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This medication carries several important safety considerations that need to be taken into account before use. Please review the following points and discuss any concerns with your healthcare provider.

• Increased Risk in Older Adults with Dementia: There is a heightened risk of serious side effects, including heart failure, irregular heartbeat, and pneumonia, which may be fatal when this medication is used by older adults with dementia. It is not approved for managing dementia-related behavior problems. Please consult your doctor to weigh the risks and benefits and explore alternative treatments.

• Dementia-Related Psychosis Risks: Individuals aged 65 and older with dementia-related psychosis face an increased risk of death when taking medications like perphenazine. This medication should not be used by this population. Inform your healthcare provider if you or someone you know has dementia before starting treatment.

• Movement Disorders: Perphenazine can cause uncontrolled movements, such as eye twitching or lip-smacking. The risk increases with prolonged use or higher doses and is especially concerning for those with Parkinson’s disease or certain dementias. If you experience such symptoms, contact your healthcare provider immediately.

• Neuroleptic Malignant Syndrome (NMS): This rare, but serious condition may occur with antipsychotic medications. Symptoms include fever, muscle stiffness, confusion, and abnormal heart rhythms. Seek immediate medical attention if these symptoms appear.

• Fall Risk: This medication may lead to tiredness, lower blood pressure, or balance issues, increasing the risk of falls. Stand up slowly from sitting or lying positions and ensure stability.

• White Blood Cell Count: Perphenazine can occasionally reduce white blood cell counts, raising the risk of infections. Regular blood tests are necessary to monitor this. Contact your healthcare provider if you notice signs of infection, such as fever or persistent cough.

• Pregnancy Considerations: Perphenazine should only be used during pregnancy if the benefits justify the potential risks to the unborn child. Inform your care team if you are pregnant or planning to become pregnant.

Contraindications: This medication should not be used in the following conditions:

• Coma
• Large doses of sedatives or opioid medications
• Excessive alcohol consumption
• Existing blood disorders, bone marrow issues, or liver damage
• Suspected or confirmed brain injuries

Ensure you discuss these points with your healthcare provider to determine whether this medication is right for you.

Common side effects:

• Drowsiness
• Trouble sleeping
• Dry mouth
• Constipation
• Dizziness
• Blurred vision
• Weight changes
• Sexual side effects

Less common but important to monitor:

• Lightheadedness
• Muscle spasms
• Unusual body movements
• Changes in breast milk production
• Skin rashes
• Itchiness
• Changes in skin color
• Urinating more at night
• Changes in menstrual bleeding
• Decreased sexual ability
• Enlarged breasts

Serious side effects:

• Tardive dyskinesia
• Neuroleptic malignant syndrome
• Infections with fever, lightheadedness, or pale skin
• Seizures
• Suicidal thoughts
• Allergic reaction with rash, swelling, severe dizziness, or trouble breathing

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Opioid pain or cough relievers (such as codeine, hydrocodone)
• Alcohol
• Marijuana (cannabis)
• Drugs for sleep or anxiety (such as Alprazolam, Lorazepam, Zolpidem)
• Muscle relaxants (such as Carisoprodol, Cyclobenzaprine)
• Antihistamines (such as Cetirizine, diphenhydramine)