AdultPediatricGeriatricDosage Forms & Strengths amitriptyline/perphenazine tablet 10mg/2mg 25mg/2mg 10mg/4mg 25mg/4mg 50mg/4mg Anxiety or Agitation with Depression Indicated for (1) moderate-to-severe anxiety and/or agitation and depressed mood, (2) depression in whom anxiety and/or agitation are severe, and (3) depression and anxiety associated with chronic physical disease Initial: 25 mg/2 mg or 25 mg/4 mg PO TID/QID, OR 50 mg/4 mg PO BID Maintenance: 2 mg/25 mg or 4 mg/25 mg PO BID/QID, OR 50 mg/4 mg PO BID 10 mg/ 2 mg and 10 mg/4 mg can be used to increase flexibility in adjusting maintenance dosage to the lowest amount consistent with relief of symptoms Do not exceed daily dose of 200 mg/16 mg Schizophrenia with Depression Indicated for patients with schizophrenic who have associated depressive symptoms Initial: 50 mg/8 mg (ie, 2 tablets of 25 mg/4 mg) PO BID/TID; if needed a fourth dose may be given at bedtime Maintenance: 2 mg/25 mg or 4 mg/25 mg PO BID/QID, OR 50 mg/4 mg PO BID 10 mg/ 2 mg and 10 mg/4 mg can be used to increase flexibility in adjusting maintenance dosage to the lowest amount consistent with relief of symptoms Do not exceed daily dose of 200 mg/16 mg Dosing Considerations Depending on the condition being treated, therapeutic response may not be observed for several days up to 2-3 weeks, or longer After a satisfactory response is noted, dosage should be reduced to the smallest amount necessary to obtain relief from the symptomsNot recommendedAvoid; strong anticholinergic and sedative effects; may cause orthostatic hypotension (Beers criteria) Consider alternatives; if must use, initiate with lower initial dose such as 1 tablet (amitriptyline 10 mg/perphenazine 4 mg) three/four times dailyInteraction CheckerEnter a drug name and amitriptyline/perphenazineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (22)amisulprideamisulpride, perphenazine. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.disopyramideamitriptyline and disopyramide both increase QTc interval. Contraindicated.perphenazine and disopyramide both increase QTc interval. Contraindicated.dronedaronedronedarone will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.dronedarone will increase the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Contraindicated.fezolinetantperphenazine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsfezolinetantamitriptyline will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitorsibutilideperphenazine and ibutilide both increase QTc interval. Contraindicated.amitriptyline and ibutilide both increase QTc interval. Contraindicated.indapamideperphenazine and indapamide both increase QTc interval. Contraindicated.amitriptyline and indapamide both increase QTc interval. Contraindicated.iobenguane I 123amitriptyline decreases effects of iobenguane I 123 by pharmacodynamic antagonism. Contraindicated. If clinically appropriate, discontinue drugs that decrease uptake of NE for at least 5 half-lives; may cause false-negative imaging results.metrizamideperphenazine, metrizamide. Mechanism: unknown. Contraindicated. Risk of seizure. D/C phenothiazine 24h before admin. of metrizamide.isocarboxazidisocarboxazid and amitriptyline both increase serotonin levels. Contraindicated.pentamidineperphenazine and pentamidine both increase QTc interval. Contraindicated.amitriptyline and pentamidine both increase QTc interval. Contraindicated.phenelzinephenelzine and amitriptyline both increase serotonin levels. Contraindicated.pimozideperphenazine and pimozide both increase QTc interval. Contraindicated.pimozideamitriptyline and pimozide both increase QTc interval. Contraindicated.procainamideamitriptyline and procainamide both increase QTc interval. Contraindicated.perphenazine and procainamide both increase QTc interval. Contraindicated.procarbazineprocarbazine and amitriptyline both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.quinidineperphenazine and quinidine both increase QTc interval. Contraindicated.quinidinequinidine and amitriptyline both increase QTc interval. Contraindicated.safinamideamitriptyline, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.selegilineselegiline and amitriptyline both increase serotonin levels. Contraindicated. Concurrent use or use within 14 days of selegiline treatment is contraindicatedsotalolperphenazine and sotalol both increase QTc interval. Contraindicated.amitriptyline and sotalol both increase QTc interval. Contraindicated.tranylcyprominetranylcypromine and amitriptyline both increase serotonin levels. Contraindicated.Serious - Use Alternative (193)adagrasibadagrasib, 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.albuterolamitriptyline, 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 oralaminolevulinic 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.aminolevulinic acid topicalperphenazine 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.amiodaroneamitriptyline and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.perphenazine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.amisulprideperphenazine and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amoxapineamitriptyline and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.amitriptyline and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.amitriptylineperphenazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.amoxapineperphenazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.apomorphineperphenazine decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.apomorphine and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.arformoterolamitriptyline, 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.aripiprazolearipiprazole and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.arsenic trioxideamitriptyline 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.artemetherartemether and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineperphenazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineamitriptyline and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.benzhydrocodone/acetaminophenbenzhydrocodone/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).benzhydrocodone/acetaminophen and amitriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebenzphetamineamitriptyline, 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.bromocriptineperphenazine decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.buprenorphinebuprenorphine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalbuprenorphine buccal and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantbuprenorphine subdermal implant and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implant and amitriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine transdermalbuprenorphine transdermal and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermal and amitriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine, long-acting injectionbuprenorphine, long-acting injection and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injection and amitriptyline both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuspironeamitriptyline and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.cabergolineperphenazine decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.calcium/magnesium/potassium/sodium oxybatesperphenazine, 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.chlorpromazinechlorpromazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.chlorpromazine and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.citalopramcitalopram 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.clarithromycinperphenazine and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinclarithromycin 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.clomipramineperphenazine 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.clonidineamitriptyline decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.dacomitinibdacomitinib 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. cyclobenzaprineamitriptyline and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.dacomitinibdacomitinib 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. dasatinibdasatinib will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.degarelixdegarelix and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.desipramineperphenazine 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.desvenlafaxineamitriptyline and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.dofetilideperphenazine and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.dexfenfluramineamitriptyline, 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.dexmethylphenidateamitriptyline, 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.dextroamphetamineamitriptyline, 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.dextromethorphanamitriptyline and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.diethylpropionamitriptyline, 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.dobutamineamitriptyline, 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.dofetilideamitriptyline and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.dolasetrondolasetron, amitriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.dopamineperphenazine decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.amitriptyline, dopamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase