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What is the most important information I should know about amitriptyline and perphenazine?

Do not use this medication if you are allergic to amitriptyline (Elavil) or perphenazine (Trilafon), or if you have liver disease, a weak immune system, a blood cell disorder (such as anemia), or if you have recently had a heart attack. Do not use amitriptyline and perphenazine if you have taken an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Do not drink alcohol while taking amitriptyline and perphenazine. Perphenazine can increase the effects of alcohol.

What is amitriptyline and perphenazine?

Amitriptyline is in a group of drugs called tricyclic antidepressants. Amitriptyline affects chemicals in the brain that may become unbalanced.

Perphenazine is in a group of drugs called phenothiazines (feen-oh-THYE-a-zeens). Perphenazine affects chemicals in the brain that may become unbalanced and cause anxiety.

The combination of amitriptyline and perphenazine is used to treat depression, anxiety, and agitation.

Amitriptyline and perphenazine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking amitriptyline and perphenazine?

Do not use this medication if you are allergic to amitriptyline (Elavil) or perphenazine (Trilafon), or if you have:

• liver damage;

• a blood cell disorder (such as anemia);

• a weak immune system (bone marrow depression); or

• if you have recently had a heart attack.

Do not use amitriptyline and perphenazine if you have taken an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take amitriptyline and perphenazine before the MAO inhibitor has cleared from your body.

Before taking amitriptyline and perphenazine, tell your doctor if you are allergic to any drugs, or if you have:

• kidney or liver disease;

• heart disease, or a history of heart attack or stroke;

• adrenal gland tumor (pheochromocytoma);

• epilepsy or other seizure disorder;

• a thyroid disorder;

• asthma, emphysema, or other breathing disorder;

• glaucoma;

• problems with urination;

• bipolar disorder (manic-depression), schizophrenia or other mental illness;

• history of drug or alcohol addiction;

• history of suicidal thoughts or behavior; or

• history of breast cancer.

If you have any of these conditions, you may not be able to use amitriptyline and perphenazine, or you may need a dosage adjustment or special tests during treatment.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Amitriptyline and perphenazine may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to anyone under 18 years old without the advice of a doctor.