Generic Name: amitriptyline and perphenazine (a mee TRIP ti leen and per FEN a zeen)Brand Names: Etrafon 2-10, Etrafon 2-25, Etrafon Forte
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 is the most important information I should know about Etrafon Forte (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 should I discuss with my healthcare provider before taking Etrafon Forte (amitriptyline and perphenazine)?Do not use this medication if you are allergic to amitriptyline (Elavil) or perphenazine (Trilafon), or if you have:
a blood cell disorder (such as anemia);
a weak immune system (bone marrow depression); or
if you have recently had a heart attack.
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;
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.
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.It may take a few weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.
To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney and liver function may also need to be tested. Do not miss any scheduled appointments.
If you need to have any type of surgery, tell the surgeon ahead of time that you are taking amitriptyline and perphenazine. You may need to stop using the medicine for a short time.Do not stop using amitriptyline and perphenazine suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. Store amitriptyline and perphenazine at room temperature away from moisture and heat.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Overdose symptoms of an overdose may include uneven heartbeats, extreme drowsiness, confusion, agitation, hallucinations, vomiting, feeling hot or cold, sweating, muscle stiffness, feeling light-headed, fainting, seizure (convulsions), or coma.What should I avoid while taking Etrafon Forte (amitriptyline and perphenazine)?Do not drink alcohol while taking amitriptyline and perphenazine. This medication can increase the effects of alcohol. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by amitriptyline and perphenazine. Tell your doctor if you need to use any of these other medicines together with amitriptyline and perphenazine. Amitriptyline and perphenazine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Perphenazine can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.
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.Call your doctor at once if you have any of these serious side effects:
restless muscle movements in your eyes, tongue, jaw, or neck;
tremor (uncontrolled shaking);
fever, stiff muscles, confusion, sweating, fast or uneven heartbeats;
feeling like you might pass out;
problems with urination;
fast, or slow heart rate, chest pain or heavy feeling;
easy bruising or bleeding;
jaundice (yellowing of your skin or eyes); or
urinating less than usual or not at all.
Less serious side effects may include:
feeling dizzy, drowsy, or tired;
strange dreams or nightmares;
sleep problems (insomnia);
dry mouth, loss of appetite;
nausea, vomiting, diarrhea, constipation;
breast changes; or
decreased sex drive, impotence, or difficulty having an orgasm.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Before taking amitriptyline and perphenazine, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).
The following drugs can interact with amitriptyline and perphenazine. Tell your doctor if you are using any of these:
atropine (Atreza, Sal-Tropine, and others);
guanethidine (Ismelin); or
a heart rhythm medicine such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Quinidex, Quinaglute).
This list is not complete and there may be other drugs that can interact with amitriptyline and perphenazine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.