of metyrapone by unspecified interaction mechanism. Minor/Significance Unknown.metyrosineMinor (1)metyrosine increases toxicity of trifluoperazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased extrapyramidal symptoms.midazolamMonitor Closely (1)midazolam and trifluoperazine both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)midazolam intranasal, trifluoperazine. 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.midodrineMonitor Closely (2)trifluoperazine, 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. trifluoperazine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.milnacipranMonitor Closely (1)milnacipran, 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).mirtazapineMonitor Closely (2)trifluoperazine and mirtazapine both increase sedation. Use Caution/Monitor. mirtazapine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.modafinilMonitor Closely (1)trifluoperazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.moexiprilMinor (1)trifluoperazine increases effects of moexipril by unspecified interaction mechanism. Minor/Significance Unknown.morphineMonitor Closely (1)morphine and trifluoperazine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)trifluoperazine and motherwort both increase sedation. Use Caution/Monitor.moxifloxacinSerious - Use Alternative (1)trifluoperazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.moxonidineMonitor Closely (1)trifluoperazine and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)trifluoperazine and nabilone both increase sedation. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine and trifluoperazine both increase sedation. Use Caution/Monitor.naratriptanMonitor Closely (1)naratriptan, 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).nilotinibSerious - Use Alternative (1)trifluoperazine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)nilotinib will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.norepinephrineMonitor Closely (2)trifluoperazine, 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. trifluoperazine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nortriptylineMonitor Closely (1)trifluoperazine and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trifluoperazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)nortriptyline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. nortriptyline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.octreotideSerious - Use Alternative (1)trifluoperazine and octreotide both increase QTc interval. Avoid or Use Alternate Drug.octreotide (Antidote)Serious - Use Alternative (1)trifluoperazine and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.ofloxacinMonitor Closely (1)trifluoperazine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.olanzapineMonitor Closely (3)olanzapine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. olanzapine and trifluoperazine both increase sedation. Use Caution/Monitor. olanzapine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.oliceridineMonitor Closely (1)oliceridine, trifluoperazine. 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).olodaterol inhaledMonitor Closely (1)trifluoperazine 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 arrhythmiasolopatadine intranasalSerious - Use Alternative (1)trifluoperazine 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. onabotulinumtoxinAMonitor Closely (3)onabotulinumtoxinA decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. onabotulinumtoxinA decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.opium tinctureMonitor Closely (1)opium tincture and trifluoperazine both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (1)orphenadrine and trifluoperazine both increase sedation. Use Caution/Monitor.oxaliplatinMonitor Closely (1)oxaliplatin and trifluoperazine both decrease QTc interval. Use Caution/Monitor.oxazepamMonitor Closely (1)oxazepam and trifluoperazine both increase sedation. Use Caution/Monitor.oxybutyninMonitor Closely (3)oxybutynin decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.oxybutynin topicalMonitor Closely (3)oxybutynin topical decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin topical increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.oxybutynin transdermalMonitor Closely (3)oxybutynin transdermal decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin transdermal increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.oxycodoneMonitor Closely (1)oxycodone and trifluoperazine both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)oxymorphone and trifluoperazine both increase sedation. Use Caution/Monitor.paliperidoneMonitor Closely (3)trifluoperazine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely. paliperidone and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. paliperidone and trifluoperazine both increase sedation. Use Caution/Monitor.pancuroniumMonitor Closely (3)pancuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. pancuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.papaveretumMonitor Closely (1)papaveretum and trifluoperazine both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)trifluoperazine and papaverine both increase sedation. Use Caution/Monitor.parecoxibMinor (1)parecoxib will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.paroxetineMonitor Closely (3)paroxetine, 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). trifluoperazine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely. paroxetine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.pazopanibMonitor Closely (1)trifluoperazine and pazopanib both increase QTc interval. Use Caution/Monitor.pentamidineContraindicated (1)trifluoperazine and pentamidine both increase QTc interval. Contraindicated.pentazocineMonitor Closely (1)pentazocine and trifluoperazine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital and trifluoperazine both increase sedation. Use Caution/Monitor.perindoprilMinor (1)trifluoperazine increases effects of perindopril by unspecified interaction mechanism. Minor/Significance Unknown.perphenazineMonitor Closely (2)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.Serious - Use Alternative (1)perphenazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)perphenazine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.phendimetrazineMonitor Closely (2)trifluoperazine, 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. trifluoperazine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenelzineMonitor Closely (1)phenelzine, 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).phenobarbitalMonitor Closely (1)phenobarbital and trifluoperazine both increase sedation. Use Caution/Monitor.phentermineMonitor Closely (2)trifluoperazine, 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. trifluoperazine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrineMonitor Closely (2)trifluoperazine, 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. trifluoperazine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine POMonitor Closely (2)trifluoperazine, 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. trifluoperazine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .pholcodineMonitor Closely (1)trifluoperazine and pholcodine both increase sedation. Use Caution/Monitor.pimozideContraindicated (1)trifluoperazine and pimozide both increase QTc interval. Contraindicated.Monitor Closely (2)pimozide and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. pimozide and trifluoperazine both increase sedation. Use Caution/Monitor.pirbuterolMonitor Closely (1)trifluoperazine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.porfimerMonitor Closely (1)trifluoperazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.posaconazoleMonitor Closely (1)trifluoperazine and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.pralidoximeMonitor Closely (3)pralidoxime decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. pralidoxime decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pramipexoleSerious - Use Alternative (1)trifluoperazine decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.primaquineMonitor Closely (1)primaquine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.primidoneMonitor Closely (1)primidone and trifluoperazine both increase sedation. Use Caution/Monitor.procainamideContraindicated (1)trifluoperazine and procainamide both increase QTc interval. Contraindicated.procarbazineMonitor Closely (2)procarbazine, 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). procarbazine, trifluoperazine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Excessive sedation.prochlorperazineMonitor Closely (2)prochlorperazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. prochlorperazine and trifluoperazine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)prochlorperazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.promazineSerious - Use Alternative (1)promazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.promethazineMonitor Closely (3)promethazine, 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). promethazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. promethazine and trifluoperazine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)promethazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.propafenoneMonitor Closely (1)propafenone will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.propanthelineMonitor Closely (3)propantheline decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. propantheline decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.propofolMonitor Closely (1)propofol and trifluoperazine both increase sedation. Use Caution/Monitor.propylhexedrineMonitor Closely (2)trifluoperazine, 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