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All about: amitriptyline and perphenazine

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

What is amitriptyline and perphenazine?

Amitriptyline is in a class of drugs called tricyclic antidepressants. It is used to relieve symptoms of depression such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia; and thoughts of death or suicide. Amitriptyline is also sometimes used to treat certain types of pain.

Perphenazine is in a class of drugs called phenothiazines. Perphenazine is used to treat psychotic disorders and nausea and vomiting.

Amitriptyline and perphenazine work by changing the actions of chemicals in your brain.

The combination, amitriptyline and perphenazine, is used to treat depression that is accompanied by anxiety or agitation.

Amitriptyline and perphenazine may also be used for purposes other than those listed in this medication guide.

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

Call your doctor immediately if you have uncontrollable movements of your mouth, tongue, cheeks, jaw, arms, or legs. Use caution when driving, operating machinery, or performing other hazardous activities. Amitriptyline and perphenazine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking amitriptyline and perphenazine.

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

Do not take amitriptyline and perphenazine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days, or if you have had a heart attack in the past 6 weeks.

Before taking amitriptyline and perphenazine, tell your doctor if you have

  • a bone marrow disease,

  • high blood pressure or any type of heart disease,

  • glaucoma or increased pressure in your eyes,

  • epilepsy or another seizure disorder,

  • Parkinson's disease,

  • liver disease, or
  • an enlarged prostate or difficulty urinating.

You may not be able to take amitriptyline and perphenazine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

It is not known whether amitriptyline and perphenazine will harm an unborn baby. Do not take amitriptyline and perphenazine without first talking to your doctor if you are pregnant. It is not known whether amitriptyline and perphenazine passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take amitriptyline and perphenazine?

Take amitriptyline and perphenazine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Do not stop taking amitriptyline and perphenazine without the approval of your doctor. It may be up to 4 months before you begin to feel better, and you may require continuous treatment for quite some time. Talk to your doctor before you stop taking this 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. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and take only the next one as directed. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical treatment.

Symptoms of an amitriptyline and perphenazine overdose include hallucinations, confusion, drowsiness, fast heartbeat, large pupils, seizures, low blood pressure (fainting, weakness), vomiting, high or low body temperature, and coma.

What should I avoid while taking amitriptyline and perphenazine?

Use caution when driving, operating machinery, or performing other hazardous activities. Amitriptyline and perphenazine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking amitriptyline and perphenazine.

Amitriptyline and perphenazine side effects

If you experience any of the following serious side effects, stop taking amitriptyline and perphenazine and seek emergency medical treatment:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  • uncontrollable movements of your tongue, face, lips, arms, or legs;

  • muscle spasms of the face or neck;

  • severe restlessness or tremor;

  • severe drowsiness or fainting; or

  • seizures.

Other, less serious side effects may be more likely to occur. Continue to take amitriptyline and perphenazine and talk to your doctor if you experience

  • decreased sweating;

  • dry mouth, stuffy nose;

  • constipation;

  • blurred vision;

  • mild restlessness, drowsiness, or tremor;

  • headache;

  • decreased sex drive;

  • dizziness or unusual weakness;

  • nausea, vomiting, or diarrhea; or

  • menstrual irregularities or swollen breasts.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect amitriptyline and perphenazine?

Do not take amitriptyline and perphenazine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.

Amitriptyline and perphenazine may increase the effects of other drugs that cause drowsiness, including other antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.

Drugs other than those listed here may also interact with amitriptyline and perphenazine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

  • Your pharmacist has additional information about amitriptyline and perphenazine written for health professionals that you may read.

What does my medicine look like?

Amitriptyline and perphenazine is available with a prescription generically and under the brand names Triavil and Etrafon. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

The following list indicates perphenazine/amitriptyline tablet strengths:

  • Triavil 2-10 (2 mg/10 mg)--blue, triangular, film-coated tablets

  • Triavil 2-25 (2 mg/25 mg)--orange, triangular, film-coated tablets

  • Triavil 4-10 (4 mg/10 mg)--salmon-colored, triangular, film-coated tablets

  • Triavil 4-25-(4 mg/25 mg)--yellow, triangular, film-coated tablets

  • Triavil 4-50 (4 mg/50 mg)--orange, diamond shaped, film-coated tablets

  • Etrafon 2-10 Tablets (2 mg/10 mg)--round, deep yellow, sugar-coated tablets

  • Etrafon Tablets (2 mg/25 mg)--round, pink, sugar-coated tablets

  • Etrafon Forte Tablets (4 mg/25 mg)--round, red, sugar-coated tablets

  • 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: 3.07. Revision Date: 7/20/04 4:54:37 PM.

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