Drug interactions
Epinephrine racemic + Perphenazine
Severity: Moderate
Epinephrine racemic and Perphenazine: moderate 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
Phenothiazines such as perphenazine block alpha-adrenergic receptors, so the vasoconstrictor effect of epinephrine may be blunted and unopposed beta-mediated vasodilation can cause hypotension. Both agents can also be proarrhythmic, adding to the risk of QT prolongation and ventricular arrhythmias.
What this interaction means in plain words
Epinephrine racemic and Perphenazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Alpha-adrenergic blockade by perphenazine opposes epinephrine pressor effects, with additive proarrhythmic and QT effects.
What to do
Monitor blood pressure and ECG when epinephrine is given to a patient on perphenazine, and use the lowest effective epinephrine dose. In hypotension, prefer a pure alpha agonist such as norepinephrine or phenylephrine over further epinephrine.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Frequently asked questions
Can I take Epinephrine racemic with Perphenazine?
MediHelp rates the interaction as moderate. Epinephrine racemic and Perphenazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Phenothiazines such as perphenazine block alpha-adrenergic receptors, so the vasoconstrictor effect of epinephrine may be blunted and unopposed beta-mediated vasodilation can cause hypotension. Both agents can also be proarrhythmic, adding to the risk of QT prolongation and ventricular arrhythmias.
How serious is the interaction between Epinephrine racemic and Perphenazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and ECG when epinephrine is given to a patient on perphenazine, and use the lowest effective epinephrine dose. In hypotension, prefer a pure alpha agonist such as norepinephrine or phenylephrine over further epinephrine.
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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