Drug interactions
Lithium + Perphenazine
Severity: Moderate
Lithium 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
Lithium with a phenothiazine like perphenazine can cause neurotoxicity, including confusion, tremor and extrapyramidal signs, sometimes at therapeutic lithium levels. Neuroleptic malignant syndrome is a rare but serious risk.
What this interaction means in plain words
Lithium 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.
Lithium belongs to Central Nervous System; Perphenazine belongs to Central Nervous System.
Why it happens
Additive dopamine blockade and CNS toxicity; the exact mechanism is not fully established.
What to do
Use the lowest effective doses and monitor lithium levels and neurological status. Discontinue both drugs and give supportive care if fever, rigidity or marked confusion occurs.
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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
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 Lithium with Perphenazine?
MediHelp rates the interaction as moderate. Lithium 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. Lithium with a phenothiazine like perphenazine can cause neurotoxicity, including confusion, tremor and extrapyramidal signs, sometimes at therapeutic lithium levels. Neuroleptic malignant syndrome is a rare but serious risk.
How serious is the interaction between Lithium 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: Use the lowest effective doses and monitor lithium levels and neurological status. Discontinue both drugs and give supportive care if fever, rigidity or marked confusion occurs.
What other medicines interact with Lithium?
MediHelp also lists interactions of Lithium with, for example, Thioridazine, Vandetanib, Aceclofenac. The full list is on the Lithium page.
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