amitriptyline and perphenazine

What is the most important information I should know about amitriptyline and perphenazine?

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

What is amitriptyline and perphenazine?

Amitriptyline is a tricyclic antidepressant. Perphenazine is a phenothiazine (feen-oh-THYE-a-zeen).

Amitriptyline and perphenazine is a combination medicine used to treat depression, anxiety, and agitation.

Amitriptyline and perphenazine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking amitriptyline and perphenazine?

• you have recently had a heart attack; or
• you have recently used alcohol, sedatives, tranquilizers, or opioid medications.

Do not use amitriptyline and perphenazine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Tell your doctor if you have ever had:

• glaucoma;
• bipolar disorder (manic-depression), schizophrenia or other mental illness;
• epilepsy or other seizure disorder;
• urination problems;
• heart problems;
• a heart attack or stroke;
• a thyroid disorder;
• liver disease; or
• breast cancer.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking antipsychotic medicine in the last 3 months of pregnancy may cause breathing problems, feeding problems, or withdrawal symptoms in the newborn. If you get pregnant, tell your doctor right away. Do not stop taking amitriptyline and perphenazine without your doctor's advice.

How should I take amitriptyline and perphenazine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

While using this medicine, you may need frequent medical tests.

If you need surgery, tell the surgeon ahead of time that you are using amitriptyline and perphenazine. You may need to stop using the medicine for a short time.

Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using amitriptyline and perphenazine.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include extreme drowsiness, confusion, agitation, hallucinations, vomiting, feeling hot or cold, muscle stiffness, dilated pupils, or coma.

What should I avoid while taking amitriptyline and perphenazine?

What are the possible side effects of amitriptyline and perphenazine?

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

High doses or long-term use of this medicine can cause a serious movement disorder that may not be reversible. The longer you use amitriptyline and perphenazine, the more likely you are to develop this disorder, especially if you are a woman or an older adult.

• uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
• a light-headed feeling, like you might pass out;
• fast, slow, or uneven heart rate;
• chest pain or pressure, pain spreading to your jaw or shoulder;
• easy bruising, unusual bleeding, purple or red spots under your skin;
• dark urine, jaundice (yellowing of the skin or eyes);
• a seizure (convulsions);
• low white blood cell counts --fever, chills, sore throat, mouth sores, skin sores, sore throat, cough, trouble breathing; or
• severe nervous system reaction --very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, fainting.

Common side effects may include:

• drowsiness;
• high blood pressure;
• problems with speech;
• involuntary muscle movements;
• feeling restless or unable to sit still;
• dry mouth;
• headache; or
• breast changes.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect amitriptyline and perphenazine?

Tell your doctor about all your other medicines, especially:

• other antidepressants or medicine to treat anxiety, mood disorders, or mental illness;
• cimetidine;
• guanethidine;
• cold or allergy medicine (Benadryl and others);
• medicine to treat Parkinson's disease;
• medicine to treat stomach problems, motion sickness, or irritable bowel syndrome;
• medicine to treat overactive bladder;
• bronchodilator asthma medication;
• heart rhythm medicine; or
• seizure medication.

This list is not complete. Other drugs may affect amitriptyline and perphenazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about amitriptyline and perphenazine.