Amitriptyline and Perphenazine (patient information)

Why this medication is prescribed
Amitriptyline (an antidepressant or mood elevator) and perphenazine (a tranquilizer) are used together to treat depression, anxiety, and agitation.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How this medication should be used
Amitriptyline and perphenazine comes as a tablet to take by mouth. It is usually taken two to four times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take amitriptyline and perphenazine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take amitriptyline and perphenazine even if you feel well. Do not stop taking amitriptyline and perphenazine without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will want to decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.

Special Precautions
Before taking amitriptyline and perphenazine:


 * tell your doctor and pharmacist if you are allergic to amitriptyline and perphenazine or any other drugs.
 * tell your doctor and pharmacist what prescription and nonprescription drugs you are taking or have taken within the last 2 weeks, especially anticoagulants [warfarin (Coumadin)]; antihistamines; cimetidine (Tagamet); estrogens; fluoxetine (Prozac); lithium (Eskalith, Lithobid); MAO inhibitors [phenelzine (Nardil), tranylcypromine (Parnate)]; levodopa (Sinemet, Larodopa); medication for high blood pressure, seizures, Parkinson's disease, diabetes, asthma, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; oral contraceptives; sedatives; sleeping pills; thyroid medications; tranquilizers; and vitamins.
 * tell your doctor if you have or have ever had glaucoma, an enlarged prostate, difficulty urinating, seizures, an overactive thyroid gland, or liver, kidney, or heart disease.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking amitriptyline and perphenazine, call your doctor immediately.
 * if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking amitriptyline and perphenazine.
 * you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
 * remember that alcohol can add to the drowsiness caused by this drug.
 * tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.

What to do if you forget a dose
If you take several doses per day, take the missed dose as soon as you remember it and take any remaining doses for that day at evenly spaced intervals. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.

If you take amitriptyline and perphenazine once a day at bedtime and do not remember to take it until the next morning, skip the missed dose. Do not take a double dose to make up for a missed one.

Minor Side Effects
Side effects from amitriptyline and perphenazine are common:


 * upset stomach
 * drowsiness
 * weakness or tiredness
 * excitement or anxiety
 * insomnia
 * nightmares
 * dry mouth
 * skin more sensitive to sunlight than usual
 * changes in appetite or weight

Tell your doctor if any of these symptoms are severe or do not go away:


 * constipation
 * difficulty urinating
 * frequent urination
 * blurred vision
 * changes in sex drive or ability
 * excessive sweating

Severe Side Effects
If you experience any of the following symptoms, call your doctor immediately:


 * jaw, neck, and back muscle spasms
 * slow or difficult speech
 * shuffling walk
 * persistent fine tremor or inability to sit still
 * fever
 * difficulty breathing or swallowing
 * severe skin rash
 * yellowing of the skin or eyes
 * irregular heartbeat

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Other information
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to amitriptyline and perphenazine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * Etrafon®
 * Triavil®