Perphenazine; Amitriptyline tablets

What is this medicine?

PERPHENAZINE; AMITRIPTYLINE (per FEN a zeen; a mee TRIP ti leen) is used to treat depression that may be accompanied by anxiety or agitation. This medicine is also used to treat schizophrenia.

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take this medicine with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking this medicine suddenly except upon the advice of your doctor. Stopping this medicine too quickly may cause serious side effects or your condition may worsen.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• anxious

• breast enlargement in both males and females

• breathing problems

• changes in vision

• confusion

• elevated mood, decreased need for sleep, racing thoughts, impulsive behavior

• eye pain

• fast, irregular heartbeat

• feeling faint or lightheaded, falls

• feeling agitated, angry, or irritable

• fever or chills, sore throat

• hallucination, loss of contact with reality

• seizures

• signs and symptoms of high blood sugar such as being more thirsty or hungry or having to urinate more than normal. You may also feel very tired or have blurry vision.

• stiff muscles

• suicidal thoughts or other mood changes

• tingling, pain, or numbness in the feet or hands

• trouble passing urine or change in the amount of urine

• trouble sleeping

• uncontrollable head, mouth, neck, arm, or leg movements

• unusually weak or tired

• vomiting

• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• change in sex drive or performance

• change in appetite or weight

• constipation

• dizziness

• dry mouth

• menstrual changes

• nausea

• tired

• upset stomach

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• linezolid

• MAOIs like Carbex, Marplan, Nardil, Parnate, and Xadago

• methylene blue

• metoclopramide

This medicine may also interact with the following medications:

• alcohol

• antihistamines for allergy, cough, and cold

• atropine

• certain medicine for bladder problems like oxybutynin, tolterodine

• certain medicines for depression, anxiety, or psychotic disorders

• certain medicines for irregular heart beat like amiodarone, deftilide, encainide, flecainide, propafenone, quinidine

• certain medicines for sleep

• certain medicines for stomach problems like dicyclomine, hyoscyamine

• certain medicines for travel sickness like scopolamine

• cimetidine

• epinephrine

• ethchlorvynol

• general anesthetics like halothane, isoflurane, methoxyflurane, propofol

• ipratropium

• levodopa or other medicines for Parkinson's disease

• lithium

• medicines for blood pressure

• medicines for seizures like phenobarbital, primidone, phenytoin

• medicines that relax muscles for surgery

• narcotic medicines for pain

• topiramate

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Protect from light. Keep container tightly closed. Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• bipolar disorder

• blockage in your bowel

• dementia

• diabetes

• difficulty swallowing

• glaucoma

• have trouble controlling your muscles

• head injury

• heart disease

• if you often drink alcohol

• kidney disease

• liver disease

• low blood counts, like low white cell, platelet, or red cell counts

• low blood pressure

• lung or breathing disease, like asthma

• Parkinson's disease

• pheochromocytoma

• seizures

• suicidal thoughts, plans or attempt; a previous suicide attempt by you or a family member

• thyroid disease

• trouble passing urine

• an unusual or allergic reaction to amitriptyline, perphenazine, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your health care professional for regular checks on your progress. Tell your health care professional if symptoms do not start to get better or if they get worse. Do not stop taking except on your health care professional's advice. You may develop a severe reaction. Your health care professional will tell you how much medicine to take.

Patients and their families should watch out for new or worsening thoughts of suicide or depression. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects.

This medicine may increase blood sugar. Ask your health care provider if changes in diet or medicines are needed if you have diabetes.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.

This medicine can cause constipation. Try to have a bowel movement at least every 2 to 3 days. If you do not have a bowel movement for 3 days, call your doctor or health care professional.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

This drug can cause problems with controlling your body temperature. It can lower the response of your body to cold temperatures. If possible, stay indoors during cold weather. If you must go outdoors, wear warm clothes. It can also lower the response of your body to heat. Do not overheat. Do not over-exercise. Stay out of the sun when possible. If you must be in the sun, wear cool clothing. Drink plenty of water. If you have trouble controlling your body temperature, call your health care provider right away.

If you are going to have surgery, tell your doctor or health care professional that you are taking this medicine.