Drug interactions
Deutetrabenazine + Perphenazine
Severity: Major
Deutetrabenazine and Perphenazine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Deutetrabenazine depletes monoamines, and combining it with a dopamine antagonist increases the risk of parkinsonism, akathisia, neuroleptic malignant syndrome and sedation. Depression and QT effects may also be additive.
What this interaction means in plain words
Deutetrabenazine and Perphenazine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Deutetrabenazine belongs to Central Nervous System; Perphenazine belongs to Central Nervous System.
Why it happens
Additive dopaminergic antagonism and depletion (VMAT2 inhibition plus D2 blockade), with additive sedation and mild QT effects.
What to do
Monitor for extrapyramidal symptoms, akathisia, rigidity and fever, and use the lowest effective doses. Obtain an ECG when other QT-prolonging risks exist, and reduce or stop one drug if parkinsonism develops.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Other interactions of Deutetrabenazine
- Deutetrabenazine + Isocarboxazid Contraindicated
- Deutetrabenazine + Linezolid Contraindicated
- Deutetrabenazine + Phenelzine Contraindicated
- Deutetrabenazine + Rasagiline Contraindicated
- Deutetrabenazine + Safinamide Contraindicated
- Deutetrabenazine + Selegiline Contraindicated
Frequently asked questions
Can I take Deutetrabenazine with Perphenazine?
MediHelp rates the interaction as major. Deutetrabenazine and Perphenazine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Deutetrabenazine depletes monoamines, and combining it with a dopamine antagonist increases the risk of parkinsonism, akathisia, neuroleptic malignant syndrome and sedation. Depression and QT effects may also be additive.
How serious is the interaction between Deutetrabenazine and Perphenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for extrapyramidal symptoms, akathisia, rigidity and fever, and use the lowest effective doses. Obtain an ECG when other QT-prolonging risks exist, and reduce or stop one drug if parkinsonism develops.
What other medicines interact with Perphenazine?
MediHelp also lists interactions of Perphenazine with, for example, Ibutilide, Pimozide, Thioridazine. The full list is on the Perphenazine page.
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