Drug interactions
Perhexiline + Thioridazine
Severity: Major
Perhexiline and Thioridazine: 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
Perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic index. Thioridazine inhibits CYP2D6, which may raise perhexiline levels and increase the risk of hepatotoxicity and neuropathy, and both drugs can prolong QT.
What this interaction means in plain words
Perhexiline and Thioridazine 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
CYP2D6 inhibition by thioridazine reduces perhexiline clearance, with additive QT effects.
What to do
Avoid if possible; otherwise monitor perhexiline plasma concentrations and adjust the dose, with ECG and liver function monitoring.
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 Thioridazine
- Abiraterone + Thioridazine Contraindicated
- Adagrasib + Thioridazine Contraindicated
- Amiodarone + Thioridazine Contraindicated
- Amisulpride + Thioridazine Contraindicated
- Amitriptyline + Thioridazine Contraindicated
- Amoxapine + Thioridazine Contraindicated
Frequently asked questions
Can I take Perhexiline with Thioridazine?
MediHelp rates the interaction as major. Perhexiline and Thioridazine 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. Perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic index. Thioridazine inhibits CYP2D6, which may raise perhexiline levels and increase the risk of hepatotoxicity and neuropathy, and both drugs can prolong QT.
How serious is the interaction between Perhexiline and Thioridazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; otherwise monitor perhexiline plasma concentrations and adjust the dose, with ECG and liver function monitoring.
What other medicines interact with Thioridazine?
MediHelp also lists interactions of Thioridazine with, for example, Abiraterone, Adagrasib, Amiodarone. The full list is on the Thioridazine page.
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