Perphenazine/Amitriptyline, Oral

What are other names for this medicine?

Type of medicine: antipsychotic; antidepressant; tranquilizer

Generic and brand names: perphenazine and amitriptyline, oral

What is this medicine used for?

This medicine is a combination of 2 drugs. It is taken by mouth to treat anxiety and depression. It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergy to any medicine
• an enlarged prostate or trouble urinating
• bone marrow problems
• glaucoma
• heart disease
• liver or kidney disease
• Parkinson's disease
• schizophrenia or another mental disorder
• seizures
• thyroid problems

Tell your provider if you have taken an MAO inhibitor antidepressant within the past 2 weeks.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are taking this medicine.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more of it or take it more often than prescribed.

You may take this medicine with food or right after meals to lessen stomach upset.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: restlessness, coma, irregular heartbeat, dizziness, lightheadedness, fainting, uncontrolled muscle movements in tongue, jaw, or neck, hallucinations, trouble urinating, cold skin, seizures.

What should I watch out for?

Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment. Older adults with dementia are at greater risk for side effects. Talk with your provider about this.

This medicine may take several weeks before you feel its full effect. Do not stop taking this medicine without your healthcare provider's approval.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may make you drowsy or dizzy for several hours or overnight. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly from sitting or lying down. Getting up slowly may help.

Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

This medicine may raise your body temperature. Exercise cautiously, especially in hot weather.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. While you are taking this medicine, avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

Using this medicine for a long time may cause muscle spasms, twitching in the face and body, and uncontrolled tongue or jaw movement. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): High fever; loss of bladder control or trouble urinating; trouble breathing; irregular heartbeat; severe drowsiness; fainting; uncontrollable movements of the mouth, tongue, jaw, arms or legs; heavy sweating; blurred vision; shuffling walk; tremor.

Other: Dizziness, drowsiness, nausea, vomiting, dry mouth, headache, weakness, tiredness, trouble sleeping, change in appetite, weight gain, sensitivity to sunlight, constipation, change in sex drive.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• alpha blockers such as prazosin (Minipress) and doxazosin (Cardura)
• angiotensin receptor II blockers such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• antianxiety medicines such as clonazepam (Klonopin), alprazolam (Xanax), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam (Serax)
• anticancer medicines such as doxorubicin (Adriamycin, Rubex, Doxil), lomustine (CCNU, CeeNU), vinblastine (Velban, Alkaban-AQ), and vinorelbine (Navelbine)
• anticholinergic medicines such as benztropine (Cogentin), hyoscyamine (Levsin), ipratropium (Atrovent), scopolamine (Isopto Hyoscine, Transderm Scop), and tolterodine (Detrol)
• antidepressants such as bupropion (Wellbutrin, Zyban), clomipramine (Anafranil), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft), and venlafaxine (Effexor)
• antifungal medicines such as fluconazole (Diflucan) and terbinafine (Lamisil)
• antihistamines such as diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), and clemastine (Tavist)
• antipsychotic medicines such as chlorpromazine (Thorazine), prochlorperazine (Compazine), trifluoperazine (Stelazine), thioridazine, promazine (Sparine), olanzapine (Zyprexa), risperidone (Risperdal), ziprasidone (Geodon), and haloperidol (Haldol)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, primidone (Mysoline), and phenytoin (Dilantin), valproic acid (Depakote, Depakene)
• barbiturates such as butabarbital (Butisol) and pentobarbital (Nembutal)
• benzodiazepines such as alprazolam (Xanax), diazepam (Valium), chlordiazepoxide (Librium), lorazepam (Ativan), and midazolam (Versed)
• beta blockers such as atenolol (Tenormin), acebutolol (Sectral), pindolol, metoprolol (Lopressor, Toprol XL), sotalol (Betapace), nadolol (Corgard), propranolol (Inderal), labetalol (Normodyne, Trandate), and carvedilol (Coreg)
• birth control pills and hormones such as estradiol (Estrace, Estratab), conjugated estrogens (Premarin), norethindrone (Aygestin, Micronor), norgestrel (Ovrette), megestrol (Megace), and medroxyprogesterone (Provera, Curretab, Cycrin)
• calcium channel blockers such as nifedipine (Adalat, Procardia), isradipine (DynaCirc), felodipine (Plendil), verapamil (Calan, Isoptin), diltiazem (Cardizem), and nicardipine (Cardene)
• clonidine (Catapres)
• grapefruit juice
• heart medicines such as amiodarone (Cordarone, Pacerone), quinidine, and propafenone (Rythmol)
• heartburn medicines such as cimetidine (Tagamet) and ranitidine (Zantac)
• herbal remedies such as St. John's wort, kava, gotu kola, valerian root, and SAMe
• levodopa/carbidopa (Larodopa)
• lithium (Eskalith, Lithobid)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• methadone (Methadose, Dolophine)
• metoclopramide (Clopra, Reglan)
• muscle relaxants such as tizanidine (Zanaflex), cyclobenzaprine (Flexeril), carisoprodol (Soma), methocarbamol (Robaxin), dantrolene Dantrium), and baclofen (Lioresal)
• nicotine (smoking)
• ritonavir (Norvir)
• sleeping pills such as zolpidem (Ambien), triazolam (Halcion), and zaleplon (Sonata), temazepam (Restoril), and flurazepam (Dalmane)
• thyroid hormones
• warfarin (Coumadin)

Do not drink alcohol while you are taking this medicine.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.