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Antipsychotic

Perphenazine is an antipsychotic medication used to treat schizophrenia and to help control severe nausea and vomiting in adults. It works by affecting the central nervous system, specifically targeting dopamine receptors, though its exact way of working is not fully understood.

How it worksPerphenazine acts as a dopamine D2 receptor antagonist, meaning it blocks certain dopamine receptors in the brain to help manage symptoms.

Brand names:TRILAFON

Used for
SchizophreniaSevere nausea and vomiting in adults
Conditions
SchizophreniaNauseaVomiting
Class
AntipsychoticPhenothiazineCentral Nervous SystemGastrointestinal

How to take

FormsOral tablets, Concentrate
RoutesOral

Dosage must be customized by a doctor based on how severe the condition is and how the patient responds. For schizophrenia, doses vary depending on whether the patient is in a hospital or at home. For nausea and vomiting, the typical daily dose is between 8 to 16 mg, though sometimes 24 mg may be needed.

The best dose is the lowest amount that works for the patient. Using high doses for a long time should generally be limited to patients in a hospital setting under close observation.

Key warnings

Elderly patients with dementia-related psychosis who take antipsychotic drugs like perphenazine have an increased risk of death, often due to heart failure or infections like pneumonia.

  • ·Elderly patients with dementia-related psychosis who take antipsychotic drugs like perphenazine have an increased risk of death, often due to heart failure or infections like pneumonia.
  • ·Perphenazine can cause tardive dyskinesia, which involves permanent, uncontrollable muscle movements.
  • ·Patients with suspected brain damage may experience dangerously high body temperatures.
  • ·High doses increase the risk of movement-related side effects like tremors or muscle stiffness.

Do not use if

  • ·Patients in a coma or very drowsy state
  • ·People taking large amounts of central nervous system depressants like alcohol or narcotics
  • ·People with existing blood, bone marrow, or liver problems
  • ·People with known allergies to perphenazine or related drugs
  • ·People with suspected subcortical brain damage

Side effects

Common

Muscle stiffness or involuntary movements (extrapyramidal symptoms)RestlessnessDrowsinessDizzinessDry mouthBlurred vision

Serious

  • ·Tardive dyskinesia (permanent, involuntary muscle movements)
  • ·Severe muscle spasms (dystonia)
  • ·High fever and confusion (especially in those with brain damage)
  • ·Blood or liver problems
  • ·Increased risk of death in elderly patients with dementia-related psychosis

Seek help if

  • ·Muscle spasms
  • ·High fever
  • ·Involuntary movements
  • ·Difficulty breathing

Interactions

  • ·Alcohol and other sleep-inducing drugs (sedatives, narcotics, antihistamines)
  • ·Tricyclic antidepressants
  • ·Selective serotonin reuptake inhibitors (SSRIs)
  • ·Certain drugs that affect liver enzymes (CYP 2D6), which can increase the levels of perphenazine in your body
AlcoholAvoid alcohol and other depressants, as they can cause dangerous levels of drowsiness when combined with perphenazine.

Special populations

PregnancyPerphenazine should only be used during pregnancy if the benefits outweigh the risks to the baby. Babies born to mothers who took antipsychotics in their third trimester may experience tremors, breathing issues, or difficulty feeding.

PediatricPerphenazine has not been shown to be effective for managing behavioral issues in people with mental retardation.

GeriatricElderly patients are more sensitive to this drug and may have higher levels of it in their blood. Doctors should start with low doses because older adults often have decreased liver function or other health conditions.

Talk to your doctor

Monitor

  • ·Involuntary muscle movements
  • ·Body temperature
  • ·Signs of liver or blood problems
  • ·Changes in mental status

Questions to ask

  • ·What is the lowest effective dose for my condition?
  • ·How will this interact with my current medications?
  • ·Am I at risk for movement side effects like tardive dyskinesia?
  • ·Should I be screened for P450 2D6 enzyme activity?

Pharmacokinetics

OnsetPeak plasma concentrations observed between 1 to 3 hours
Half-life9 to 12 hours
DurationSteady-state reached within 72 hours
MetabolismExtensively metabolized in the liver via cytochrome P450 2D6 (CYP 2D6)

Practical

OverdoseIf an overdose is suspected, seek emergency medical help immediately. Overdoses can cause severe muscle movements, stupor, or coma, and death can occur with large amounts.

StorageStore between 68° to 77°F in a tight, light-resistant container.

Ingredients

Allergens

lactose

Inactive

black iron oxidelactose monohydratemagnesium stearatemicrocrystalline cellulosepolyethylene glycolpolyvinyl alcoholsodium starch glycolatetalctitanium dioxideyellow iron oxide

Educational summary derived from FDA labeling, AI-assisted. Not medical advice — consult a healthcare professional. Updated 2026-04-25.