Amitriptyline  and Perphenazine Precautions 

USES: This combination medication is used to treat depression, anxiety  and agitation. The  amitriptyline component is an antidepressant which elevates depressed moods. Perphenazine relieves anxiety  and agitation. 

HOW TO USE:  Take this as prescribed. Try to take each dose at the same time(s) each day so you remember to routinely take it. Keep all appointments with  your doctor. Your dose of this medication may be changed a few times at first to find  the best dose  for you. 

SIDE EFFECTS:  May cause drowsiness, dizziness, increased sun sensitivity or blurred vision. May initially cause dizziness and lightheadedness when rising too quickly from a sitting or lying position. Other side effects include heartburn, increased appetite, dry mouth, strange taste in mouth, anxiety, restlessness or sweating. If these effects persist or worsen, notify your doctor promptly. Notify  your doctor promptly if you develop: chest pain, a rapid  or irregular heartbeat,  difficulty urinating, nightmares, excessive drowsiness, tremor, uncontrollable movements of the mouth/tongue/face, muscle stiffness  or weakness in the arms  or legs, fainting, uncoordinated movements, ringing in the ears, confusion. In the unlikely event  you have an allergic reaction  to this drug, seek medical attention immediately. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing.  If you notice other effects not listed above, contact  your doctor or pharmacist. 

PRECAUTIONS: Before using this drug  tell your doctor your medical history, especially of: glaucoma, prostate problems, decreased urine output, thyroid disease, breathing problems, seizure problems, alcohol use, heart disease, mental/emotional problems, liver  or kidney disease, drug allergies. This medication can increase sensitivity to sunlight. Avoid prolonged sun exposure. Wear a sunscreen  and protective clothing. Limit alcohol while using  this drug to avoid excessive drowsiness. Caution is advised when performing tasks requiring alertness (e.g., driving). Though uncommon, depression itself can lead to thoughts  or attempts of suicide. Tell your doctor immediately if  you have any suicidal thoughts or other mental/mood changes. Keep all medical appointments so your doctor can monitor your progress closely. Caution is advised when using  this drug in the elderly because they may be more sensitive  to the side effects of the drug. This drug should be used during pregnancy only if clearly needed. Discuss the risks and benefits with your doctor. This drug is excreted into breast milk and may have an effect on a nursing infant. Consult your doctor before breast-feeding. 

DRUG INTERACTIONS:  Tell  your doctor of all the medicines  you use (both prescription and nonprescription), especially of: thyroid medication, other antidepressants or tranquilizers (including SSRI's such as fluoxetine, fluvoxamine), clonidine-like drugs, MAO inhibitors (e.g., furazolidone, linezolid, moclobemide, phenelzine, selegiline, tranylcypromine), cimetidine, drugs to treat Parkinsonism (levodopa), narcotic pain medications (e.g., codeine), St John's wort. Do not start or stop any medicine without doctor or pharmacist approval. 

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents  should call their local poison control center directly. Symptoms of overdose may include: drowsiness, rapid pulse, dilated pupils, convulsions, lightheadedness, vomiting, muscle rigidity, and uncontrollable movements of the tongue/mouth/face. 

NOTES: It may take 2 to 3 weeks before the full effects of this medication are noticed. 

MISSED DOSE:  If you miss a dose,  take as soon as remembered; do not  take if it is almost time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do  not "double-up"  the dose to catch up.
STORAGE: Store at room temperature away from sunlight and moisture.