Drug interactions
Dextromoramide + Perphenazine
Severity: Major
Dextromoramide and Perphenazine: major interaction.
Last updated Sources: Health Canada product monograph
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
Dextromoramide is a potent opioid, and combining it with sedating perphenazine increases the risk of profound sedation, respiratory depression and hypotension. The effect is greatest at treatment initiation or after dose increases.
What this interaction means in plain words
Dextromoramide 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.
Why it happens
Additive CNS and respiratory depression from opioid and phenothiazine.
What to do
Start with the lowest effective doses and monitor sedation and respiratory rate closely. Avoid alcohol and other CNS depressants.
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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References
Other interactions of Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Dextromoramide with Perphenazine?
MediHelp rates the interaction as major. Dextromoramide 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. Dextromoramide is a potent opioid, and combining it with sedating perphenazine increases the risk of profound sedation, respiratory depression and hypotension. The effect is greatest at treatment initiation or after dose increases.
How serious is the interaction between Dextromoramide 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: Start with the lowest effective doses and monitor sedation and respiratory rate closely. Avoid alcohol and other CNS depressants.
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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