pts. only. trifluoperazine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineMonitor Closely (1)trifluoperazine and protriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trifluoperazine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)protriptyline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. protriptyline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.pseudoephedrineMonitor Closely (1)trifluoperazine, 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.pyrimethamineMinor (1)pyrimethamine increases levels of trifluoperazine by decreasing metabolism. Minor/Significance Unknown.quazepamMonitor Closely (1)quazepam and trifluoperazine both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (2)quetiapine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. quetiapine and trifluoperazine both increase sedation. Use Caution/Monitor.quinacrineMinor (1)quinacrine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.quinaprilMinor (1)trifluoperazine increases effects of quinapril by unspecified interaction mechanism. Minor/Significance Unknown.quinidineContraindicated (1)trifluoperazine and quinidine both increase QTc interval. Contraindicated.Monitor Closely (1)quinidine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)quinidine, trifluoperazine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive cardiac effects.ramelteonMonitor Closely (1)trifluoperazine and ramelteon both increase sedation. Use Caution/Monitor.ramiprilMinor (1)trifluoperazine increases effects of ramipril by unspecified interaction mechanism. Minor/Significance Unknown.ranolazineMonitor Closely (1)trifluoperazine and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)ranolazine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.rapacuroniumMonitor Closely (3)rapacuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. rapacuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.remimazolamMonitor Closely (1)remimazolam, trifluoperazine. 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.rimabotulinumtoxinBMonitor Closely (1)trifluoperazine, 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.risperidoneMonitor Closely (3)trifluoperazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. risperidone and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. risperidone and trifluoperazine both increase sedation. Use Caution/Monitor.ritonavirMinor (1)ritonavir will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.rizatriptanMonitor Closely (1)rizatriptan, trifluoperazine. 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).rocuroniumMonitor Closely (3)rocuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. rocuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.romidepsinMonitor Closely (1)trifluoperazine and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.ropiniroleSerious - Use Alternative (1)trifluoperazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.safinamideSerious - Use Alternative (1)trifluoperazine decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.sageMinor (1)trifluoperazine and sage both increase sedation. Minor/Significance Unknown.salmeterolMonitor Closely (1)trifluoperazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.scopolamineMonitor Closely (3)scopolamine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. scopolamine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.scullcapMonitor Closely (1)trifluoperazine and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital and trifluoperazine both increase sedation. Use Caution/Monitor.selegilineMonitor Closely (1)selegiline, trifluoperazine. 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).selinexorSerious - Use Alternative (1)selinexor, trifluoperazine. 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.serdexmethylphenidate/dexmethylphenidateMonitor Closely (1)trifluoperazine, 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.sertralineMonitor Closely (1)sertraline and trifluoperazine both decrease QTc interval. Use Caution/Monitor.Minor (1)sertraline will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.sevofluraneMonitor Closely (2)sevoflurane and trifluoperazine both increase sedation. Use Caution/Monitor. sevoflurane and trifluoperazine both decrease QTc interval. Use Caution/Monitor.shepherd's purseMonitor Closely (1)trifluoperazine and shepherd's purse both increase sedation. Use Caution/Monitor.siponimodMonitor Closely (1)siponimod and trifluoperazine both decrease QTc interval. Use Caution/Monitor.smokingMonitor Closely (1)smoking decreases levels of trifluoperazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.sodium oxybateSerious - Use Alternative (1)trifluoperazine, 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.sodium sulfate/?magnesium sulfate/potassium chlorideMonitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases effects of trifluoperazine 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 sulfateMonitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases effects of trifluoperazine 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.solifenacinMonitor Closely (4)solifenacin decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. solifenacin and trifluoperazine both decrease QTc interval. Use Caution/Monitor.sotalolContraindicated (1)trifluoperazine and sotalol both increase QTc interval. Contraindicated.stiripentolMonitor Closely (1)stiripentol, trifluoperazine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.sufentanilMonitor Closely (1)sufentanil and trifluoperazine both increase sedation. Use Caution/Monitor.sufentanil SLSerious - Use Alternative (1)sufentanil SL, trifluoperazine. 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.sulfamethoxazoleMonitor Closely (1)trifluoperazine and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.sumatriptanMonitor Closely (1)sumatriptan, trifluoperazine. 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 intranasalMonitor Closely (1)sumatriptan intranasal, trifluoperazine. 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).sunitinibMonitor Closely (1)sunitinib and trifluoperazine both decrease QTc interval. Use Caution/Monitor.tacrolimusMonitor Closely (1)tacrolimus and trifluoperazine both decrease QTc interval. Use Caution/Monitor.tapentadolMonitor Closely (1)tapentadol and trifluoperazine both increase sedation. Use Caution/Monitor.teduglutideMonitor Closely (1)teduglutide increases levels of trifluoperazine by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.telavancinMonitor Closely (1)trifluoperazine and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.temazepamMonitor Closely (1)temazepam and trifluoperazine both increase sedation. Use Caution/Monitor.terbutalineMonitor Closely (1)trifluoperazine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.teriflunomideMonitor Closely (1)teriflunomide decreases levels of trifluoperazine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.tetrabenazineMonitor Closely (1)trifluoperazine and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)tetrabenazine and trifluoperazine both decrease QTc interval. Avoid or Use Alternate Drug.thioridazineMonitor Closely (2)thioridazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. thioridazine and trifluoperazine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)thioridazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)thioridazine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.thiothixeneMonitor Closely (2)thiothixene and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. thiothixene and trifluoperazine both increase sedation. Use Caution/Monitor.tiotropiumMonitor Closely (3)tiotropium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.tipranavirMinor (1)tipranavir will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.tobacco useMonitor Closely (1)tobacco use decreases levels of trifluoperazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.tolterodineMonitor Closely (3)tolterodine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tolterodine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.topiramateMonitor Closely (1)trifluoperazine and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)tramadol and trifluoperazine both increase sedation. Use Caution/Monitor.trandolaprilMinor (1)trifluoperazine increases effects of trandolapril by unspecified interaction mechanism. Minor/Significance Unknown.tranylcypromineMonitor Closely (1)tranylcypromine, trifluoperazine. 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).trazodoneMonitor Closely (1)trifluoperazine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trifluoperazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trazodone, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects. trazodone, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.tretinoinSerious - Use Alternative (1)trifluoperazine, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.tretinoin topicalSerious - Use Alternative (1)trifluoperazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.triazolamMonitor Closely (1)triazolam and trifluoperazine both increase sedation. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos and trifluoperazine both increase sedation. Use Caution/Monitor.trihexyphenidylMonitor Closely (2)trihexyphenidyl decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of trihexyphenidyl by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive anticholinergic effects.trimethoprimMonitor Closely (1)trifluoperazine and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.trimipramineMonitor Closely (1)trifluoperazine and trimipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trifluoperazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trimipramine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. trimipramine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.triprolidineMonitor Closely (1)triprolidine and trifluoperazine both increase sedation. Use Caution/Monitor.tropisetronMonitor Closely (1)trifluoperazine and