Amitriptyline/perphenazine dosing, indications, interactions, adverse effects, and more (2023)

adagrasib, amitriptyline.Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.adagrasib, perphenazine.Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.

amitriptyline, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

aminolevulinic acid oral, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

perphenazine increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.

amitriptyline and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.perphenazine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

amitriptyline and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.apomorphine and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline, arformoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

aripiprazole and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.perphenazine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.

artemether and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

benzhydrocodone/acetaminophen, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).

amitriptyline, benzphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

buprenorphine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

buprenorphine buccal and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

buprenorphine subdermal implant and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

buprenorphine transdermal and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

buprenorphine, long-acting injection and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.

perphenazine, calcium/magnesium/potassium/sodium oxybates.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.amitriptyline, calcium/magnesium/potassium/sodium oxybates.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

chlorpromazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.chlorpromazine and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.

citalopram and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Citalopram may increase TCA levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome. Potential risk for QT prolongation. ECG monitoring is recommended.citalopram and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.

clarithromycin will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.amitriptyline and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.amitriptyline and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

dacomitinib will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.

amitriptyline and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.

dacomitinib will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.

dasatinib will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

degarelix and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and desipramine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and desipramine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline, dexfenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline, diethylpropion. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, dobutamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

dolasetron, amitriptyline.Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

perphenazine decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.amitriptyline, dopamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, dopexamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine and dosulepin both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and dosulepin both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.perphenazine and doxepin both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and doxepin both increase QTc interval. Avoid or Use Alternate Drug.

dronedarone and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.perphenazine and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and droperidol both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and droperidol both increase QTc interval. Avoid or Use Alternate Drug.

duloxetine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

epinephrine and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.

encorafenib and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline, ephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

epinephrine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline, epinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

epinephrine racemic and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.epinephrine racemic and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.erythromycin base will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.erythromycin base will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.perphenazine and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.

erythromycin ethylsuccinate will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.erythromycin ethylsuccinate will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.perphenazine and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.

erythromycin lactobionate will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin lactobionate will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.perphenazine and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.

erythromycin stearate will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin stearate will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.perphenazine and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.

escitalopram and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.escitalopram increases toxicity of amitriptyline by QTc interval. Avoid or Use Alternate Drug.

fentanyl, perphenazine.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

amitriptyline, fenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

fentanyl intranasal, perphenazine.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

fentanyl transdermal, perphenazine.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

fentanyl transmucosal, perphenazine.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

fexinidazole and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.

amitriptyline and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.perphenazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.

fluoxetine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug.perphenazine and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug.fluoxetine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.perphenazine will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.fluoxetine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

fluphenazine and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.fluphenazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

fluvoxamine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and formoterol both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

fosamprenavir increases levels of amitriptyline by decreasing metabolism. Avoid or Use Alternate Drug.

givosiran will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.givosiran will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.

granisetron, amitriptyline.Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.granisetron and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

amitriptyline and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

hydrocodone, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).

hydroxychloroquine sulfate and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.hydroxychloroquine sulfate and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and imipramine both increase QTc interval. Avoid or Use Alternate Drug.perphenazine and imipramine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

isocarboxazid, perphenazine. Other (see comment). Contraindicated. Comment: Concurrent use may prolong or intensify the hypotensive, anticholinergic, or sedative effects of isocarboxazid or perphenazine.

amitriptyline, isoproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.

ivosidenib and perphenazine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.ivosidenib and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

perphenazine and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

lasmiditan increases effects of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

perphenazine decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

lefamulin and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline, levalbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Phenothiazine/1st generation antipsychotics inhibit dopamine D2 receptors in varying degrees.

perphenazine and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

levomilnacipran and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine decreases effects of lisuride by pharmacodynamic antagonism. Contraindicated.

linezolid and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

amitriptyline, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline and lofepramine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.perphenazine and lofepramine both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.perphenazine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

macimorelin and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.macimorelin and perphenazine both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

amitriptyline and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.perphenazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

mefloquine increases toxicity of amitriptyline by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

perphenazine, methyl aminolevulinate.Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

amitriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline, metaproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, methamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

methylene blue and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

amitriptyline, methylenedioxymethamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine, metoclopramide intranasal.Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.perphenazine increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome.amitriptyline, metoclopramide intranasal.Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

amitriptyline, midodrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

mobocertinib and perphenazine both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

milnacipran and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

mirtazapine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

mobocertinib will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently

perphenazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

nefazodone and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

netupitant/palonosetron, amitriptyline.Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

amitriptyline and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline, norepinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.amitriptyline and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and octreotide both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.perphenazine and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. amitriptyline and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

perphenazine and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.amitriptyline and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.ondansetron, amitriptyline.Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

ozanimod increases toxicity of amitriptyline by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

paroxetine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.perphenazine will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.perphenazine and paroxetine both increase QTc interval. Avoid or Use Alternate Drug.

palonosetron, amitriptyline.Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.

paroxetine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline, phendimetrazine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, phenylephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, phenylephrine PO. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline, pirbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

amitriptyline decreases effects of pitolisant by Other (see comment). Avoid or Use Alternate Drug. Comment: Pitolisant increases histamine levels in the brain; therefore, H1 receptor antagonists that cross the blood-brain barrier may reduce the efficacy of pitolisant.

perphenazine decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.

perphenazine and prochlorperazine both increase QTc interval. Avoid or Use Alternate Drug.

promazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.perphenazine and promazine both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and promethazine both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline, propylhexedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

quinidine, perphenazine.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive cardiac effects.

quinidine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

ranolazine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

rasagiline and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.

ribociclib increases toxicity of amitriptyline by QTc interval. Avoid or Use Alternate Drug.ribociclib increases toxicity of perphenazine by QTc interval. Avoid or Use Alternate Drug.

perphenazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.

amitriptyline, salmeterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.

saquinavir, perphenazine.Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Increased risk of PR or QT prolongation and cardiac arrhythmias.

selegiline transdermal and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

selinexor, amitriptyline. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.selinexor, perphenazine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

amitriptyline, serdexmethylphenidate/dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine, sodium oxybate.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

sertraline and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline, sodium oxybate.Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

amitriptyline and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.

sufentanil SL, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

tedizolid, amitriptyline.Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

amitriptyline, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

tetrabenazine and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and thioridazine both increase QTc interval. Avoid or Use Alternate Drug.thioridazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.perphenazine will increase the level or effect of thioridazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.

amitriptyline and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.

perphenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.trazodone and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

perphenazine, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

perphenazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

perphenazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.trifluoperazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

perphenazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline and umeclidinium bromide/vilanterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedamitriptyline increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.perphenazine increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

amitriptyline, vandetanib.Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

perphenazine and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug.

vemurafenib and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

venlafaxine and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

amitriptyline and vilanterol/fluticasone furoate inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiatedamitriptyline increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.perphenazine increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

amitriptyline, vilazodone.Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

yohimbe decreases effects of perphenazine by pharmacodynamic antagonism. Contraindicated.

amitriptyline, vortioxetine.Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.

amitriptyline, xylometazoline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

yohimbe, amitriptyline. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.

amitriptyline, yohimbine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

amitriptyline and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.

abiraterone increases levels of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.abiraterone increases levels of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.

abobotulinumtoxinA increases effects of amitriptyline by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .abobotulinumtoxinA increases effects of perphenazine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

aclidinium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.aclidinium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

perphenazine, albiglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

amitriptyline increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.albuterol and amitriptyline both increase QTc interval. Use Caution/Monitor.

perphenazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

alfentanil and perphenazine both increase sedation. Use Caution/Monitor.alfentanil and amitriptyline both increase sedation. Use Caution/Monitor.

alfuzosin and amitriptyline both increase QTc interval. Use Caution/Monitor.amitriptyline and alfuzosin both increase QTc interval. Use Caution/Monitor.alfuzosin and perphenazine both increase QTc interval. Use Caution/Monitor.perphenazine and alfuzosin both increase QTc interval. Use Caution/Monitor.

almotriptan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).almotriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

alprazolam and perphenazine both increase sedation. Use Caution/Monitor.alprazolam and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.perphenazine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

amiodarone will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.amisulpride and amitriptyline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.

amobarbital and amitriptyline both increase sedation. Use Caution/Monitor.amobarbital will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.amobarbital will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.amobarbital and perphenazine both increase sedation. Use Caution/Monitor.amobarbital, amitriptyline. Other (see comment). Use Caution/Monitor. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

amitriptyline and amoxapine both increase sedation. Use Caution/Monitor.perphenazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.perphenazine and amoxapine both increase sedation. Use Caution/Monitor.amitriptyline and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

anagrelide and perphenazine both increase QTc interval. Use Caution/Monitor.

anticholinergic/sedative combos and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

anticholinergic/sedative combos decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.anticholinergic/sedative combos decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

apomorphine and amitriptyline both increase QTc interval. Use Caution/Monitor.perphenazine and apomorphine both increase sedation. Use Caution/Monitor.amitriptyline and apomorphine both increase sedation. Use Caution/Monitor.

aprepitant will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

perphenazine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.arformoterol and perphenazine both increase QTc interval. Use Caution/Monitor.

amitriptyline increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.arformoterol and amitriptyline both increase QTc interval. Use Caution/Monitor.

aripiprazole and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.aripiprazole and amitriptyline both increase sedation. Use Caution/Monitor.aripiprazole and perphenazine both increase sedation. Use Caution/Monitor.aripiprazole and amitriptyline both increase QTc interval. Use Caution/Monitor.

perphenazine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.armodafinil will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.amitriptyline increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

artemether and perphenazine both increase QTc interval. Use Caution/Monitor.

asenapine and amitriptyline both increase QTc interval. Use Caution/Monitor.

artemether/lumefantrine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

asenapine and perphenazine both increase QTc interval. Use Caution/Monitor.

asenapine transdermal and amitriptyline both increase QTc interval. Use Caution/Monitor.asenapine transdermal and perphenazine both increase QTc interval. Use Caution/Monitor.

atazanavir will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atazanavir increases levels of amitriptyline by unspecified interaction mechanism. Use Caution/Monitor.

perphenazine will increase the level or effect of atomoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.atomoxetine and perphenazine both increase QTc interval. Use Caution/Monitor.

atomoxetine and amitriptyline both increase QTc interval. Use Caution/Monitor.

atorvastatin will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atracurium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.atracurium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.atracurium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

atropine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.atropine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.

atropine IV/IM decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IM decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.atropine IV/IM and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

azelastine and amitriptyline both increase sedation. Use Caution/Monitor.azelastine and perphenazine both increase sedation. Use Caution/Monitor.

perphenazine and azithromycin both increase QTc interval. Use Caution/Monitor.amitriptyline and azithromycin both increase QTc interval. Use Caution/Monitor.

baclofen and perphenazine both increase sedation. Use Caution/Monitor.baclofen and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelyperphenazine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

perphenazine increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna alkaloids and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.belladonna alkaloids decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.belladonna alkaloids decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

belladonna and opium and perphenazine both increase sedation. Use Caution/Monitor.belladonna and opium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opium and amitriptyline both increase sedation. Use Caution/Monitor.belladonna and opium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.belladonna and opium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

benperidol and perphenazine both increase sedation. Use Caution/Monitor.benperidol and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.benperidol and amitriptyline both increase sedation. Use Caution/Monitor.

benzhydrocodone/acetaminophen, amitriptyline.Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.perphenazine will increase the level or effect of benzhydrocodone/acetaminophen by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone [benzhydrocodone is prodrug of hydrocodone]) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

perphenazine, benzphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

benztropine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely. Additive anticholinergic adverse effects may be seen with concurrent use. perphenazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

bethanechol increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

brexanolone, perphenazine.Either increases toxicity of the other by sedation. Use Caution/Monitor.

brompheniramine and amitriptyline both increase sedation. Use Caution/Monitor.brompheniramine and perphenazine both increase sedation. Use Caution/Monitor.

buprenorphine and perphenazine both increase QTc interval. Use Caution/Monitor.buprenorphine and amitriptyline both increase sedation. Use Caution/Monitor.buprenorphine and perphenazine both increase sedation. Use Caution/Monitor.

buprenorphine buccal and amitriptyline both increase sedation. Use Caution/Monitor.buprenorphine buccal and perphenazine both increase QTc interval. Use Caution/Monitor.buprenorphine buccal and perphenazine both increase sedation. Use Caution/Monitor.

buprenorphine subdermal implant and perphenazine both increase QTc interval. Use Caution/Monitor.amitriptyline, buprenorphine subdermal implant.Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

buprenorphine transdermal and perphenazine both increase QTc interval. Use Caution/Monitor.

amitriptyline, buprenorphine, long-acting injection.Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

perphenazine increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.buprenorphine, long-acting injection and perphenazine both increase QTc interval. Use Caution/Monitor.

bupropion will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.bupropion will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.perphenazine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.amitriptyline increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.

butabarbital and perphenazine both increase sedation. Use Caution/Monitor.butabarbital will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.butabarbital will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.butabarbital and amitriptyline both increase sedation. Use Caution/Monitor.

butalbital will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.butalbital will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.butalbital and perphenazine both increase sedation. Use Caution/Monitor.butalbital and amitriptyline both increase sedation. Use Caution/Monitor.

butorphanol and perphenazine both increase sedation. Use Caution/Monitor.butorphanol and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

carbachol increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

carbinoxamine and perphenazine both increase sedation. Use Caution/Monitor.

carbamazepine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

carbinoxamine and amitriptyline both increase sedation. Use Caution/Monitor.

carisoprodol and amitriptyline both increase sedation. Use Caution/Monitor.carisoprodol and perphenazine both increase sedation. Use Caution/Monitor.

perphenazine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

cenobamate, amitriptyline.Either increases effects of the other by sedation. Use Caution/Monitor.

cenobamate, perphenazine.Either increases effects of the other by sedation. Use Caution/Monitor.

ceritinib and perphenazine both increase QTc interval. Use Caution/Monitor.ceritinib and amitriptyline both increase QTc interval. Use Caution/Monitor.

cevimeline increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

chloral hydrate and perphenazine both increase sedation. Use Caution/Monitor.

chloral hydrate and amitriptyline both increase sedation. Use Caution/Monitor.

chlordiazepoxide and perphenazine both increase sedation. Use Caution/Monitor.chlordiazepoxide and amitriptyline both increase sedation. Use Caution/Monitor.

chloroquine increases toxicity of amitriptyline by QTc interval. Use Caution/Monitor.

chlorpheniramine and perphenazine both increase sedation. Use Caution/Monitor.

chlorpheniramine and amitriptyline both increase sedation. Use Caution/Monitor.

chlorpromazine and perphenazine both increase sedation. Use Caution/Monitor.chlorpromazine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.chlorpromazine and amitriptyline both increase sedation. Use Caution/Monitor.

chlorzoxazone and perphenazine both increase sedation. Use Caution/Monitor.chlorzoxazone and amitriptyline both increase sedation. Use Caution/Monitor.

cigarette smoking decreases levels of perphenazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.

cimetidine will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

cinnarizine and amitriptyline both increase sedation. Use Caution/Monitor.cinnarizine and perphenazine both increase sedation. Use Caution/Monitor.

cisatracurium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.cisatracurium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cisatracurium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

citalopram and perphenazine both increase QTc interval. Use Caution/Monitor.

clarithromycin will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

clemastine and amitriptyline both increase sedation. Use Caution/Monitor.clemastine and perphenazine both increase sedation. Use Caution/Monitor.

amitriptyline, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clobazam will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly. clobazam will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.

amitriptyline and clomipramine both increase sedation. Use Caution/Monitor.perphenazine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.amitriptyline and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine and clomipramine both increase sedation. Use Caution/Monitor.

clonazepam and perphenazine both increase sedation. Use Caution/Monitor.clonazepam and amitriptyline both increase sedation. Use Caution/Monitor.

clonidine, perphenazine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.

clorazepate and amitriptyline both increase sedation. Use Caution/Monitor.

clorazepate and perphenazine both increase sedation. Use Caution/Monitor.

clotrimazole will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

clozapine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.clozapine and amitriptyline both increase sedation. Use Caution/Monitor.clozapine and perphenazine both increase QTc interval. Use Caution/Monitor.clozapine and amitriptyline both increase QTc interval. Use Caution/Monitor.clozapine and perphenazine both increase sedation. Use Caution/Monitor.

cobicistat will increase the level or effect of perphenazine by Other (see comment). Modify Therapy/Monitor Closely. A decrease in the dose of antipsychotics that are metabolized by CYP3A or CYP2D6 may be needed upon coadministration. cobicistat will increase the level or effect of amitriptyline by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with TCAs and cobicistat. cobicistat will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Carefully titrate antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitoring for antidepressant response

amitriptyline and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.

codeine and perphenazine both increase sedation. Use Caution/Monitor.

codeine and amitriptyline both increase sedation. Use Caution/Monitor.

conivaptan will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

crizotinib and amitriptyline both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.crizotinib and perphenazine both increase QTc interval. Use Caution/Monitor.

cyclizine and amitriptyline both increase sedation. Use Caution/Monitor.cyclizine and perphenazine both increase sedation. Use Caution/Monitor.cyclizine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cyclizine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.cyclizine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

cyclobenzaprine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.cyclobenzaprine and perphenazine both increase sedation. Use Caution/Monitor.perphenazine increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cyclobenzaprine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.cyclobenzaprine and amitriptyline both increase sedation. Use Caution/Monitor.

cyclosporine will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cyclosporine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

cyproheptadine and perphenazine both increase sedation. Use Caution/Monitor.

cyproheptadine and amitriptyline both increase sedation. Use Caution/Monitor.

dantrolene and perphenazine both increase sedation. Use Caution/Monitor.dantrolene and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. amitriptyline and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

darifenacin will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.darifenacin decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.darifenacin decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.darifenacin and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.

darunavir will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor for antidepressant response.

perphenazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.

amitriptyline and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.

amitriptyline decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.

degarelix and amitriptyline both increase QTc interval. Use Caution/Monitor.

desflurane and amitriptyline both increase sedation. Use Caution/Monitor.desflurane and perphenazine both increase QTc interval. Use Caution/Monitor.desflurane and perphenazine both increase sedation. Use Caution/Monitor.desflurane and amitriptyline both increase QTc interval. Use Caution/Monitor.

amitriptyline and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.perphenazine and desipramine both increase sedation. Use Caution/Monitor.amitriptyline and desipramine both increase sedation. Use Caution/Monitor.

desvenlafaxine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg

amitriptyline and deutetrabenazine both increase sedation. Use Caution/Monitor.deutetrabenazine and amitriptyline both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

perphenazine and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.perphenazine and deutetrabenazine both increase sedation. Use Caution/Monitor.deutetrabenazine and perphenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

dexchlorpheniramine and amitriptyline both increase sedation. Use Caution/Monitor.dexchlorpheniramine and perphenazine both increase sedation. Use Caution/Monitor.

perphenazine, dexfenfluramine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.amitriptyline and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.perphenazine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

dexmedetomidine and perphenazine both increase sedation. Use Caution/Monitor.dexmedetomidine and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

amitriptyline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.perphenazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.amitriptyline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.perphenazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

amitriptyline will increase the level or effect of dextroamphetamine transdermal by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in dextroamphetamine levels in brain; May be potentiate cardiovascular effects. Monitor frequently and adjust or use an alternant based on clinical response.perphenazine, dextroamphetamine transdermal.Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).

dextromethorphan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

dextromoramide and amitriptyline both increase sedation. Use Caution/Monitor.

dextromoramide and perphenazine both increase sedation. Use Caution/Monitor.

diamorphine and perphenazine both increase sedation. Use Caution/Monitor.diamorphine and amitriptyline both increase sedation. Use Caution/Monitor.

diazepam and perphenazine both increase sedation. Use Caution/Monitor.diazepam and amitriptyline both increase sedation. Use Caution/Monitor.

diazepam intranasal, amitriptyline.Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

dicyclomine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.dicyclomine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

dicyclomine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.

perphenazine, diethylpropion. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

difelikefalin and perphenazine both increase sedation. Use Caution/Monitor.difelikefalin and amitriptyline both increase sedation. Use Caution/Monitor.

difenoxin hcl and perphenazine both increase sedation. Use Caution/Monitor.difenoxin hcl and amitriptyline both increase sedation. Use Caution/Monitor.

dihydroergotamine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).amitriptyline and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

amitriptyline and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

dimenhydrinate and perphenazine both increase sedation. Use Caution/Monitor.

diltiazem will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Concomitant use with amitriptyline may alter blood pressure control.

dimenhydrinate and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.diphenhydramine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.diphenhydramine and amitriptyline both increase sedation. Use Caution/Monitor.diphenhydramine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.diphenhydramine and perphenazine both increase sedation. Use Caution/Monitor.diphenhydramine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

diphenoxylate hcl and perphenazine both increase sedation. Use Caution/Monitor.diphenoxylate hcl and amitriptyline both increase sedation. Use Caution/Monitor.

dipipanone and perphenazine both increase sedation. Use Caution/Monitor.dipipanone and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine, dobutamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

dofetilide increases toxicity of perphenazine by QTc interval. Use Caution/Monitor.dofetilide increases toxicity of amitriptyline by QTc interval. Use Caution/Monitor.

perphenazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.amitriptyline and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.

donepezil and amitriptyline both increase QTc interval. Use Caution/Monitor.donepezil increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.donepezil and perphenazine both increase QTc interval. Use Caution/Monitor.

donepezil transdermal, perphenazine.Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.

amitriptyline increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

perphenazine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, dopamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

perphenazine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

amitriptyline and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine and dosulepin both increase sedation. Use Caution/Monitor.amitriptyline and dosulepin both increase sedation. Use Caution/Monitor.

perphenazine and doxepin both increase sedation. Use Caution/Monitor.amitriptyline and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.amitriptyline and doxepin both increase sedation. Use Caution/Monitor.

doxylamine and amitriptyline both increase sedation. Use Caution/Monitor.doxylamine and perphenazine both increase sedation. Use Caution/Monitor.

droperidol and perphenazine both increase sedation. Use Caution/Monitor.droperidol and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.droperidol and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine will increase the level or effect of duloxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

echothiophate iodide increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

efavirenz and amitriptyline both increase QTc interval. Use Caution/Monitor.efavirenz and perphenazine both increase QTc interval. Use Caution/Monitor.efavirenz will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.efavirenz will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

elagolix will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

eletriptan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

eletriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

eliglustat and perphenazine both increase QTc interval. Use Caution/Monitor.eliglustat and amitriptyline both increase QTc interval. Use Caution/Monitor.eliglustat increases levels of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.eliglustat increases levels of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.eliglustat increases levels of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.

elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; A decrease in dose of the neuroleptic may be needed when coadministered.elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

encorafenib and perphenazine both increase QTc interval. Use Caution/Monitor.

entrectinib and amitriptyline both increase QTc interval. Use Caution/Monitor.

entrectinib and perphenazine both increase QTc interval. Use Caution/Monitor.

perphenazine, ephedrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases effects of ephedrine by unknown mechanism. Use Caution/Monitor.amitriptyline increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

amitriptyline increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases effects of epinephrine by unknown mechanism. Use Caution/Monitor.perphenazine decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.perphenazine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, epinephrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

amitriptyline and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system.

perphenazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

amitriptyline increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

ergoloid mesylates, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

ergotamine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).amitriptyline and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

eribulin and amitriptyline both increase QTc interval. Use Caution/Monitor.eribulin and perphenazine both increase QTc interval. Use Caution/Monitor.

escitalopram increases toxicity of perphenazine by QTc interval. Use Caution/Monitor.

esketamine intranasal, amitriptyline.Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

eslicarbazepine acetate will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

esomeprazole will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

estazolam and amitriptyline both increase sedation. Use Caution/Monitor.estazolam and perphenazine both increase sedation. Use Caution/Monitor.

perphenazine and ethanol both increase sedation. Use Caution/Monitor.amitriptyline and ethanol both increase sedation. Use Caution/Monitor.

etomidate and amitriptyline both increase sedation. Use Caution/Monitor.etomidate and perphenazine both increase sedation. Use Caution/Monitor.

etravirine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

fedratinib will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.

ezogabine, amitriptyline.Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

fedratinib will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.

felbamate will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

felodipine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.perphenazine, fenfluramine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.fenfluramine, amitriptyline.Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.

fentanyl, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

fesoterodine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.

fesoterodine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.fesoterodine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of fesoterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

fingolimod and perphenazine both increase QTc interval. Use Caution/Monitor.fingolimod and amitriptyline both increase QTc interval. Use Caution/Monitor.

perphenazine increases effects of flavoxate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.flavoxate and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.flavoxate decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.flavoxate decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

amitriptyline and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.perphenazine will increase the level or effect of flecainide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.perphenazine and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.

flibanserin, perphenazine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

fluconazole will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.fluconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

amitriptyline and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

fluphenazine and perphenazine both increase sedation. Use Caution/Monitor.fluphenazine and amitriptyline both increase sedation. Use Caution/Monitor.fluphenazine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

flurazepam and perphenazine both increase sedation. Use Caution/Monitor.flurazepam and amitriptyline both increase sedation. Use Caution/Monitor.

fluvoxamine and perphenazine both increase QTc interval. Use Caution/Monitor.fluvoxamine and amitriptyline both increase QTc interval. Modify Therapy/Monitor Closely.

perphenazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

fosamprenavir will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

perphenazine and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

fosaprepitant will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

amitriptyline and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

fosphenytoin will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fosphenytoin will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

amitriptyline and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

frovatriptan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).frovatriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

gabapentin, amitriptyline.Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

perphenazine and ganaxolone both increase sedation. Use Caution/Monitor.

gabapentin enacarbil, amitriptyline.Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

galantamine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

amitriptyline and ganaxolone both increase sedation. Use Caution/Monitor.

gemifloxacin and perphenazine both increase QTc interval. Use Caution/Monitor.gemifloxacin and amitriptyline both increase QTc interval. Use Caution/Monitor.

gilteritinib and amitriptyline both increase QTc interval. Use Caution/Monitor.gilteritinib and perphenazine both increase QTc interval. Use Caution/Monitor.

glecaprevir/pibrentasvir will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely.

perphenazine increases toxicity of glycopyrrolate by unknown mechanism. Use Caution/Monitor.perphenazine increases effects of glycopyrrolate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

glycopyrrolate and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.amitriptyline increases levels of glycopyrrolate by unknown mechanism. Use Caution/Monitor.

perphenazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.glycopyrrolate inhaled decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.glycopyrrolate inhaled decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.amitriptyline increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor.glycopyrrolate inhaled and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.

glycopyrronium tosylate topical, amitriptyline.Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.glycopyrronium tosylate topical, perphenazine.Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

granisetron and perphenazine both increase QTc interval. Use Caution/Monitor.

grapefruit will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

guanfacine, perphenazine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.

haloperidol and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.haloperidol and amitriptyline both increase sedation. Use Caution/Monitor.perphenazine will increase the level or effect of haloperidol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.haloperidol and perphenazine both increase sedation. Use Caution/Monitor.

henbane decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.henbane decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.henbane and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

homatropine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.homatropine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.homatropine and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.

huperzine A increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

perphenazine will increase the level or effect of hydrocodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

hydrocodone, amitriptyline.Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

perphenazine will increase the level or effect of hydromorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.hydromorphone and perphenazine both increase sedation. Use Caution/Monitor.hydromorphone and amitriptyline both increase sedation. Use Caution/Monitor.

hydroxyzine and amitriptyline both increase sedation. Use Caution/Monitor.hydroxyzine and amitriptyline both increase QTc interval. Use Caution/Monitor.hydroxyzine and perphenazine both increase QTc interval. Use Caution/Monitor.hydroxyzine and perphenazine both increase sedation. Use Caution/Monitor.

hyoscyamine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.hyoscyamine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.hyoscyamine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

perphenazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.hyoscyamine spray and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.hyoscyamine spray decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.hyoscyamine spray decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

perphenazine and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.iloperidone and perphenazine both increase sedation. Use Caution/Monitor.perphenazine will increase the level or effect of iloperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.amitriptyline and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.iloperidone and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.iloperidone and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine and imipramine both increase sedation. Use Caution/Monitor.amitriptyline and imipramine both increase sedation. Use Caution/Monitor.perphenazine will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

perphenazine, incobotulinumtoxinA.Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

indacaterol, inhaled, amitriptyline. QTc interval. Use Caution/Monitor. Indacaterol should be administered with extreme caution to patients treated with TCAs. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

indacaterol, inhaled, perphenazine. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

indinavir will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase blood glucose concentrations.

perphenazine decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase blood glucose concentrations.

perphenazine decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase blood glucose concentrations.

ipratropium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.ipratropium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.ipratropium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

isoflurane and amitriptyline both increase QTc interval. Use Caution/Monitor.isoflurane and perphenazine both increase QTc interval. Use Caution/Monitor.

isoniazid will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.amitriptyline and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.

perphenazine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

amitriptyline increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

istradefylline will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates.

itraconazole will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.itraconazole and amitriptyline both increase QTc interval. Use Caution/Monitor.

ivacaftor increases levels of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index.

ketamine and amitriptyline both increase sedation. Use Caution/Monitor.ketamine and perphenazine both increase sedation. Use Caution/Monitor.

ketoconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ketoconazole will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

amitriptyline and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

amitriptyline and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.

amitriptyline and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.perphenazine and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.

lasmiditan, amitriptyline.Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.lasmiditan, perphenazine.Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.amitriptyline increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome.

lemborexant, perphenazine.Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.lemborexant, amitriptyline.Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

letermovir increases levels of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

perphenazine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

amitriptyline increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

amitriptyline and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.perphenazine and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

levoketoconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.levoketoconazole will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

levomilnacipran, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

levorphanol and amitriptyline both increase sedation. Use Caution/Monitor.levorphanol and perphenazine both increase sedation. Use Caution/Monitor.

levothyroxine increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

linezolid, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

liothyronine increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

liotrix increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

perphenazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

amitriptyline increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline, lisdexamfetamine.Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).perphenazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

lithium and amitriptyline both increase QTc interval. Use Caution/Monitor.lithium and perphenazine both increase QTc interval. Use Caution/Monitor.lithium, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).amitriptyline and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.lithium, perphenazine. Other (see comment). Use Caution/Monitor. Comment: Risk of neurotoxicity. Multiple mechanisms involved.

perphenazine and lofepramine both increase sedation. Use Caution/Monitor.amitriptyline and lofepramine both increase sedation. Use Caution/Monitor.amitriptyline and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine will increase the level or effect of lofepramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

perphenazine and lofexidine both increase sedation. Use Caution/Monitor.amitriptyline decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor.amitriptyline and lofexidine both increase sedation. Use Caution/Monitor.

loprazolam and amitriptyline both increase sedation. Use Caution/Monitor.loprazolam and perphenazine both increase sedation. Use Caution/Monitor.

loratadine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

lorazepam and perphenazine both increase sedation. Use Caution/Monitor.

lorazepam and amitriptyline both increase sedation. Use Caution/Monitor.

lorcaserin will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.lorcaserin will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.lorcaserin, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

lormetazepam and perphenazine both increase sedation. Use Caution/Monitor.lormetazepam and amitriptyline both increase sedation. Use Caution/Monitor.

loxapine and perphenazine both increase sedation. Use Caution/Monitor.loxapine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.loxapine and amitriptyline both increase sedation. Use Caution/Monitor.

loxapine inhaled and perphenazine both increase sedation. Use Caution/Monitor.loxapine inhaled and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.loxapine inhaled and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.

lumefantrine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

lurasidone, amitriptyline.Either increases toxicity of the other by sedation. Use Caution/Monitor. Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.lurasidone, perphenazine.Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.lurasidone increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

perphenazine and maprotiline both increase sedation. Use Caution/Monitor.amitriptyline and maprotiline both increase sedation. Use Caution/Monitor.amitriptyline and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

maraviroc, amitriptyline.Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.

perphenazine and marijuana both increase sedation. Use Caution/Monitor.

amitriptyline and marijuana both increase sedation. Use Caution/Monitor.

amitriptyline will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose.

meclizine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.meclizine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of meclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.meclizine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

perphenazine and melatonin both increase sedation. Use Caution/Monitor.amitriptyline and melatonin both increase sedation. Use Caution/Monitor.

meperidine and perphenazine both increase sedation. Use Caution/Monitor.meperidine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).meperidine and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline and meprobamate both increase sedation. Use Caution/Monitor.perphenazine and meprobamate both increase sedation. Use Caution/Monitor.

perphenazine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

metaxalone and amitriptyline both increase sedation. Use Caution/Monitor.metaxalone and perphenazine both increase sedation. Use Caution/Monitor.

perphenazine decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor. Patient should be closely observed for loss of blood glucose control; when drugs are withdrawn from a patient receiving metformin, patient should be observed closely for hypoglycemia.

amitriptyline and methadone both increase QTc interval. Modify Therapy/Monitor Closely.methadone and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine and methadone both increase QTc interval. Modify Therapy/Monitor Closely.methadone and perphenazine both increase sedation. Use Caution/Monitor.methadone, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

perphenazine, methamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine will increase the level or effect of methamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

methocarbamol and perphenazine both increase sedation. Use Caution/Monitor.methocarbamol and amitriptyline both increase sedation. Use Caution/Monitor.

methoxsalen, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive photosensitizing effects.

methscopolamine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

methscopolamine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.methscopolamine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of methscopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

perphenazine, methylenedioxymethamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

methylergonovine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

amitriptyline, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

perphenazine, methylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.

methylphenidate transdermal will increase the level or effect of amitriptyline by decreasing elimination. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate.

perphenazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

perphenazine will increase the level or effect of metoprolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

perphenazine will increase the level or effect of mexiletine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

midazolam and perphenazine both increase sedation. Use Caution/Monitor.midazolam and amitriptyline both increase sedation. Use Caution/Monitor.

midazolam intranasal, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midazolam intranasal, amitriptyline.Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

perphenazine, midodrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

mifepristone, perphenazine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.mifepristone, amitriptyline. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

milnacipran, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

mipomersen, amitriptyline.Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

mirabegron will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirabegron will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

perphenazine and mirtazapine both increase sedation. Use Caution/Monitor.amitriptyline and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.amitriptyline and mirtazapine both increase sedation. Use Caution/Monitor.mirtazapine and perphenazine both increase QTc interval. Use Caution/Monitor.

perphenazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.modafinil will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

perphenazine will increase the level or effect of morphine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.amitriptyline and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.morphine and perphenazine both increase sedation. Use Caution/Monitor.morphine and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine and motherwort both increase sedation. Use Caution/Monitor.amitriptyline and motherwort both increase sedation. Use Caution/Monitor.

perphenazine and moxonidine both increase sedation. Use Caution/Monitor.amitriptyline and moxonidine both increase sedation. Use Caution/Monitor.

perphenazine and nabilone both increase sedation. Use Caution/Monitor.amitriptyline and nabilone both increase sedation. Use Caution/Monitor.

nalbuphine and amitriptyline both increase sedation. Use Caution/Monitor.nalbuphine and perphenazine both increase sedation. Use Caution/Monitor.

naratriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.naratriptan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

perphenazine will increase the level or effect of nebivolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

nefazodone will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nefazodone will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

nefopam, amitriptyline. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.

nelfinavir will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

neostigmine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

nicardipine will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

nifedipine will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine, norepinephrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.amitriptyline increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor.

amitriptyline and nortriptyline both increase sedation. Use Caution/Monitor.perphenazine will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.amitriptyline and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine and nortriptyline both increase sedation. Use Caution/Monitor.

amitriptyline and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.perphenazine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

olanzapine and perphenazine both increase sedation. Use Caution/Monitor.olanzapine and amitriptyline both increase QTc interval. Use Caution/Monitor.olanzapine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.olanzapine and amitriptyline both increase sedation. Use Caution/Monitor.olanzapine and perphenazine both increase QTc interval. Use Caution/Monitor.

amitriptyline, oliceridine.Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.oliceridine, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).amitriptyline increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.

amitriptyline and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasperphenazine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

onabotulinumtoxinA and amitriptyline both decrease cholinergic effects/transmission. Modify Therapy/Monitor Closely.onabotulinumtoxinA decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.onabotulinumtoxinA decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

opium tincture and perphenazine both increase sedation. Use Caution/Monitor.opium tincture and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.orphenadrine and perphenazine both increase sedation. Use Caution/Monitor.orphenadrine and amitriptyline both increase sedation. Use Caution/Monitor.

osilodrostat and amitriptyline both increase QTc interval. Use Caution/Monitor.

osimertinib and perphenazine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

osimertinib and amitriptyline both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

oxaliplatin will increase the level or effect of amitriptyline by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.oxaliplatin and perphenazine both increase QTc interval. Use Caution/Monitor.

oxazepam and perphenazine both increase sedation. Use Caution/Monitor.oxazepam and amitriptyline both increase sedation. Use Caution/Monitor.

oxybutynin decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.oxybutynin decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.oxybutynin and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

oxybutynin topical decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.oxybutynin topical and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin topical decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

oxybutynin transdermal decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.oxybutynin transdermal decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.oxybutynin transdermal and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

oxycodone and perphenazine both increase sedation. Use Caution/Monitor.perphenazine will increase the level or effect of oxycodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.oxycodone and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.

perphenazine will increase the level or effect of oxymorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.oxymorphone and perphenazine both increase sedation. Use Caution/Monitor.

oxymorphone and amitriptyline both increase sedation. Use Caution/Monitor.

ozanimod and perphenazine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.ozanimod and amitriptyline both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

amitriptyline and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and perphenazine both increase sedation. Use Caution/Monitor.paliperidone and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.paliperidone and amitriptyline both increase sedation. Use Caution/Monitor.perphenazine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

pancuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pancuronium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.pancuronium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

panobinostat will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Panobinostat can increase the levels and effects of sensitive CYP2D6 substrates or those with a narrow therapeutic index CYP2D6.

papaveretum and amitriptyline both increase sedation. Use Caution/Monitor.

papaveretum and perphenazine both increase sedation. Use Caution/Monitor.

perphenazine and papaverine both increase sedation. Use Caution/Monitor.amitriptyline and papaverine both increase sedation. Use Caution/Monitor.

paroxetine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).amitriptyline and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

amitriptyline and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.perphenazine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

perphenazine and pazopanib both increase QTc interval. Use Caution/Monitor.amitriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.

peginterferon alfa 2b, perphenazine. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.peginterferon alfa 2b, amitriptyline. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.

amitriptyline and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.pentazocine and perphenazine both increase sedation. Use Caution/Monitor.pentazocine and amitriptyline both increase sedation. Use Caution/Monitor.

pentobarbital and perphenazine both increase sedation. Use Caution/Monitor.pentobarbital will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.pentobarbital will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.pentobarbital and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, phendimetrazine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

amitriptyline increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

phenelzine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

phenobarbital will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.phenobarbital will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.phenobarbital will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.phenobarbital and perphenazine both increase sedation. Use Caution/Monitor.phenobarbital and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, phentermine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

perphenazine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, phenylephrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

perphenazine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .perphenazine, phenylephrine PO. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

amitriptyline increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

amitriptyline, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

phenytoin will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor therapeutic efficacy of amitriptyline; an increased dose may be required. Serum phenytoin levels should be obtained when tricyclic antidepressant agents are added to therapy due to the potential for impaired phenytoin metabolism and decreased seizure threshold. Tricyclic antidepressants when given concomitantly with anticonvulsants can increase CNS depression.phenytoin will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor therapeutic efficacy of amitriptyline; an increased dose may be required. Serum phenytoin levels should be obtained when tricyclic antidepressant agents are added to therapy due to the potential for impaired phenytoin metabolism and decreased seizure threshold. Tricyclic antidepressants when given concomitantly with anticonvulsants can increase CNS depression.

perphenazine and pholcodine both increase sedation. Use Caution/Monitor.amitriptyline and pholcodine both increase sedation. Use Caution/Monitor.

physostigmine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

perphenazine and pimozide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.perphenazine and pimozide both increase sedation. Use Caution/Monitor.

pilocarpine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

pimozide and amitriptyline both increase sedation. Use Caution/Monitor.

amitriptyline increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

ponatinib increases levels of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

perphenazine and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.amitriptyline and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

perphenazine increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pralidoxime decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.pralidoxime decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.pralidoxime and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

pregabalin, amitriptyline.Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

primaquine and perphenazine both increase QTc interval. Use Caution/Monitor.

primidone and perphenazine both increase sedation. Use Caution/Monitor.primidone will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.primidone and amitriptyline both increase sedation. Use Caution/Monitor.primidone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

procarbazine, perphenazine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Excessive sedation.procarbazine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

prochlorperazine and amitriptyline both increase QTc interval. Use Caution/Monitor.prochlorperazine and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine and prochlorperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.perphenazine and prochlorperazine both increase sedation. Use Caution/Monitor.

promethazine and amitriptyline both increase sedation. Use Caution/Monitor.promethazine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).perphenazine and promethazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.promethazine and perphenazine both increase sedation. Use Caution/Monitor.promethazine and amitriptyline both increase QTc interval. Use Caution/Monitor.

perphenazine will increase the level or effect of propafenone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.propafenone will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

propantheline and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

propantheline decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.propantheline decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

propofol and amitriptyline both increase sedation. Use Caution/Monitor.propofol and perphenazine both increase sedation. Use Caution/Monitor.

perphenazine will increase the level or effect of propranolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

amitriptyline increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

perphenazine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, propylhexedrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

amitriptyline and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine and protriptyline both increase sedation. Use Caution/Monitor.amitriptyline and protriptyline both increase sedation. Use Caution/Monitor.

perphenazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use.

pyridostigmine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

quazepam and perphenazine both increase sedation. Use Caution/Monitor.quazepam and amitriptyline both increase sedation. Use Caution/Monitor.

quercetin will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine and quetiapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.perphenazine and quetiapine both increase sedation. Use Caution/Monitor.

quetiapine and amitriptyline both increase sedation. Use Caution/Monitor.quetiapine, amitriptyline.Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

quinidine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

perphenazine and quinine both increase QTc interval. Use Caution/Monitor.amitriptyline and quinine both increase QTc interval. Use Caution/Monitor.

perphenazine and ramelteon both increase sedation. Use Caution/Monitor.amitriptyline and ramelteon both increase sedation. Use Caution/Monitor.

amitriptyline and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.perphenazine and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

perphenazine increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rapacuronium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.rapacuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.rapacuronium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

amitriptyline, remifentanil.Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May also increase risk of serotonin syndrome.

remimazolam, perphenazine.Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

remimazolam, amitriptyline.Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

rifabutin will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifabutin decreases levels of amitriptyline by increasing metabolism. Use Caution/Monitor.

rifampin will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.rifampin will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifampin will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

rifapentine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

rilpivirine increases toxicity of amitriptyline by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.

perphenazine, rimabotulinumtoxinB.Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

amitriptyline and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.risperidone and amitriptyline both increase sedation. Use Caution/Monitor.perphenazine and risperidone both increase sedation. Use Caution/Monitor.perphenazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.perphenazine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

ritonavir will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.ritonavir will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

rizatriptan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

rivastigmine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

rizatriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

rocuronium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.rocuronium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rocuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

rolapitant will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.rolapitant will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.

perphenazine and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.amitriptyline and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.

perphenazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

amitriptyline and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

scopolamine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.scopolamine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

sarecycline will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.

scopolamine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

perphenazine and scullcap both increase sedation. Use Caution/Monitor.amitriptyline and scullcap both increase sedation. Use Caution/Monitor.

secobarbital will decrease the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.secobarbital and amitriptyline both increase sedation. Use Caution/Monitor.secobarbital and perphenazine both increase sedation. Use Caution/Monitor.

selegiline, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

selpercatinib increases toxicity of amitriptyline by QTc interval. Use Caution/Monitor.

selpercatinib increases toxicity of perphenazine by QTc interval. Use Caution/Monitor.

perphenazine, serdexmethylphenidate/dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

sertraline and perphenazine both increase QTc interval. Use Caution/Monitor.sertraline and amitriptyline both increase QTc interval. Use Caution/Monitor.

sevoflurane and amitriptyline both increase sedation. Use Caution/Monitor.sevoflurane and perphenazine both increase sedation. Use Caution/Monitor.sevoflurane and amitriptyline both increase QTc interval. Use Caution/Monitor.sevoflurane and perphenazine both increase QTc interval. Use Caution/Monitor.

perphenazine and shepherd's purse both increase sedation. Use Caution/Monitor.amitriptyline and shepherd's purse both increase sedation. Use Caution/Monitor.

simvastatin will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

siponimod and perphenazine both increase QTc interval. Use Caution/Monitor.

sirolimus will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

smoking decreases levels of perphenazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.

sodium sulfate/?magnesium sulfate/potassium chloride increases effects of amitriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.sodium sulfate/?magnesium sulfate/potassium chloride increases effects of perphenazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

sodium sulfate/potassium sulfate/magnesium sulfate increases effects of amitriptyline by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.sodium sulfate/potassium sulfate/magnesium sulfate increases effects of perphenazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

amitriptyline, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.

solifenacin decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.solifenacin decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.solifenacin and perphenazine both increase QTc interval. Use Caution/Monitor.

solifenacin and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.solifenacin and amitriptyline both increase QTc interval. Use Caution/Monitor.

sorafenib and amitriptyline both increase QTc interval. Use Caution/Monitor.sorafenib and perphenazine both increase QTc interval. Use Caution/Monitor.

St John's Wort will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.St John's Wort will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

stiripentol, perphenazine.Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

stiripentol, amitriptyline.Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

succinylcholine increases and amitriptyline decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

sufentanil and amitriptyline both increase sedation. Use Caution/Monitor.sufentanil and perphenazine both increase sedation. Use Caution/Monitor.

sufentanil SL, amitriptyline.Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

perphenazine and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.

amitriptyline and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.

sumatriptan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).sumatriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

sumatriptan intranasal, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).sumatriptan intranasal and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.

sunitinib and perphenazine both increase QTc interval. Use Caution/Monitor.

suvorexant and amitriptyline both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary

tacrolimus and perphenazine both increase QTc interval. Use Caution/Monitor.tacrolimus will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

perphenazine decreases effects of tamoxifen by decreasing metabolism. Use Caution/Monitor. Inhibition of CYP2D6 metabolism to tamoxifen's active metabolite, endoxifen.

tapentadol and amitriptyline both increase sedation. Use Caution/Monitor.amitriptyline and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

tapentadol and perphenazine both increase sedation. Use Caution/Monitor.

perphenazine and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.amitriptyline and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

temazepam and amitriptyline both increase sedation. Use Caution/Monitor.temazepam and perphenazine both increase sedation. Use Caution/Monitor.

terbinafine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.terbinafine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.

perphenazine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

teriflunomide decreases levels of amitriptyline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

perphenazine and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

tetrabenazine and amitriptyline both increase QTc interval. Use Caution/Monitor.

perphenazine and thioridazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.thioridazine and amitriptyline both increase sedation. Use Caution/Monitor.perphenazine and thioridazine both increase sedation. Use Caution/Monitor.

perphenazine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.perphenazine and thiothixene both increase sedation. Use Caution/Monitor.thiothixene and amitriptyline both increase sedation. Use Caution/Monitor.

thyroid desiccated increases effects of amitriptyline by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.

perphenazine will increase the level or effect of timolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

tiotropium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.tiotropium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.tiotropium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.perphenazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

tobacco use decreases levels of perphenazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.

tolterodine and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

tolterodine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.tolterodine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

tolvaptan will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

amitriptyline and topiramate both increase sedation. Modify Therapy/Monitor Closely.perphenazine and topiramate both increase sedation. Modify Therapy/Monitor Closely.topiramate increases toxicity of amitriptyline by unspecified interaction mechanism. Use Caution/Monitor. Amitriptyline levels may increase; adjust dose based on clinical response and not on basis of plasma levels.

tramadol and perphenazine both increase sedation. Use Caution/Monitor.amitriptyline and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.tramadol and amitriptyline both increase sedation. Use Caution/Monitor.

tranylcypromine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

trazodone will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.amitriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.amitriptyline and trazodone both increase sedation. Use Caution/Monitor.

perphenazine and trazodone both increase sedation. Use Caution/Monitor.

triazolam and perphenazine both increase sedation. Use Caution/Monitor.triazolam and amitriptyline both increase sedation. Use Caution/Monitor.

triclofos and perphenazine both increase sedation. Use Caution/Monitor.triclofos and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.perphenazine and trifluoperazine both increase sedation. Use Caution/Monitor.trifluoperazine and amitriptyline both increase sedation. Use Caution/Monitor.

trihexyphenidyl decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.trihexyphenidyl and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.perphenazine increases effects of trihexyphenidyl by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive anticholinergic effects.

perphenazine and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.amitriptyline and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

perphenazine and trimipramine both increase sedation. Use Caution/Monitor.amitriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.amitriptyline and trimipramine both increase sedation. Use Caution/Monitor.

triprolidine and perphenazine both increase sedation. Use Caution/Monitor.triprolidine and amitriptyline both increase sedation. Use Caution/Monitor.

perphenazine and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.amitriptyline and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

trospium chloride decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.trospium chloride and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.trospium chloride decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

tucatinib will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.

valbenazine and perphenazine both increase QTc interval. Use Caution/Monitor.

valbenazine and amitriptyline both increase QTc interval. Use Caution/Monitor.

valerian and amitriptyline both increase sedation. Use Caution/Monitor.

vecuronium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.vecuronium decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.vecuronium and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

venlafaxine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).amitriptyline and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.venlafaxine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

verapamil will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. The frequency and severity of amitriptyline adverse effects (sedation, anticholinergic effects and orthostatic hypotension) may be increased. Cardiac dysrhythmic effects may be additive.

vilazodone, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

voclosporin, amitriptyline.Either increases effects of the other by QTc interval. Use Caution/Monitor.

perphenazine and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.voriconazole will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.amitriptyline and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

vorinostat and perphenazine both increase QTc interval. Use Caution/Monitor.

amitriptyline increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.

perphenazine, xylometazoline. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.amitriptyline increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

amitriptyline increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazine, yohimbine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.perphenazine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

amitriptyline and ziconotide both increase sedation. Use Caution/Monitor.perphenazine and ziconotide both increase sedation. Use Caution/Monitor.

ziprasidone and amitriptyline both increase sedation. Use Caution/Monitor.perphenazine and ziprasidone both increase sedation. Use Caution/Monitor.perphenazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

zolmitriptan and amitriptyline both increase serotonin levels. Modify Therapy/Monitor Closely.zolmitriptan, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

perphenazine will increase the level or effect of zolpidem by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Additive effect of decreased alertness and psychomotor performance

perphenazine and zotepine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.perphenazine and zotepine both increase sedation. Use Caution/Monitor.

amitriptyline increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

amiodarone will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

amitriptyline, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

amoxapine, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amoxapine, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

perphenazine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

armodafinil will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

artemether/lumefantrine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

asenapine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.amitriptyline increases levels of atropine by unknown mechanism. Minor/Significance Unknown.

perphenazine increases toxicity of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.amitriptyline increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.

bazedoxifene/conjugated estrogens, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

perphenazine increases effects of benazepril by unspecified interaction mechanism. Minor/Significance Unknown.

bortezomib will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.

bosentan will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

amitriptyline decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.brimonidine increases effects of perphenazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

budesonide will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

perphenazine increases effects of captopril by unspecified interaction mechanism. Minor/Significance Unknown.

butabarbital, amitriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

butalbital, amitriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

carbamazepine decreases levels of amitriptyline by increasing metabolism. Minor/Significance Unknown.

celecoxib will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

chasteberry decreases effects of perphenazine by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).

chloroquine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.chloroquine increases levels of perphenazine by decreasing metabolism. Minor/Significance Unknown.chloroquine increases toxicity of perphenazine by QTc interval. Minor/Significance Unknown.

amitriptyline, chlorpromazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, chlorpromazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.perphenazine will increase the level or effect of chlorpromazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

amitriptyline increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.

cimetidine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

clomipramine, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.clomipramine, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

perphenazine will increase the level or effect of codeine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.perphenazine decreases effects of codeine by decreasing metabolism. Minor/Significance Unknown. Decreased conversion of codeine to active metabolite morphine.

conjugated estrogens, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

conjugated estrogens, vaginal, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

cortisone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

darifenacin will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

desflurane, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

desipramine, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.desipramine, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

dexamethasone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

perphenazine will increase the level or effect of dexfenfluramine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

dexmethylphenidate increases effects of amitriptyline by decreasing metabolism. Minor/Significance Unknown.

DHEA, herbal will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

perphenazine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine will increase the level or effect of dextromethorphan by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

diphenhydramine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.doxepin, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.doxepin, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

dronedarone will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

duloxetine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

perphenazine will increase the level or effect of encainide by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

eslicarbazepine acetate will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

estradiol, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

estrogens conjugated synthetic, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

estrogens esterified, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens may inhibit hepatic metabolism of tricyclic antidepressants. However, interactions are not common.

estropipate, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

ethanol, amitriptyline.Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive impairment of motor skills.ethanol, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

ethinylestradiol, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

perphenazine and eucalyptus both increase sedation. Minor/Significance Unknown.

etomidate, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

etravirine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

amitriptyline and eucalyptus both increase sedation. Minor/Significance Unknown.

felodipine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.

perphenazine will increase the level or effect of fesoterodine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

fludrocortisone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

amitriptyline, fluphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, fluphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.perphenazine will increase the level or effect of fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine increases effects of fosinopril by unspecified interaction mechanism. Minor/Significance Unknown.

amitriptyline increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.

perphenazine will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

amitriptyline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

amitriptyline increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

griseofulvin will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

haloperidol will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

hydrocortisone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

hydroxyprogesterone caproate, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

imatinib will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine increases effects of imidapril by unspecified interaction mechanism. Minor/Significance Unknown.

imipramine, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.imipramine, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

amitriptyline increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.

amitriptyline increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.

amitriptyline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

amitriptyline increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.

amitriptyline increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.

amitriptyline increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.

amitriptyline increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.

isoniazid will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

isoproterenol, amitriptyline. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

itraconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

ketamine, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

lapatinib will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

perphenazine increases effects of lisinopril by unspecified interaction mechanism. Minor/Significance Unknown.

lithium, amitriptyline. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.

lofepramine, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.lofepramine, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

perphenazine will increase the level or effect of loratadine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

lumefantrine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

maprotiline, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.maprotiline, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

maraviroc will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

marijuana will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.marijuana will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

mestranol, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

perphenazine decreases effects of metyrapone by unspecified interaction mechanism. Minor/Significance Unknown.

amitriptyline increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.

methylprednisolone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

metronidazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

amitriptyline decreases effects of metyrapone by unspecified interaction mechanism. Minor/Significance Unknown.

metyrosine increases toxicity of perphenazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased extrapyramidal symptoms.

miconazole vaginal will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

amitriptyline increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

perphenazine increases effects of moexipril by unspecified interaction mechanism. Minor/Significance Unknown.

amitriptyline increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.

nevirapine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

nifedipine will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

nilotinib will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.nilotinib will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

nortriptyline, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.nortriptyline, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

oxcarbazepine will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.oxcarbazepine will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

oxybutynin increases toxicity of perphenazine by unspecified interaction mechanism. Minor/Significance Unknown.

oxybutynin topical increases toxicity of perphenazine by unspecified interaction mechanism. Minor/Significance Unknown.

oxybutynin transdermal increases toxicity of perphenazine by unspecified interaction mechanism. Minor/Significance Unknown.

perphenazine decreases effects of oxycodone by decreasing metabolism. Minor/Significance Unknown. Decreased conversion of oxycodone to active metabolite morphine.

panax ginseng increases effects of amitriptyline by pharmacodynamic synergism. Minor/Significance Unknown.

parecoxib will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.parecoxib will increase the level or effect of amitriptyline by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.

pentobarbital, amitriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

perphenazine will increase the level or effect of perhexiline by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine increases effects of perindopril by unspecified interaction mechanism. Minor/Significance Unknown.

amitriptyline, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

phenobarbital, amitriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

amitriptyline increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

pleurisy root decreases effects of amitriptyline by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

posaconazole will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

prednisone will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

primidone, amitriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

amitriptyline, prochlorperazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, prochlorperazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.perphenazine will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

progesterone micronized, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

perphenazine will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

amitriptyline, promazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, promazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

perphenazine will increase the level or effect of promethazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.amitriptyline, promethazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, promethazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

propofol, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

protriptyline, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.protriptyline, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

pyrimethamine increases levels of perphenazine by decreasing metabolism. Minor/Significance Unknown.

quinacrine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine increases effects of quinapril by unspecified interaction mechanism. Minor/Significance Unknown.

quinupristin/dalfopristin will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

perphenazine increases effects of ramipril by unspecified interaction mechanism. Minor/Significance Unknown.

ranolazine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

amitriptyline increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.

perphenazine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

ritonavir will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

amitriptyline increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

rufinamide will decrease the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

perphenazine and sage both increase sedation. Minor/Significance Unknown.amitriptyline and sage both increase sedation. Minor/Significance Unknown.

amitriptyline increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

sertraline will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

secobarbital, amitriptyline. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

serdexmethylphenidate/dexmethylphenidate increases effects of amitriptyline by decreasing metabolism. Minor/Significance Unknown.

sevoflurane, amitriptyline. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

amitriptyline increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

sulfamethoxazole decreases levels of amitriptyline by unspecified interaction mechanism. Minor/Significance Unknown.

amitriptyline, thioridazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, thioridazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.thioridazine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

tipranavir will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

amitriptyline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.

amitriptyline increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.

perphenazine will increase the level or effect of tolterodine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

perphenazine increases effects of trandolapril by unspecified interaction mechanism. Minor/Significance Unknown.

trazodone, perphenazine.Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.trazodone, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

perphenazine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.amitriptyline, trifluoperazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.amitriptyline, trifluoperazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

trimipramine, perphenazine.Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.trimipramine, perphenazine.Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

amitriptyline increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.

perphenazine will increase the level or effect of tropisetron by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

verapamil will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.verapamil increases levels of amitriptyline by decreasing metabolism. Minor/Significance Unknown.