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Perphenazine Side Effects Center
Medical Editor: John P. Cunha, DO, FACOEP
Perphenazine (perphenazine) Tablets are a piperazinyl phenothiazine prescribed for use in the treatment of schizophrenia, and for the control of severe nausea and vomiting in adults. Perphenazine is available in generic form. Common side effects of Perphenazine include twitching or uncontrollable movements of lips, tongue, face, arms, or legs, tremors, and feeling restless, dizziness, drowsiness, anxiety, blurred vision, headache, sleep problems (insomnia), strange dreams, constipation, dry mouth or stuffy nose, breast swelling or discharge, changes in your menstrual periods, weight gain, swelling in your hands or feet, impotence, trouble having an orgasm, itching or skin rash. Serious side effects of Perphenazine include tardive dyskinesia and neuroleptic malignant syndrome.
Perphenazine is available in strengths of 2, 4, 8 and 16 mg. Dosage must be individualized and adjusted according to the severity of the condition and the response obtained. Perphenazine may interact with cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, medicine for seizures, depression or anxiety, atropine, lithium, gefitinib, imatinib, nilotinib, antibiotics, birth control pills or hormone replacement estrogens, blood pressure medication, blood thinners, certain asthma medications or bronchodilators, heart rhythm medications, HIV or AIDS medications, incontinence medications, insulin or diabetes medications you take by mouth, medication for nausea, vomiting, or motion sickness, medications to treat or prevent malaria, medications used for general anesthesia, medicines used to prevent organ transplant rejection, numbing medicines, stimulants or ADHD medications, ulcer or irritable bowel medications, or medicines to treat Parkinson's disease, restless leg syndrome, or pituitary gland tumor (prolactinoma). Tell your doctor all medications and supplements you use. Safe use of perpenazine during pregnancy and lactation has not been established. Therefore, in administering the drug to pregnant patients, nursing mothers, or women who may become pregnant, possible benefits must be weighed against the possible hazards to mother and child. Use of this drug in children under 12 years old is not recommended.
Our Perphenazine (perphenazine) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
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 is Patient Information in Detail?
Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.
Perphenazine in Detail - Patient Information: 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.
Stop using perphenazine and call your doctor at once if you have a serious side effect such as:
- twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;
- tremor (uncontrolled shaking), drooling, trouble swallowing, problems with balance or walking;
- feeling restless, jittery, or agitated;
- confusion, unusual thoughts or behavior;
- feeling like you might pass out;
- seizure (convulsions);
- decreased night vision, tunnel vision, watery eyes, increased sensitivity to light;
- nausea and stomach pain, skin rash, and jaundice (yellowing of the skin or eyes);
- high fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing;
- pale skin, easy bruising or bleeding, fever, sore throat, flu symptoms;
- urinating less than usual or not at all;
- joint pain or swelling with fever, swollen glands, muscle aches, chest pain, vomiting, unusual thoughts or behavior, and patchy skin color; or
- slow heart rate, weak pulse, fainting, slow breathing (breathing may stop).
Less serious side effects may include:
- dizziness, drowsiness, anxiety;
- blurred vision, headache;
- sleep problems (insomnia), strange dreams;
- dry mouth or stuffy nose;
- breast swelling or discharge;
- changes in your menstrual periods;
- weight gain, swelling in your hands or feet;
- impotence, trouble having an orgasm; or
- mild itching or skin rash.
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.
Read the entire detailed patient monograph for Perphenazine (Perphenazine)
What is Patient Information Overview?
A concise overview of the drug for the patient or caregiver from First DataBank.
Perphenazine Overview - Patient Information: Side Effects
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Some people using this medication do not have serious side effects.
This drug may cause muscle/nervous system problems (extrapyramidal symptoms-EPS). Your doctor may prescribe another medication to decrease these side effects. Therefore, tell your doctor immediately if you notice any of the following side effects: increased anxiety, drooling/trouble swallowing, restlessness/constant need to move, shaking (tremor), shuffling walk, stiff muscles.
Tell your doctor immediately if any of these unlikely but serious side effects occur: difficulty urinating.
This medication may cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor immediately if you develop any involuntary/repetitive muscle movements such as lip smacking/puckering, tongue thrusting, chewing, or finger/toe movements.
In rare cases, perphenazine may increase your level of a certain chemical made by the body (prolactin). For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor immediately.
Tell your doctor immediately if any of these rare but very serious side effects occur: easy bruising/bleeding, slow heartbeat, signs of infection (e.g., sore throat), severe muscle spasm/cramping (e.g., twisting neck, arching back, eyes rolling up), persistent nausea, seizures, stomach/abdominal pain, yellowing eyes/skin.
This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, change in the amount of urine.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for Perphenazine (Perphenazine)
What is Prescribing information?
The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.
Perphenazine FDA Prescribing Information: Side Effects
Not all of the following adverse reactions have been reported with this specific drug; however, pharmacological similarities among various phenothiazine derivatives require that each be considered. With the piperazine group (of which perphenazine (perphenazine) is an example), the extrapyramidal symptoms are more common, and others (e.g., sedative effects, jaundice, and blood dyscrasias) are less frequently seen.
opisthotonus, trismus, torticollis, retrocollis, aching and numbness of the limbs, motor restlessness, oculogyric crisis, hyperreflexia, dystonia, including protrusion, discoloration, aching and rounding of the tongue, tonic spasm of the masticatory muscles, tight feeling in the throat, slurred speech, dysphagia, akathisia, dyskinesia, parkinsonism, and ataxia. Their incidence and severity usually increase with an increase in dosage, but there is considerable individual variation in the tendency to develop such symptoms. Extrapyramidal symptoms can usually be controlled by the concomitant use of effective antiparkinsonian drugs, such as benztropine mesylate, and/or by reduction in dosage. In some instances, however, these extrapyramidal reactions may persist after discontinuation of treatment with perphenazine (perphenazine) .
Persistent Tardive Dyskinesia
As with all antipsychotic agents, tardive dyskinesia may appear in some patients on long-term therapy or may appear after drug therapy has been discontinued. Although the risk appears to be greater in elderly patients on high-dose therapy, especially females, it may occur in either sex and in children. The symptoms are persistent and in some patients appear to be irreversible. The syndrome is characterized by rhythmical, involuntary movements of the tongue, face, mouth or jaw (e.g., protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements).
Sometimes these may be accompanied by involuntary movements of the extremities. There is no known effective treatment for tardive dyskinesia; antiparkinsonism agents usually do not alleviate the symptoms of this syndrome. It is suggested that all antipsychotic agents be discontinued if these symptoms appear. Should it be necessary to reinstitute treatment, or increase the dosage of the agent, or switch to a different antipsychotic agent, the syndrome may be masked. It has been reported that fine, vermicular movements of the tongue may be an early sign of the syndrome, and if the medication is stopped at that time the syndrome may not develop.
Other CNS Effects
include cerebral edema; abnormality of cerebrospinal fluid proteins; convulsive seizures, particularly in patients with EEG abnormalities or a history of such disorders; and headaches.
Neuroleptic malignant syndrome has been reported in patients treated with antipsychotic drugs (see WARNINGS).
Drowsiness may occur, particularly during the first or second week, after which it generally disappears. If troublesome, lower the dosage. Hypnotic effects appear to be minimal, especially in patients who are permitted to remain active.
Adverse behavioral effects include paradoxical exacerbation of psychotic symptoms, catatonic-like states, paranoid reactions, lethargy, paradoxical excitement, restlessness, hyperactivity, nocturnal confusion, bizarre dreams, and insomnia.
Hyperreflexia has been reported in the newborn when a phenothiazine was used during pregnancy.
dry mouth or salivation, nausea, vomiting, diarrhea, anorexia, constipation, obstipation, fecal impaction, urinary retention, frequency or incontinence, bladder paralysis, polyuria, nasal congestion, pallor, myosis, mydriasis, blurred vision, glaucoma, perspiration, hypertension, hypotension, and change in pulse rate occasionally may occur. Significant autonomic effects have been infrequent in patients receiving less than 24 mg perphenazine (perphenazine) daily.
Adynamic ileus occasionally occurs with phenothiazine therapy, and if severe, can result in complications and death. It is of particular concern in psychiatric patients, who may fail to seek treatment of the condition.
urticaria, erythema, eczema, exfoliative dermatitis, pruritus, photosensitivity, asthma, fever, anaphylactoid reactions, laryngeal edema, and angioneurotic edema; contact dermatitis in nursing personnel administering the drug; and in extremely rare instances, individual idiosyncrasy or hypersensitivity to phenothiazines has resulted in cerebral edema, circulatory collapse, and death.
lactation, galactorrhea, moderate breast enlargement in females and gynecomastia in males on large doses, disturbances in the menstrual cycle, amenorrhea, changes in libido, inhibition of ejaculation, syndrome of inappropriate ADH (antidiuretic hormone) secretion, false positive pregnancy tests, hyperglycemia, hypoglycemia, glycosuria.
postural hypotension, tachycardia (especially with sudden marked increase in dosage), bradycardia, cardiac arrest, faintness, and dizziness. Occasionally the hypotensive effect may produce a shock-like condition. ECG changes, nonspecific (quinidine-like effect) usually reversible, have been observed in some patients receiving phenothiazine antipsychotics.
Sudden death has occasionally been reported in patients who have received phenothiazines. In some cases, the death was apparently due to cardiac arrest; in others, the cause appeared to be asphyxia due to failure of the cough reflex. In some patients, the cause could not be determined nor could it be established that the death was due to the phenothiazine.
agranulocytosis, eosinophilia, leukopenia, hemolytic anemia, thrombocytopenic purpura, and pancytopenia. Most cases of agranulocytosis have occurred between the fourth and tenth weeks of therapy. Patients should be watched closely, especially during that period, for the sudden appearance of sore throat or signs of infection. If white blood cell and differential cell counts show significant cellular depression, discontinue the drug and start appropriate therapy. However, a slightly lowered white count is not in itself an indication to discontinue the drug.
Special considerations in long-term therapy include pigmentation of the skin, occurring chiefly in the exposed areas; ocular changes consisting of deposition of fine particulate matter in the cornea and lens, progressing in more severe cases to star-shaped lenticular opacities; epithelial keratopathies; and pigmentary retinopathy. Also noted: peripheral edema, reversed epinephrine effect, increase in PBI not attributable to an increase in thyroxine, parotid swelling (rare), hyperpyrexia, systemic lupus erythematosus-like syndrome, increases in appetite and weight, polyphagia, photophobia, and muscle weakness.
Liver damage (biliary stasis) may occur. Jaundice may occur, usually between the second and fourth weeks of treatment, and is regarded as a hypersensitivity reaction. Incidence is low. The clinical picture resembles infectious hepatitis but with laboratory features of obstructive jaundice. It is usually reversible; however, chronic jaundice has been reported.
Read the entire FDA prescribing information for Perphenazine (Perphenazine)
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