Amitriptyline-Perphenazine

Amitriptyline/Perphenazine is a prescription combination medication used to treat symptoms of anxiety or agitation with depression, and Schizophrenia with depression.

• Amitriptyline/Perphenazine is available under the following different brand names: Etrafon

Adult dosage

Tablet

• 10mg/2mg
• 25mg/2mg
• 10mg/4mg
• 25mg/4mg
• 50mg/4mg

Anxiety or Agitation with Depression

Adult dosage

• Initial: 25 mg/2 mg or 25 mg/4 mg orally three or four times daily, OR 50 mg/4 mg orally twice daily
• Maintenance: 2 mg/25 mg or 4 mg/25 mg orally two or four times daily, OR 50 mg/4 mg orally twice daily
• 10 mg/ 2 mg and 10 mg/4 mg can be used to increase flexibility in adjusting maintenance dosage to the lowest amount consistent with relief of symptoms
• Do not exceed a daily dose of 200 mg/16 mg

Schizophrenia with Depression

Adult dosage

• Initial: 50 mg/8 mg (ie, 2 tablets of 25 mg/4 mg) orally two or three times daily; if needed a fourth dose may be given at bedtime
• Maintenance: 2 mg/25 mg or 4 mg/25 mg orally two or four times daily, OR 50 mg/4 mg orally twice daily
• 10 mg/ 2 mg and 10 mg/4 mg can be used to increase flexibility in adjusting maintenance dosage to the lowest amount consistent with relief of symptoms
• Do not exceed a daily dose of 200 mg/16 mg

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Amitriptyline/Perphenazine include:

• drowsiness,
• dizziness,
• dry mouth,
• blurred vision,
• constipation,
• tiredness,
• weight gain, and
• difficulty urinating.

Serious side effects of Amitriptyline/Perphenazine include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• drooling,
• trouble swallowing,
• mask-like expression of the face,
• restlessness,
• a constant need to move,
• shaking,
• shuffling walk,
• stiff muscles,
• severe muscle spasms or cramping,
• twisting neck,
• arching back,
• eyes rolling up,
• easy bruising,
• unusual bleeding,
• fever,
• persistent sore throat,
• severe stomach pain,
• persistent nausea, 
• vomiting,
• yellowing of the eyes or skin (jaundice),
• persistent heartburn,
• uncontrollable movements (lip smacking, mouth puckering, tongue thrusting, chewing, or unusual arm or leg movements),
• unwanted breast milk (in females),
• stopped or missed periods,
• difficulty becoming pregnant,
• decreased sexual ability (in males),
• inability to produce sperm,
• enlarged breasts (in males),
• muscle tenderness or weakness,
• severe tiredness,
• severe confusion,
• sweating,
• fast or irregular heartbeat,
• dark urine,
• changes in the amount of urine,
• weakness on one side of the body,
• slurred speech,
• eye pain, swelling or redness,
• vision changes,
• seeing halos around lights at night,
• cough,
• fever,
• chest, jaw, or left arm pain,
• severe dizziness,
• fainting,
• black or tarry stools,
• vomit that looks like coffee grounds,
• seizures,
• rash, and
• itching.

Rare side effects of Amitriptyline/Perphenazine include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Amitriptyline/Perphenazine has severe interactions with the following drugs:
  • amisulpride
  • disopyramide
  • dronedarone
  • ibutilide
  • ibutilide
  • indapamide
  • iobenguane I 123
  • metrizamide
  • isocarboxazid
  • pentamidine
  • phenelzine
  • pimozide
  • pimozide
  • procainamide
  • procarbazine
  • quinidine
  • quinidine
  • safinamide
  • selegiline
  • sotalol
  • tranylcypromine
• Amitriptyline/Perphenazine has serious interactions with at least 184 other drugs.
• Amitriptyline/Perphenazine has moderate interactions with at least 501 other drugs.
• Amitriptyline/Perphenazine has minor interactions with at least 164 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Tricyclic Antidepressant (amitriptyline): hypersensitivity, severe cardiovascular disorder, narrow-angle glaucoma, within 14 days of MAOIs (risk of serotonin syndrome), any drugs or conditions that prolong QT interval, acute recovery post-MI
• Antipsychotic (perphenazine): hypersensitivity, CNS depression, neuroleptic malignant syndrome, poorly controlled seizure disorder, subcortical brain damage, coma, severe obtundation, high dose CNS depressants, blood dyscrasia, myelosuppression, liver damage

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Amitriptyline/Perphenazine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Amitriptyline/Perphenazine?”

Cautions

• None

Pregnancy and Lactation

• Use in LIFE-THREATENING emergencies when no safer drug is available. Positive evidence of human fetal risk
• Lactation
  • Excreted in breast milk; not recommended