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perphenazine

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Brand names: Trilafon

Typical Antipsychotic (Phenothiazine) Rx

Perphenazine is a medicine used to treat schizophrenia and control severe nausea and vomiting. It belongs to a class of drugs called typical antipsychotics.

Drug Pricing (NADAC)

Generic Price

$0.40/unit

Generic Available

Yes (9 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Perphenazine is used to treat schizophrenia in adults.

Common side effects

Muscle stiffness or spasms, Restlessness, Slow movements

Key warnings

This medicine may increase the risk of death in elderly patients with dementia-related psychosis.

How It Works

Perphenazine works by changing the levels of certain natural chemicals in the brain. These chemicals, called neurotransmitters, help to regulate mood and behavior. By affecting these chemicals, perphenazine can help reduce symptoms of schizophrenia and control nausea.

How to Take It

Take perphenazine exactly as your doctor tells you. The dose will be based on your condition and how you respond to the medicine. For schizophrenia, you may take it 2 to 4 times a day. Your doctor may adjust your dose over time to find what works best for you.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. It is not known if perphenazine will harm an unborn baby. Talk to your doctor about the risks and benefits of taking this medicine while pregnant or breastfeeding.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store perphenazine tablets at room temperature, away from light and moisture.

Side Effects (from patient reports)

Based on 2,010 FDA adverse event reports.

Medicine not working
357
Harmful reaction to substances
274
Weight gain
222
Restlessness
184
Attempt to end one's life
180
Using the medicine for a condition it's not approved for
172
Condition causing repetitive thoughts and behaviors
163
Feeling more hungry
155
Feeling very happy
153
Using the medicine for a condition it's not approved for
150

FDA Adverse Event Report Analysis

Detailed analysis of 2,013 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

2,013

Death-Related Reports

221

Hospitalization Reports

971

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 1,027 (56%)
Male 810 (44%)

Age Distribution

0–17 58
18–44 528
45–64 486
65–74 145
75+ 151

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DRUG INEFFECTIVE 357
2 TOXICITY TO VARIOUS AGENTS 274
3 WEIGHT INCREASED 222
4 AKATHISIA 184
5 SUICIDE ATTEMPT 180
6 OFF LABEL USE 172
7 OBSESSIVE-COMPULSIVE DISORDER 163
8 INCREASED APPETITE 155
9 EUPHORIC MOOD 153
10 PRODUCT USE IN UNAPPROVED INDICATION 150
11 ANTIPSYCHOTIC DRUG LEVEL BELOW THERAPEUTIC 149
12 DISINHIBITION 148
13 THERAPEUTIC PRODUCT EFFECT INCOMPLETE 142
14 THERAPEUTIC PRODUCT EFFECT VARIABLE 140
15 LEUKOPENIA 139

Reactions in Death Reports

COMPLETED SUICIDE 87
TOXICITY TO VARIOUS AGENTS 53
DEATH 39
CARDIAC ARREST 29
BRADYCARDIA 17
ATRIOVENTRICULAR BLOCK 14
SEIZURE 14
HYPOTENSION 13
SOMNOLENCE 13
DYSPNOEA 10

Reactions in Hospitalization Reports

DRUG INEFFECTIVE 263
TOXICITY TO VARIOUS AGENTS 230
WEIGHT INCREASED 179
SUICIDE ATTEMPT 175
AKATHISIA 166
OBSESSIVE-COMPULSIVE DISORDER 152
INCREASED APPETITE 151
EUPHORIC MOOD 150
ANTIPSYCHOTIC DRUG LEVEL BELOW THERAPEUTIC 148
DISINHIBITION 148

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

This medicine may increase the risk of death in elderly patients with dementia-related psychosis. Perphenazine is not approved to treat dementia-related psychosis. Talk to your doctor about the risks if you are an older adult with dementia.

Known Drug Interactions

Among these are tricyclic antidepressants and selective serotonin reuptake inhibitors, e.g., fluoxetine, sertraline and paroxetine.

Mechanism: Sertraline can slow down how your body breaks down perphenazine, which could lead to higher levels of the drug in your system.

What to do: Your doctor should watch for increased side effects and may need to adjust your perphenazine dose.

Among these are tricyclic antidepressants and selective serotonin reuptake inhibitors, e.g., fluoxetine, sertraline and paroxetine.

Mechanism: Fluoxetine can interfere with the way your body processes perphenazine, potentially causing the medication to build up in your body.

What to do: Your healthcare provider may need to lower your dose of perphenazine or monitor you more closely for side effects.

perphenazine, risperidone, thioridazine ↑ antipsychotics A decrease in the dose of antipsychotics that are metabolized by CYP3A or CYP2D6 may be needed when co-administered with darunavir/ritonavir.

Mechanism: Darunavir stops the body from breaking down perphenazine normally, which can cause the drug to build up to higher levels.

What to do: Your doctor may need to lower your dose of perphenazine to avoid potential side effects.

Examples desipramine, atomoxetine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine 7.2 Drugs Having No Clinically Important Interactions with PRISTIQ Based on pharmacokinetic studies, no dosage adjustment is required for drugs that are mainly metabolized by CYP3A4 (e.g., midazolam), or for drugs that are metabolized by both CYP2D6 and CYP3A4 (e.g., tamoxifen, aripiprazole), when administered concomitantly with PRISTIQ [see Clinical Pharmacology (12.3) ].

Mechanism: This combination can affect how your liver clears perphenazine from your body, which might slightly increase the risk of side effects.

What to do: You should continue your medication as prescribed and report any new symptoms to your healthcare provider.

Examples propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, tolterodine, venlafaxine, risperidone.

Mechanism: Paroxetine slows down the process that clears perphenazine from your system. This leads to higher amounts of the medication in your body than intended.

What to do: Talk to your doctor about adjusting your perphenazine dose to avoid unwanted side effects.

Common Questions

Can I drink alcohol while taking perphenazine?
You should avoid alcohol while taking perphenazine, as it can increase drowsiness and other side effects.
How long does it take for perphenazine to start working?
It may take several weeks for you to feel the full effects of perphenazine. Talk to your doctor if you don't notice any improvement in your symptoms.
Can I stop taking perphenazine suddenly?
Do not stop taking perphenazine without talking to your doctor. Stopping suddenly can cause withdrawal symptoms.
Will perphenazine interact with other medications I'm taking?
Perphenazine can interact with other medications. Tell your doctor about all the medicines you take, including prescription and over-the-counter drugs, vitamins, and herbal supplements.
Can perphenazine cause weight gain?
Yes, weight gain is a common side effect of perphenazine.
What should I do if I experience muscle stiffness or spasms?
Tell your doctor if you experience muscle stiffness or spasms. They may prescribe another medicine to help.
Can perphenazine cause drowsiness?
Yes, perphenazine can cause drowsiness. Be careful when driving or operating machinery.
Is it safe to take perphenazine if I have liver problems?
You should not take perphenazine if you have liver damage.
What are the symptoms of tardive dyskinesia?
Tardive dyskinesia causes movements you can't control, like sticking out your tongue, puffing your cheeks, or chewing.
Can perphenazine cause changes in my heart rhythm?
Yes, perphenazine can cause changes in your heart rhythm. Your doctor may want to monitor your heart while you are taking this medicine.
What are the common side effects of perphenazine?
The most commonly reported side effects of perphenazine include Muscle stiffness or spasms, Restlessness, Slow movements, Shaking, Weight gain. Based on 2,010 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does perphenazine interact with other medications?
Yes, perphenazine has 5 known drug interactions. Notable interactions include sertraline, fluoxetine, darunavir. Always inform your doctor about all medications you are taking.
What drug class is perphenazine?
perphenazine belongs to the Typical Antipsychotic (Phenothiazine) drug class. It requires a prescription (Rx). Perphenazine is used to treat schizophrenia in adults.
Is perphenazine safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if perphenazine will harm an unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for perphenazine

The FDA label for perphenazine (sold under brand names such as Trilafon) classifies it as a prescription-only medication in the Typical Antipsychotic (Phenothiazine) class. Perphenazine is used to treat schizophrenia in adults. Official labeling lists 8 commonly reported side effects, including Muscle stiffness or spasms, Restlessness, Slow movements.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 2,010 voluntary reports. The database also lists 5 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.40.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: November 14, 2024

All federal data sources used on this page