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Amitriptyline and perphenazine

 
  Generic Name: Amitriptyline and perphenazine (a mee TRIP ti leen and per FEN a zeen)
 
  Brand Names: Etrafon 2-10, Etrafon 2-25, Etrafon Forte, Triavil  
     
   
 

What is amitriptyline and perphenazine?

Amitriptyline is in a group of drugs called tricyclic antidepressants. Amitriptyline affects chemicals in the brain that may become unbalanced.

Perphenazine is in a group of drugs called phenothiazines (feen-oh-THYE-a-zeens). Perphenazine affects chemicals in the brain that may become unbalanced and cause anxiety.

The combination of amitriptyline and perphenazine is used to treat depression, anxiety, and agitation.

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

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

Do not use this medication if you are allergic to amitriptyline (Elavil) or perphenazine (Trilafon), or if you have liver disease, a weak immune system, a blood cell disorder (such as anemia), or if you have recently had a heart attack. Do not use amitriptyline and perphenazine if you have taken an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms 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. Do not drink alcohol while taking amitriptyline and perphenazine. Perphenazine can increase the effects of alcohol.

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

Do not use this medication if you are allergic to amitriptyline (Elavil) or perphenazine (Trilafon), or if you have:

  • liver damage;

  • a blood cell disorder (such as anemia);

  • a weak immune system (bone marrow depression); or

  • if you have recently had a heart attack.

Do not use amitriptyline and perphenazine if you have taken an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take amitriptyline and perphenazine before the MAO inhibitor has cleared from your body.

Before taking amitriptyline and perphenazine, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney or liver disease;

  • heart disease, or a history of heart attack or stroke;

  • adrenal gland tumor (pheochromocytoma);

  • epilepsy or other seizure disorder;

  • a thyroid disorder;

  • asthma, emphysema, or other breathing disorder;

  • glaucoma;

  • problems with urination;

  • bipolar disorder (manic-depression), schizophrenia or other mental illness;

  • history of drug or alcohol addiction;

  • history of suicidal thoughts or behavior; or

  • history of breast cancer.

If you have any of these conditions, you may not be able to use amitriptyline and perphenazine, or you may need a dosage adjustment or special tests during treatment.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Amitriptyline and perphenazine may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to anyone under 18 years old without the advice of a doctor.

How should I take amitriptyline and perphenazine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

It may take a few weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney and liver function may also need to be tested. Do not miss any scheduled appointments.

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

Do not stop using amitriptyline and perphenazine suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. Store amitriptyline and perphenazine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of amitriptyline and perphenazine can be fatal.

Overdose symptoms of an overdose may include uneven heartbeats, extreme drowsiness, confusion, agitation, hallucinations, vomiting, feeling hot or cold, sweating, muscle stiffness, feeling light-headed, fainting, seizure (convulsions), or coma.

What should I avoid while taking amitriptyline and perphenazine?

Do not drink alcohol while taking amitriptyline and perphenazine. This medication can increase the effects of alcohol. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by amitriptyline and perphenazine. Tell your doctor if you need to use any of these other medicines together with amitriptyline and perphenazine. Amitriptyline and perphenazine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Perphenazine can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Amitriptyline and perphenazine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms 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.

Call your doctor at once if you have any of these serious side effects:
  • restless muscle movements in your eyes, tongue, jaw, or neck;

  • tremor (uncontrolled shaking);

  • fever, stiff muscles, confusion, sweating, fast or uneven heartbeats;

  • feeling like you might pass out;

  • seizures (convulsions);

  • problems with urination;

  • fast, or slow heart rate, chest pain or heavy feeling;

  • easy bruising or bleeding;

  • jaundice (yellowing of your skin or eyes); or

  • urinating less than usual or not at all.

Less serious side effects may include:

  • feeling dizzy, drowsy, or tired;

  • strange dreams or nightmares;

  • sleep problems (insomnia);

  • dry mouth, loss of appetite;

  • nausea, vomiting, diarrhea, constipation;

  • blurred vision;

  • breast changes; or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect amitriptyline and perphenazine?

Before taking amitriptyline and perphenazine, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

The following drugs can interact with amitriptyline and perphenazine. Tell your doctor if you are using any of these:

  • atropine (Atreza, Sal-Tropine, and others);

  • cimetidine (Tagamet;

  • guanethidine (Ismelin); or

  • a heart rhythm medicine such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Quinidex, Quinaglute).

This list is not complete and there may be other drugs that can interact with amitriptyline and perphenazine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about amitriptyline and perphenazine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 3.09. Revision Date: 4/12/2009 4:41:11 PM.;
 
 
 
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