Perphenazine + DesvenlafaxineModerate
Desvenlafaxine increases perphenazine levels. Reduce dose by up to one-half with 400 mg desvenlafaxine; no adjustment needed with 100 mg or lower.
Source: NLP:desvenlafaxine
Perphenazine Interactions
Brand names: Perphenazine
Phenothiazine
Route: Oral
FDA Black Box Warning
WARNING Increased Mortality in Elderly Patients with Dementia-Related Psychosis Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Perphenazine is not approved for the treatment of patients with dementia-related psychosis (see WARNINGS ).
Contraindications
CONTRAINDICATIONS Perphenazine products are contraindicated in comatose or greatly obtunded patients and in patients receiving large doses of central nervous system depressants (barbiturates, alcohol, narcotics, analgesics, or antihistamines); in the presence of existing blood dyscrasias, bone marrow depression, or liver damage; and in patients who have shown hypersensitivity to perphenazine products, their components, or related compounds. Perphenazine products are also contraindicated in patients with suspected or established subcortical brain damage, with or without hypothalamic damage, since a hyperthermic reaction with temperatures in excess of 104°F may occur in such patients, sometimes not until 14 to 16 hours after drug administration. Total body ice-packing is recommended for such a reaction; antipyretics may also be useful.
Pregnancy & Breastfeeding
Pregnancy Non-teratogenic Effects: Neonates exposed to antipsychotic drugs, during the third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery. There have been reports of agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress and feeding disorder in these neonates. These complications have varied in severity; while in some cases symptoms have been self-limited, in other cases neonates have required intensive care unit support and prolonged hospitalization. Perphenazine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
7 interactions on record
Perphenazine + Desvenlafaxine ErModerate
Desvenlafaxine increases perphenazine exposure. Reduce dose by up to one-half with 400 mg desvenlafaxine; no adjustment needed with 100 mg or lower.
Source: NLP:desvenlafaxine er
Concomitant use increases exposure (Cmax and AUC). Reduce dose by up to one-half if co-administered with 400 mg desvenlafaxine.
Source: NLP:desvenlafaxine succinate
Perphenazine + FluoxetineModerate
Fluoxetine inhibits P450 2D6, increasing perphenazine plasma concentrations. Close monitoring is essential and dose reduction may be necessary to avoid toxicity.
Source: NLP:perphenazine
Perphenazine + ParoxetineModerate
Paroxetine inhibits P450 2D6, increasing perphenazine plasma concentrations. Close monitoring is essential and dose reduction may be necessary to avoid toxicity.
Source: NLP:perphenazine
Increased exposure of CYP2D6 substrate; decrease dosage if needed.
Source: NLP:paroxetine hydrochloride
Perphenazine + SertralineModerate
Sertraline inhibits P450 2D6, increasing perphenazine plasma concentrations. Close monitoring is essential and dose reduction may be necessary to avoid toxicity.
Source: NLP:perphenazine