Other

Frequency not reported: Fever/hyperpyrexia, reversed epinephrine effect
Postmarketing reports: Fatigue, body temperature dysregulation, hyperthermia, sudden unexplained death, neonatal drug withdrawal syndrome[Ref]

Endocrine

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]

Hepatic

Frequency not reported: Liver damage/biliary stasis, infectious hepatitis
Postmarketing reports: Obstructive jaundice, cholestasis and chronic jaundice[Ref]

Hypersensitivity

Frequency not reported: Anaphylactoid reactions[Ref]

Renal

Frequency not reported: Glycosuria[Ref]

Genitourinary

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]

Immunologic

Postmarketing reports: Antinuclear antibodies[Ref]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. "Product Information. Trilafon (perphenazine)" Schering Corporation, Kenilworth, NJ.

It is possible that some side effects of perphenazine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.

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