Drug interactions
Midodrine + Perphenazine
Severity: Moderate
Midodrine 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
Perphenazine has alpha-adrenergic blocking activity that can oppose the pressor effect of midodrine and cause orthostatic hypotension. Perphenazine can also affect cardiac repolarization, and midodrine can cause bradycardia, so the overall effect on the cardiovascular system is unpredictable.
What this interaction means in plain words
Midodrine 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.
Midodrine belongs to Miscellaneous; Perphenazine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism at alpha-1 adrenergic receptors, with possible additive cardiac effects.
What to do
Monitor supine and standing blood pressure and heart rate, adjusting the midodrine dose as needed. Review the need for perphenazine in patients with orthostatic hypotension.
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
Other interactions of Midodrine
- Isocarboxazid + Midodrine Contraindicated
- Midodrine + Phenelzine Contraindicated
- Midodrine + Tranylcypromine Contraindicated
- Dextroamphetamine + Midodrine Major
- Dihydroergotamine intranasal + Midodrine Major
- Dihydroergotamine + Midodrine Major
Frequently asked questions
Can I take Midodrine with Perphenazine?
MediHelp rates the interaction as moderate. Midodrine 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. Perphenazine has alpha-adrenergic blocking activity that can oppose the pressor effect of midodrine and cause orthostatic hypotension. Perphenazine can also affect cardiac repolarization, and midodrine can cause bradycardia, so the overall effect on the cardiovascular system is unpredictable.
How serious is the interaction between Midodrine 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 supine and standing blood pressure and heart rate, adjusting the midodrine dose as needed. Review the need for perphenazine in patients with orthostatic hypotension.
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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