perphenazine and amitriptyline hydrochloride (Etrafon - brand no longer available in the US) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

DOSING:

  • Anxiety or agitation with depression: Initial dose is one tablet of 2/25 mg or 4/25 mg by mouth three to four times a day OR take one tablet of 4/50 mg by mouth twice a day.
  • Depression with schizophrenia: Initial dose is two tablets of 4/25 mg by mouth twice or three times a day, a fourth dose may be given at bedtime.
  • Maintenance dose for all patients: Take one tablet of 2/25 mg or 4/25 mg by mouth two to four times a day OR take one tablet of 4/50 mg by mouth twice a day. 2/10 mg and 4/10 mg doses can be used to increase flexibility in adjusting maintenance dosage to the lowest amount consistent with relief of symptoms.

The maximum dose is 16/200 mg per day.

DRUG INTERACTIONS: Perphenazine/amitriptyline should be used with caution with medications like paroxetine (Paxil), fluoxetine (Prozac), and sertraline (Zoloft) because these medications also increase the concentration of neurotransmitters in the body leading to severe and deadly reactions.

Perphenazine/amitriptyline should be avoided with medications like quinidine, disopyramide (Norpace), procainamide (Pronestyl), propafenone (Rhythmol), and flecainide (Tambocor) because they may also affect heart rhythm and increase the risk of an irregular heart rate and rhythm.

Perphenazine/amitriptyline should be used with caution with medications like epinephrine due to increased risk of irregular heart rates and rhythms.

PREGNANCY: Newborn babies may be at risk for withdrawal or extrapyramidal symptoms. Perphenazine/amitriptyline is not recommended for use in pregnant women.

NURSING MOTHERS: Perphenazine/amitriptyline enters breast milk and is not recommended during breastfeeding.

SIDE EFFECTS: Side effects of Perphenazine/amitriptyline are abnormal muscle contractions, difficulty breathing and swallowing, neck spasms, and movement abnormalities on face, arms, and legs. This medication also causes dizziness, drowsiness, sedation, irregular heart rate and rhythm, increase or decrease in blood pressure, and blurred vision.

Medically Reviewed by a Doctor on 8/11/2014


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