$Unique_ID{BRK03277} $Pretitle{} $Title{perphenazine} $Subject{Trilafon Schering Phenothiazine tranquilizer perphenazine mental illness psychosis manic manic-depressive behavioral problems children chemicals transmission nerve impulses brain} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. perphenazine ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) perphenazine (various manufacturers) Trilafon (Schering) TYPE OF DRUG Phenothiazine tranquilizer INGREDIENT perphenazine DOSAGE FORMS Tablets (2 mg, 4 mg, 8 mg, and 16 mg) Oral concentrate (16 mg per 5-ml spoonful, with less than 0.1% alcohol) STORAGE The tablet forms of this medication should be stored at room temperature in tightly closed, light-resistant containers. The oral concentrate form may be stored in the refrigerator in a tightly closed, light-resistant container. If the oral concentrate turns slightly yellow, the medicine is still effective and can be used. However, if it changes color markedly or has particles floating in it, it should not be used; rather, it should be discarded down the sink. This medication should never be frozen. USES Perphenazine is prescribed to treat the symptoms of certain types of mental illness, such as psychosis, the manic phase of manic-depressive illness, and severe behavioral problems in children. This medication is thought to relieve the symptoms of mental illness by blocking certain chemicals involved with the transmission of nerve impulses in the brain. TREATMENT To avoid stomach irritation, you can take the tablet form of this medication with a meal or with a glass of water or milk (unless your doctor directs you to do otherwise). The oral concentrate form of this medication should be measured carefully with the dropper provided, then added to four ounces (1/2 cup) or more of water, milk, or a carbonated beverage or to applesauce or pudding immediately prior to administration. To prevent possible loss of effectiveness, do not dilute this drug in tea, coffee, or apple juice. Antacids and antidiarrheal medicines may decrease the absorption of this medication from the gastrointestinal tract. Therefore, at least an hour should separate doses of one of these medicines and perphenazine. If you miss a dose, take the missed dose as soon as possible, then return to your regular dosing schedule. If it is almost time for the next dose, however, skip the one you missed and return to your regular schedule. Do not double the next dose (unless your doctor directs you to do so). The full effects of this medication for the control of emotional or mental symptoms may not become apparent for two weeks after you start to take it. SIDE EFFECTS Minor. Blurred vision, constipation, decreased sweating, diarrhea, dizziness, drooling, drowsiness, dry mouth, fatigue, jitteriness, menstrual irregularities, nasal congestion, restlessness, vomiting, or weight gain. As your body adjusts to the drug, these side effects should disappear. Perphenazine can also cause discoloration of the urine--a harmless side effect. The urine may become red, pink, or red-brown. This medication can cause increased sensitivity to sunlight. It is, therefore, important to avoid prolonged exposure to sunlight and sunlamps. Wear protective clothing and sunglasses, and use an effective sunscreen. If you are constipated, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). Chew sugarless gum, or suck on ice chips or a piece of hard candy to reduce mouth dryness. To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by pushing one foot against the floor while raising the other foot slightly, alternating feet so that you are "pumping" your legs in a pedaling motion. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about breast enlargement (in both sexes); chest pain; convulsions; darkened skin; difficulty in swallowing or breathing; fainting; fever; impotence; involuntary movements of the face, mouth, jaw, or tongue; palpitations; rash; sleep disorders; sore throat; tremors; uncoordinated movements; unusual bleeding or bruising; visual disturbances; weakness; or yellowing of the eyes or skin. INTERACTIONS Perphenazine interacts with several other types of drugs: 1. It can cause extreme drowsiness when combined with alcohol or other central nervous system (brain and spinal cord) depressants, such as barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, and pain medications or with tricyclic antidepressants. 2. Perphenazine can decrease the effectiveness of amphetamines, guanethidine, anticonvulsants, and levodopa. 3. The side effects of epinephrine, monoamine oxidase (MAO) inhibitors, propranolol, phenytoin, and tricyclic antidepressants may be increased by this medication. At least 14 days should separate the use of this drug and the use of an MAO inhibitor. 4. Lithium may increase the side effects and decrease the effectiveness of this medication. Before starting to take perphenazine, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to perphenazine or other phenothiazine tranquilizers (such as chlorpromazine, fluphenazine, mesoridazine, prochlorperazine, promazine, thioridazine, trifluoperazine, and triflupromazine) or to loxapine. * Tell your doctor if you have a history of alcoholism or if you now have or have ever had blood disease, bone marrow disease, brain disease, breast cancer, blockage in the urinary or digestive tracts, drug-induced depression, epilepsy, high or low blood pressure, diabetes mellitus, glaucoma, heart or circulatory disease, liver disease, lung disease, Parkinson's disease, peptic ulcers, or enlarged prostate gland. * Tell your doctor about any recent exposure to a pesticide or an insecticide. Perphenazine may increase the side effects from the exposure. * To prevent oversedation, avoid drinking alcoholic beverages while taking this medication. * If this drug makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating dangerous machinery. Be careful on stairs and avoid getting up suddenly from a lying or sitting position. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Some of the side effects caused by this drug can be prevented by taking an antiparkinsonism drug. Discuss this with your doctor. * This medication can decrease sweating and heat release from the body. You should, therefore, try not to get overheated (avoid exercising strenuously in hot weather and taking hot baths, showers, and saunas). * Do not stop taking this medication suddenly. If the drug is stopped abruptly, you may experience nausea, vomiting, stomach upset, headache, increased heart rate, insomnia, tremors, or a worsening of your condition. Your doctor may want to reduce the dosage gradually. * If you are planning to have a myelogram or any other procedure in which dye will be injected into your spinal cord, tell your doctor that you are taking this medication. * Avoid spilling the oral concentrate form on your skin or clothing; it may cause redness and irritation of the skin. * While taking this medication, do not take any over-the-counter (nonprescription) medications for weight control or for cough, cold, allergy, asthma, or sinus problems without first checking with your doctor. * Be sure to tell your doctor if you are pregnant. Small amounts of this medication cross the placenta. Although there are reports of safe use of this drug during pregnancy, there are also reports of liver disease and tremors in newborn infants whose mothers received this type of medication close to term. Also, tell your doctor if you are breast-feeding an infant. Small amounts of this medication pass into breast milk and may cause unwanted effects in the nursing infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.