the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive cardiac effects.ribociclibribociclib increases toxicity of perphenazine by QTc interval. Avoid or Use Alternate Drug.ropiniroleperphenazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.safinamideperphenazine decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.saquinavirsaquinavir, 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.selinexorselinexor, 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.sodium oxybateperphenazine, 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.sufentanil SLsufentanil 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.tetrabenazinetetrabenazine and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.thioridazineperphenazine will increase the level or effect of thioridazine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.perphenazine and thioridazine both increase QTc interval. Avoid or Use Alternate Drug.trazodoneperphenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.tretinoinperphenazine, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.tretinoin topicalperphenazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.trifluoperazineperphenazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.trimipramineperphenazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.umeclidinium bromide/vilanterol inhaledperphenazine 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.venlafaxineperphenazine and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug.vilanterol/fluticasone furoate inhaledperphenazine 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.yohimbeyohimbe decreases effects of perphenazine by pharmacodynamic antagonism. Contraindicated.ziprasidoneperphenazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.Monitor Closely (363)abirateroneabiraterone 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.abobotulinumtoxinAabobotulinumtoxinA 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.aclidiniumaclidinium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.acrivastineacrivastine and perphenazine both increase sedation. Use Caution/Monitor.albiglutideperphenazine, albiglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.albuterolperphenazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.alfentanilalfentanil and perphenazine both increase sedation. Use Caution/Monitor.alfuzosinperphenazine and alfuzosin both increase QTc interval. Use Caution/Monitor.alfuzosin and perphenazine both increase QTc interval. Use Caution/Monitor.almotriptanalmotriptan, 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).alprazolamalprazolam and perphenazine both increase sedation. Use Caution/Monitor.amifampridineperphenazine 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.amitriptylineperphenazine and amitriptyline both increase sedation. Use Caution/Monitor.amobarbitalamobarbital and perphenazine both increase sedation. Use Caution/Monitor.amoxapineperphenazine 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.anagrelideanagrelide and perphenazine both increase QTc interval. Use Caution/Monitor.anticholinergic/sedative combosanticholinergic/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.apomorphineperphenazine and apomorphine both increase sedation. Use Caution/Monitor.arformoterolperphenazine 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.aripiprazolearipiprazole and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.aripiprazole and perphenazine both increase sedation. Use Caution/Monitor.armodafinilperphenazine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.artemetherartemether and perphenazine both increase QTc interval. Use Caution/Monitor.artemether/lumefantrineartemether/lumefantrine will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.asenapineasenapine and perphenazine both increase QTc interval. Use Caution/Monitor.asenapine and perphenazine both increase sedation. Use Caution/Monitor.asenapine transdermalasenapine transdermal and perphenazine both increase QTc interval. Use Caution/Monitor.asenapine transdermal and perphenazine both increase sedation. Use Caution/Monitor.atomoxetineperphenazine 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.atracuriumatracurium 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.perphenazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropineatropine decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.atropine decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IMperphenazine 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 inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.atropine IV/IM decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.avapritinibavapritinib and perphenazine both increase sedation. Use Caution/Monitor.azelastineazelastine and perphenazine both increase sedation. Use Caution/Monitor.azithromycinperphenazine and azithromycin both increase QTc interval. Use Caution/Monitor.baclofenbaclofen and perphenazine both increase sedation. Use Caution/Monitor.bedaquilineperphenazine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsbelladonna 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.perphenazine increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opiumbelladonna 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.belladonna and opium decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.perphenazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.benperidolbenperidol and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.benperidol and perphenazine both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenperphenazine 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.benzhydrocodone/acetaminophen and perphenazine both increase sedation. Use Caution/Monitor.benzphetamineperphenazine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.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.benztropineperphenazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .brexanolonebrexanolone, perphenazine. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazolebrexpiprazole and perphenazine both increase sedation. Use Caution/Monitor.brimonidinebrimonidine and perphenazine both increase sedation. Use Caution/Monitor.brivaracetambrivaracetam and perphenazine both increase sedation. Use Caution/Monitor.brompheniraminebrompheniramine and perphenazine both increase sedation. Use Caution/Monitor.buprenorphinebuprenorphine and perphenazine both increase sedation. Use Caution/Monitor.buprenorphine and perphenazine both increase QTc interval. Use Caution/Monitor.buprenorphine buccalbuprenorphine buccal and perphenazine both increase sedation. Use Caution/Monitor.buprenorphine buccal and perphenazine both increase QTc interval. Use Caution/Monitor.buprenorphine subdermal implantbuprenorphine subdermal implant and perphenazine both increase QTc interval. Use Caution/Monitor.buprenorphine subdermal implant and perphenazine both increase sedation. Use Caution/Monitor.buprenorphine transdermalbuprenorphine transdermal and perphenazine both increase QTc interval. Use Caution/Monitor.buprenorphine transdermal and perphenazine both increase sedation. Use Caution/Monitor.buprenorphine, long-acting injectionperphenazine 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.buprenorphine, long-acting injection and perphenazine both increase sedation. Use Caution/Monitor.bupropionbupropion 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.butabarbitalbutabarbital and perphenazine both increase sedation. Use Caution/Monitor.butalbitalbutalbital and perphenazine both increase sedation. Use Caution/Monitor.butorphanolbutorphanol and perphenazine both increase sedation. Use Caution/Monitor.caffeineperphenazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbinoxaminecarbinoxamine and perphenazine both increase sedation. Use Caution/Monitor.carisoprodolcarisoprodol and perphenazine both increase sedation. Use Caution/Monitor.carvedilolperphenazine will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cenobamatecenobamate, perphenazine. Either increases effects of the other by sedation. Use Caution/Monitor.ceritinibceritinib and perphenazine both increase QTc interval. Use Caution/Monitor.chloral hydratechloral hydrate and perphenazine both increase sedation. Use Caution/Monitor.chlordiazepoxidechlordiazepoxide and perphenazine both increase sedation. Use Caution/Monitor.chlorpheniraminechlorpheniramine and perphenazine both increase sedation. Use Caution/Monitor.chlorpromazinechlorpromazine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.chlorpromazine and perphenazine both increase sedation. Use Caution/Monitor.chlorzoxazonechlorzoxazone and perphenazine both increase sedation. Use Caution/Monitor.cigarette smokingcigarette smoking decreases levels of perphenazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.cinnarizinecinnarizine and perphenazine both increase sedation. Use Caution/Monitor.cisatracuriumcisatracurium 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.citalopramcitalopram and perphenazine both increase QTc interval. Use Caution/Monitor.clemastineclemastine and perphenazine both increase sedation. Use Caution/Monitor.clobazamclobazam 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. clomipramineperphenazine will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.perphenazine and clomipramine both increase sedation. Use Caution/Monitor.clonazepamclonazepam and perphenazine both increase sedation. Use Caution/Monitor.clonidineclonidine, perphenazine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.clorazepateclorazepate and perphenazine both increase sedation. Use Caution/Monitor.clozapineclozapine and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.clozapine and perphenazine both increase sedation. Use Caution/Monitor.clozapine and perphenazine both increase QTc interval. Use Caution/Monitor.cobicistatcobicistat 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. codeinecodeine and perphenazine both increase sedation. Use Caution/Monitor.crizotinibcrizotinib and perphenazine both increase QTc interval. Use Caution/Monitor.cyclizinecyclizine and perphenazine both increase sedation. Use Caution/Monitor.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.perphenazine increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cyclobenzaprinecyclobenzaprine and perphenazine both increase sedation. 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 decreases