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 fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. rocuronium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rolapitantMonitor Closely (1)rolapitant will increase the level or effect of fluphenazine 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.romidepsinMonitor Closely (1)fluphenazine and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.ropiniroleSerious - Use Alternative (1)fluphenazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.safinamideSerious - Use Alternative (1)fluphenazine 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)fluphenazine and sage both increase sedation. Minor/Significance Unknown.salmeterolMonitor Closely (1)fluphenazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.saquinavirSerious - Use Alternative (1)saquinavir increases levels of fluphenazine by QTc interval. Avoid or Use Alternate Drug. Potential for increased toxicity. .scopolamineMonitor Closely (3)scopolamine decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. scopolamine decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.scullcapMonitor Closely (1)fluphenazine and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital and fluphenazine both increase sedation. Use Caution/Monitor.selegilineMonitor Closely (1)selegiline, fluphenazine. 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, fluphenazine. 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.selpercatinibMonitor Closely (1)selpercatinib increases toxicity of fluphenazine by QTc interval. Use Caution/Monitor.serdexmethylphenidate/dexmethylphenidateMonitor Closely (1)fluphenazine, 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.sertralineMinor (1)sertraline will increase the level or effect of fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.sevofluraneMonitor Closely (2)sevoflurane and fluphenazine both increase sedation. Use Caution/Monitor. sevoflurane and fluphenazine both increase QTc interval. Use Caution/Monitor.shepherd's purseMonitor Closely (1)fluphenazine and shepherd's purse both increase sedation. Use Caution/Monitor.siponimodMonitor Closely (1)siponimod and fluphenazine both increase QTc interval. Use Caution/Monitor.smokingMonitor Closely (1)smoking decreases levels of fluphenazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.sodium oxybateSerious - Use Alternative (1)fluphenazine, 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 fluphenazine 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 fluphenazine 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 fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. solifenacin and fluphenazine both increase QTc interval. Use Caution/Monitor.sorafenibMonitor Closely (1)sorafenib and fluphenazine both increase QTc interval. Use Caution/Monitor.sotalolContraindicated (1)fluphenazine and sotalol both increase QTc interval. Contraindicated.stiripentolMonitor Closely (1)stiripentol, fluphenazine. 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.sufentanilMonitor Closely (1)sufentanil and fluphenazine both increase sedation. Use Caution/Monitor.sufentanil SLSerious - Use Alternative (1)sufentanil SL, fluphenazine. 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)fluphenazine and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.sumatriptanMonitor Closely (1)sumatriptan, fluphenazine. 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, fluphenazine. 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 fluphenazine both increase QTc interval. Use Caution/Monitor.tacrolimusMonitor Closely (1)tacrolimus and fluphenazine both increase QTc interval. Use Caution/Monitor.tapentadolMonitor Closely (1)tapentadol and fluphenazine both increase sedation. Use Caution/Monitor.teduglutideMonitor Closely (1)teduglutide increases levels of fluphenazine 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)fluphenazine and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.temazepamMonitor Closely (1)temazepam and fluphenazine both increase sedation. Use Caution/Monitor.terbinafineMonitor Closely (1)terbinafine will increase the level or effect of fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.terbutalineMonitor Closely (1)fluphenazine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tetrabenazineMonitor Closely (1)fluphenazine and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)tetrabenazine and fluphenazine both increase QTc interval. Avoid or Use Alternate Drug.thioridazineMonitor Closely (2)fluphenazine and thioridazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. fluphenazine and thioridazine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)fluphenazine and thioridazine both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)thioridazine will increase the level or effect of fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.thiothixeneMonitor Closely (2)fluphenazine and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. fluphenazine and thiothixene both increase sedation. Use Caution/Monitor.tiotropiumMonitor Closely (3)tiotropium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine 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 fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.tobacco useMonitor Closely (1)tobacco use decreases levels of fluphenazine 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 fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tolterodine decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.topiramateMonitor Closely (1)fluphenazine and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)tramadol and fluphenazine both increase sedation. Use Caution/Monitor.trandolaprilMinor (1)fluphenazine increases effects of trandolapril by unspecified interaction mechanism. Minor/Significance Unknown.tranylcypromineMonitor Closely (1)tranylcypromine, fluphenazine. 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)fluphenazine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)fluphenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trazodone, fluphenazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects. trazodone, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.tretinoinSerious - Use Alternative (1)fluphenazine, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.tretinoin topicalSerious - Use Alternative (1)fluphenazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.triazolamMonitor Closely (1)triazolam and fluphenazine both increase sedation. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos and fluphenazine both increase sedation. Use Caution/Monitor.trifluoperazineMonitor Closely (2)fluphenazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. fluphenazine and trifluoperazine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)fluphenazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.trihexyphenidylMonitor Closely (2)trihexyphenidyl decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine increases effects of trihexyphenidyl by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive anticholinergic effects.trimethoprimMonitor Closely (1)fluphenazine and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.trimipramineMonitor Closely (1)fluphenazine and trimipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)fluphenazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trimipramine, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. trimipramine, fluphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.triprolidineMonitor Closely (1)triprolidine and fluphenazine both increase sedation. Use Caution/Monitor.tropisetronMonitor Closely (1)fluphenazine and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.trospium chlorideMonitor Closely (3)trospium chloride decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.umeclidinium bromide/vilanterol inhaledSerious - Use Alternative (1)fluphenazine 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.valbenazineMonitor Closely (1)valbenazine and fluphenazine both increase QTc interval. Use Caution/Monitor.vecuroniumMonitor Closely (3)vecuronium decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. vecuronium decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor. fluphenazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.venlafaxineMonitor Closely (2)venlafaxine, fluphenazine. 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). venlafaxine will increase the level or effect of fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)fluphenazine and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug.vilanterol/fluticasone furoate inhaledSerious - Use Alternative (1)fluphenazine 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.vilazodoneMonitor Closely (1)vilazodone, fluphenazine. 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).voriconazoleMonitor Closely (1)fluphenazine and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.vorinostatMonitor Closely (1)vorinostat and fluphenazine both increase QTc interval. Use