Perphenazine
ATC code N05AB03
Also known as: Perphenazin, Perfenazin
- Key facts
- Active substance
- Perphenazine
- Drug class
- Antipsychotics
- ATC code
- N05AB03
- Authorisation
- authorised nationally; no central EU authorisation
- Information as of
- 2026-10-29
Boxed warning
Increased Mortality in Elderly Patients with Dementia-Related Psychosis:
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10- week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Perphenazine is not approved for the treatment of patients with dementia-related psychosis (see WARNINGS).
Key facts
Perphenazine is a piperazine phenothiazine antipsychotic. Per the US prescribing information, it is used to treat schizophrenia and to control severe nausea and vomiting in adults.
What it is used for
- Schizophrenia
- Severe nausea and vomiting in adults
- Not approved for dementia-related psychosis; not shown effective for behavioral complications in mental retardation
Dosing
- Individualize; use the lowest effective dose, as extrapyramidal symptoms increase with dose
- Non-hospitalized patients with schizophrenia: 4 to 8 mg three times daily initially, reduced as soon as possible
- Hospitalized patients with schizophrenia: 8 to 16 mg two to four times daily; avoid more than 64 mg daily
- Severe nausea and vomiting: 8 to 16 mg daily in divided doses, occasionally 24 mg; reduce early
- Prolonged doses above 24 mg daily only for hospitalized or closely observed patients; elderly patients: lower starting doses
Contraindications
- Comatose or greatly obtunded patients; large doses of CNS depressants (barbiturates, alcohol, narcotics, analgesics, antihistamines)
- Blood dyscrasias, bone marrow depression or liver damage
- Hypersensitivity to perphenazine or related compounds
- Suspected or established subcortical brain damage (risk of hyperthermic reaction)
Important warnings
- Boxed warning: increased mortality in elderly patients with dementia-related psychosis
- Tardive dyskinesia, potentially irreversible; older patients are at increased risk
- Neuroleptic malignant syndrome, potentially fatal
- Leukopenia, neutropenia and agranulocytosis
- Seizures in patients with EEG abnormalities; avoid undue sun exposure
Side effects
- Extrapyramidal reactions (dystonia, akathisia, parkinsonism, dyskinesia), more common with the piperazine group and increasing with dose
- Drowsiness, particularly in the first or second week
- Less frequent: sedation, jaundice, blood dyscrasias
- Serious: tardive dyskinesia, neuroleptic malignant syndrome
Interactions
- Drugs metabolized by or inhibiting CYP2D6 (antidepressants, other antipsychotics, beta blockers, antiarrhythmics): higher perphenazine levels; poor metabolizers have higher concentrations
- CNS depressants (barbiturates, alcohol, narcotics, analgesics, antihistamines): large doses are a contraindication
Pregnancy and breastfeeding
- Newborns exposed in the third trimester are at risk of extrapyramidal and/or withdrawal symptoms; benefits must be weighed against hazards
Summary of the official product information, written with AI on 2026-10-29. Every number was checked automatically against the original text. Not reviewed by a physician – the full official text is authoritative.
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For patients
Patient information (US)
This product has no separate US patient information.
Authorisation and brand names by country
Medicines with exactly this active-substance composition, as listed in the national registers – alphabetical and without ranking. Whether a product is currently available is not shown here.
Germany
- Perphenazin NeuraxpharmNeuraxpharm Arzneimittel Gmbh · 1 register entry
Source: EMA – Article 57 product data (EU/EEA), as of 2026-10-29
Brand names in 7 more European countries
- Denmark
- Trilafon Dekanoat
- Finland
- Peratsin
- Iceland
- Peratsin, Trilafon Dekanoat
- Italy
- Trilafon
- Norway
- Trilafon Dekanoat
- Spain
- Decentán
- Sweden
- Trilafon Dekanoat
EMA – Article 57 product data (EU/EEA), 2026-10-29
Medelix receives no money from pharmaceutical companies. Brand names are listed alphabetically and without ranking.
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Sources
- U.S. Food and Drug Administration. Perphenazine (Chartwell RX, LLC) – Prescribing Information, 2025-12-10. DailyMed (NLM), 2026-10-29. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ba5f3963-3080-48bc-806a-0aed72e2c25b
- EMA – Article 57 product data (EU/EEA), 2026-10-29. https://www.ema.europa.eu/en/human-regulatory-overview/post-authorisation/data-medicines-iso-idmp-standards-post-authorisation/public-data-article-57-database
- Wikidata (CC0): ATC N05AB.
Editorial: Medelix editorial team · last updated 2026-10-29 · How these pages are made · Report an error
Source: U.S. Food and Drug Administration (FDA), prescribing information, via DailyMed (NLM); public domain. Not advertising, not a treatment recommendation. For questions about your own treatment, ask your doctor or pharmacist.