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Perphenazine Coupon - Perphenazine 4mg tablet

perphenazine

Generic Trilafon
Used for Nausea, Schizophrenia

Perphenazine is a typical antipsychotic. It's used to treat schizophrenia, as well as severe nausea and vomiting in adults. Perphenazine comes as tablets that are taken by mouth, typically up to 3 to 4 times per day, depending on the condition. Side effects of this medication include sleepiness, insomnia, and changes in body weight (both weight gain and loss); drinking alcohol can worsen certain side effects. Brand name Trilafon has been discontinued; perphenazine is only available as a generic medication.

Reviewed by:
reviewerRobert Chad Hakim, PharmD, BCCCP
reviewerKristianne Hannemann, PharmD
Last reviewed on November 2, 2024
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What is Perphenazine?

What is Perphenazine used for?

How Perphenazine works

Perphenazine is a typical antipsychotic. It's thought to treat schizophrenia, and nausea and vomiting by blocking different chemicals in the brain, including dopamine, histamine, and acetylcholine.

Drug facts

Common BrandsTrilafon(brand name no longer available)
Drug ClassFirst generation (typical) antipsychotic
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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Side effects of Perphenazine

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Sleepiness (28%)
  • Trouble sleeping (25%)
  • Sexual side effects (25%)
  • Dry mouth (22%)
  • Constipation (22%)
  • Trouble urinating (22%)
  • Abnormal body movements (17%)
  • Weight gain (12%)
  • Changes in menstrual bleeding (11%)
  • Dizziness when standing (11%)

Less Common Side Effects

  • Muscle spasms
  • Changes in breast milk production
  • Changes in skin color
  • Rash
  • Itchiness
  • Blurry vision
  • Urinating more at night
  • Weight loss

Perphenazine serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Tardive dyskinesia (TD): uncontrollable movements like lip smacking, eye blinking, sticking out your tongue, grimacing
  • Neuroleptic malignant syndrome: high fever, fast heart rate, full body stiffness, confusion
  • Serious infection: fever, pale skin, fast heart rate, lightheadedness, feeling unwell
  • Suicidal thoughts or behavior in people with depression
  • Seizures

Source: DailyMed

The following Perphenazine side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Phenothiazines can sometimes cause serious unwanted effects. Tardive dyskinesia or tardive dystonia (muscle movement disorders) may occur and may not go away after you stop using the medicine. Signs of tardive dyskinesia or tardive dystonia include worm-like movements of the tongue, or other uncontrolled movements of the mouth, tongue, cheeks, jaw, body, arms, or legs. Another possible serious unwanted effect is the neuroleptic malignant syndrome (NMS). Signs and symptoms of NMS include severe muscle stiffness, fever, fast heartbeat, difficult breathing, increased sweating, and loss of bladder control. You and your doctor should discuss the good this medicine will do as well as the risks of taking it.

Stop taking this medicine and get emergency help immediately if any of the following effects occur:

Rare

Symptoms of neuroleptic malignant syndrome

Confusion (severe) or coma

difficult or fast breathing

drooling

fast heartbeat

high or low (irregular) blood pressure

increased sweating

loss of bladder control

muscle stiffness (severe)

trembling or shaking

trouble in speaking or swallowing

Check with your doctor immediately if any of the following side effects occur:

More common

Inability to move eyes

increased blinking or spasms of eyelid

lip smacking or puckering

muscle spasms of face, neck, body, arms, or legs causing unusual postures or unusual expressions on face

puffing of cheeks

rapid or worm-like movements of tongue

sticking out of tongue

tic-like or twitching movements

trouble in breathing, speaking, or swallowing

uncontrolled chewing movements

uncontrolled movements of arms or legs

uncontrolled twisting movements of neck, trunk, arms, or leg

Rare

Irregular or slow heart rate

recurrent fainting

Check with your doctor as soon as possible if any of the following side effects occur:

More common

Blurred vision, change in color vision, or difficulty in seeing at night

fainting

loss of balance control

mask-like face

restlessness or need to keep moving

shuffling walk

stiffness of arms or legs

trembling and shaking of hands and fingers

Less common

Difficulty in urinating

skin rash

sunburn (severe)

Rare

Abdominal or stomach pains

aching muscles and joints

agitation, bizarre dreams, excitement, or trouble in sleeping

bleeding or bruising (unusual

chest pain

clumsiness

confusion (mild)

constipation (severe)

convulsions (seizures)

dark urine

fever and chills

hair loss

headaches

hot, dry skin or lack of sweating

itchy skin (severe)

muscle weakness

nausea, vomiting, or diarrhea

pain in joints

prolonged, painful, inappropriate erection of the penis

redness of hands

shivering

skin discoloration (tan or blue-gray)

sore throat and fever

sores in mouth

unusual bleeding or bruising

unusual tiredness or weakness

yellow eyes or skin

Phenothiazines may cause your urine to be dark. In most cases, this is not a sign of a serious problem. However, if your urine does become dark, discuss it with your doctor.

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Constipation (mild)

decreased sweating

dizziness

drowsiness

dryness of mouth

nasal congestion

Less common

Changes in menstrual period

decreased sexual ability

increased sensitivity of eyes to light

rough or “fuzzy” tongue

secretion of milk (unusual)

swelling or pain in breasts

watering of mouth

weight gain (unusual)

After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this time, check with your doctor if you notice dizziness, nausea and vomiting, stomach pain, trembling of the fingers and hands, or any of the following signs of tardive dyskinesia or tardive dystonia:

Inability to move eyes

lip smacking or puckering

muscle spasms of face, neck, body, arms, or legs, causing unusual body positions or unusual expressions on face

puffing of cheeks

rapid or worm-like movements of tongue

sticking out of tongue

tic-like or twitching movements

trouble in breathing, speaking, or swallowing

uncontrolled chewing movements

uncontrolled twisting or other movements of neck, trunk, arms, or legs

Although not all of the side effects listed above have been reported for all of the phenothiazines, they have been reported for at least one of them. However, since all of the phenothiazines are very similar, any of the above side effects may occur with any of these medicines.

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Pros and cons of Perphenazine

Pros

  • Taken by mouth
  • Less likely to cause weight gain than some other antipsychotic medications
  • An option for severe nausea and vomiting

Cons

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Pharmacist tips for Perphenazine

pharmacist
  • It's best to avoid alcohol while you're taking perphenazine. Drinking alcohol can worsen sleepiness and dizziness, which can raise the risk for falls. Doing so can also worsen mood-related side effects.
  • Perphenazine can cause a drop in blood pressure when moving positions, such as from sitting to standing. This is more common when starting treatment and when your dose changes. Make sure to get up slowly and try to hold onto something for stability. If you end up falling or hitting your head, seek medical help right away.
  • Although rare, perphenazine can cause difficulty swallowing, which can raise the risk for choking. Make sure to take small bites of food and eat slowly to lower your risk for choking.
  • Let your healthcare team know right away if you experience uncontrolled body movements, including fidgeting, lip-smacking, or tremors. These side effects can happen if your dose of perphenazine is too high. Your care team can help ease these symptoms by lowering your dose or by prescribing a medication called benztropine. If needed, they might ask you to stop taking perphenazine and consider other treatment options.
  • If you've taken perphenazine for a long time, don't stop taking it suddenly without talking to your prescriber first. Doing so might result in serious withdrawal symptoms, such as nausea, headache, anxiety. If you want to stop treatment, your psychiatrist can help you do so safely by lowering your dose slowly over time.
  • Let your prescriber know right away if you're pregnant or thinking of becoming pregnant. They'll discuss with you the risks and benefits of taking perphenazine during pregnancy.
faq-icon

Common questions about Perphenazine

No, perphenazine isn't a benzodiazepine. Instead, it's a typical antipsychotic.

Perphenazine isn't FDA-approved to treat anxiety. But there's a combination medication that contains both perphenazine and amitriptyline that's approved to treat moderate-to-severe anxiety and depression. Talk to your psychiatrist if you're experiencing anxiety symptoms. They can talk with you about possible treatment options.

No, perphenazine isn't a controlled substance because it isn't known to carry a risk of addiction or dependence.

Based on a study of people who took perphenazine long-term to treat schizophrenia, some of the more common side effects reported included sleepiness and trouble sleeping, lowered sex drive, and movement-related side effects. Talk to your psychiatrist if you have more questions on these or other possible side effects of perphenazine.

Studies show that people who took perphenazine for schizophrenia have reported both weight gain and weight loss. And perphenazine is less likely to cause weight gain compared to certain antipsychotic medications, such as olanzapine (Zyprexa) and quetiapine (Seroquel). If you're concerned about the risk of weight gain while taking perphenazine, talk with your healthcare team. They can recommend ways to maintain a healthy body weight while taking this medication, such as planning balanced and nutritious meals with ingredients, such as lean proteins, whole-grains, fruits, and vegetables. They can also help build a regular exercise routine that's appropriate for you.

Yes, perphenazine can make you sleepy. This side effect tends to be most common within the first 2 weeks of starting the medication, but should go away with time. On the other hand, some people also experience insomnia from taking perphenazine, which can make you feel sleepy the next day. Don't drive or do anything that requires concentration until you know how the medication affects you. Also, don't drink alcohol because doing so can make you more sleepy. If perphenazine is making you too sleepy throughout the day, contact your healthcare team.

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Risks and warnings for Perphenazine

Perphenazine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Higher risk of death in older people with dementia-related psychosis

  • Risk factors: Age 65 and older with dementia and psychosis

Black Box Warning People 65 years and older with dementia sometimes have delusions and hallucinations (believing, seeing, or hearing things that aren't real). This is called dementia-related psychosis. Older people with dementia-related psychosis have a higher risk of death if they take medications like perphenazine. Because of this risk, perphenazine shouldn't be taken by people ages 65 years and older with dementia-related psychosis. Let your prescriber know if you or someone you know has dementia before starting perphenazine.

blank iconIn addition, older patients with dementia-related psychosis treated with some antipsychotics had a higher risk of stroke. Seek medical help immediately if you experience sudden numbness in your face, arms, or legs (especially on one side of your body), or if you have sudden trouble speaking, seeing, walking, or understanding people.

Difficulty controlling body movements

  • Risk factors: Taking other antipsychotic medications | Older age | Female sex | High dose | Taking perphenazine for a long period of time | Parkinson's disease | Lewy body dementia

Antipsychotic medications like perphenazine can cause uncontrolled body movements, such as eye-twitching or lip-smacking. Your risk of this happening is more likely the longer you take medications like perphenazine and if you're taking a higher dose. If you have Parkinson's disease or certain types of dementia, your risk is higher and you shouldn't take perphenazine. These movement problems can become permanent. If you experience any uncontrolled movements and aren't able to stop them, talk to your prescriber right away.

Neuroleptic malignant syndrome (NMS)

  • Risk factors: Taking antipsychotic medications

Taking antipsychotic medications like perphenazine can cause a rare, but life-threatening condition called neuroleptic malignant syndrome (NMS). Symptoms include fever, sweating, stiff muscles, confusion, not aware of your surroundings, and fast or irregular heartbeat. If you experience any of these symptoms while taking perphenazine, seek medication attention as soon as possible. You prescriber will likely have you stop taking perphenazine and switch you to something else.

Higher risk of falls

  • Risk factors: Low blood pressure | Taking medications that lower blood pressure | History of medical conditions that can lower blood pressure | High perphenazine doses | Liver or kidney problems | 65 years or older

Perphenazine can make you tired, lower your blood pressure, or cause you to lose your balance, which can lead to falls. When standing from a sitting or lying position, make sure to get up slowly and hold onto something.

Lower white blood cell counts

  • Risk factors: History of low blood cell counts

Though not common, perphenazine can lower your white blood cell (WBC) counts, especially if you already have low WBC levels from other medical conditions. This can raise your risk of serious infection. You'll need to get blood tests done regularly during the first few months of taking perphenazine so your prescriber can make sure your blood cell counts are in the normal range. If your WBC levels drop too low, you'll likely need to stop taking perphenazine. If you develop any signs of infection, such as fever, tiredness, chills, cough, or trouble breathing, and they don't go away, contact your prescriber right away.

Harm to unborn babies

Perphenazine should only be taken in pregnancy if the benefits outweigh the potential risks to your unborn baby. Newborn babies exposed to perphenazine during the third trimester of pregnancy are at a higher risk for side effects and withdrawal symptoms following delivery. Let your care team know if you're pregnant or plan to become pregnant while taking perphenazine.

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Perphenazine dosage

The average cost for 90 tablets of 4mg of Perphenazine is $25.90 with a free GoodRx coupon. This is 83.80% off the average retail price of $159.86.
tabletTablet
DosageQuantityPrice as low asPrice per unit
4mg90 tablets$25.90$0.29
8mg60 tablets$23.75$0.40
2mg90 tablets$27.59$0.31
16mg60 tablets$35.26$0.59

Typical dosage for Perphenazine

  • Schizophrenia: The typical starting dose ranges from 4 mg to 8 mg by mouth three times a day. People who are hospitalized for schizophrenia typically start at 8 mg to 16 mg by mouth two to four times per day. Your prescriber will adjust the dose to the lowest dose needed to treat your symptoms.
  • Nausea and vomiting: The typical dose is 8 mg to 16 mg by mouth per day, split up and taken as smaller doses throughout the day.
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Interactions between Perphenazine and other drugs

Perphenazine may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Perphenazine. Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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Perphenazine contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Perphenazine will not be safe for you to take.

  • Coma
  • Take large doses of sedating medications (e.g., sleep medications, opioid pain medications)
  • Drinking large amounts of alcohol
  • Current blood conditions, bone marrow problems, or liver damage
  • Certain cases of suspected or known brain damage
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What are alternatives to Perphenazine?

There are a number of medications that your doctor can prescribe in place of Perphenazine. Compare a few possible alternatives below.
Perphenazine
Used for:
$23.75Lowest GoodRx priceView prices
Used for:
  • Psychotic and behavioral disorders
  • Tourette syndrome in adults and children
  • Hyperactivity in children
$7.48Lowest GoodRx priceView prices
Used for:
  • Management of psychotic disorders
  • Schizophrenia
  • Nausea and vomiting
  • Restlessness and anxiety before surgery
  • Acute intermittent porphyria
  • Tetanus
  • Manic episodes of bipolar disorder
  • Hiccups that won't go away
  • Severe behavioral issues in children 1 to 12 years old (e.g., aggressive behavior, frustration, explosive or hyperexcitable behavior)
$31.03Lowest GoodRx priceView prices
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Perphenazine images

White Round A And 281 - Perphenazine 4mg Tablet
This medicine is White, Round Tablet Imprinted With "281" And "A".White Round A And 281 - Perphenazine 4mg Tablet
Gray Round V And 4941 - Perphenazine 4mg Tablet
This medicine is Gray, Round Tablet Imprinted With "V" And "4941".Gray Round V And 4941 - Perphenazine 4mg Tablet
White Round Ac393 - Perphenazine 4mg Tablet
This medicine is White, Round Tablet Imprinted With "Ac393".White Round Ac393 - Perphenazine 4mg Tablet
White Round Ac393 - Perphenazine 4mg Tablet
This medicine is White, Round Tablet Imprinted With "Ac393".White Round Ac393 - Perphenazine 4mg Tablet
White Round 592 - Perphenazine 4mg Tablet
This medicine is White, Round Tablet Imprinted With "592".White Round 592 - Perphenazine 4mg Tablet

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References

Best studies we found

Brandt, L., et al. (2020). Antipsychotic withdrawal symptoms: A systematic review and meta-analysis. Frontiers in Psychiatry.

Hermes, E., et al. (2011). The association between weight change and symptom reduction in the CATIE schizophrenia trial. Schizophrenia Research.

Lieberman, J. A., et al. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. The New England Journal of Medicine.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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