Perphenazine and Amitriptyline (Oral Route)

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Side Effects

Along with its needed effects, perphenazine (included in this combination medicine) can sometimes cause serious side effects. Tardive dyskinesia (a movement disorder) may occur and may not go away after you stop using the medicine. Signs of tardive dyskinesia include fine, worm-like movements of the tongue, or other uncontrolled movements of the mouth, tongue, cheeks, jaw, or arms and legs. Other serious but rare side effects may also occur. These include severe muscle stiffness, fever, unusual tiredness or weakness, fast heartbeat, difficult breathing, increased sweating, loss of bladder control, and seizures (neuroleptic malignant syndrome). You and your doctor should discuss the good this medicine will do as well as the risks of taking it.

Stop taking this medicine and get emergency help immediately if any of the following effects occur:

• Convulsions (seizures)
• Difficulty in breathing
• Fast heartbeat
• Fever
• High or low blood pressure
• Increased sweating
• Loss of bladder control
• Muscle stiffness (severe)
• Unusual tiredness or weakness
• Unusually pale skin

Check with your doctor as soon as possible if any of the following side effects occur:

• Blurred vision or any change in vision
• Difficulty in speaking or swallowing
• Fainting
• Inability to move eyes
• Lip smacking or puckering
• Loss of balance control
• Mask-like face
• Muscle spasms, especially of face, neck, and back
• Nervousness, restlessness, or need to keep moving
• Puffing of cheeks
• Rapid or fine, worm-like movements of tongue
• Shuffling walk
• Stiffness of arms and legs
• Trembling and shaking of fingers and hands
• Tic-like or twitching movements
• Twisting movements of body
• Uncontrolled chewing movements
• Uncontrolled movements of arms or legs
• Weakness of arms and legs

• Confusion
• Constipation
• Difficult urination
• Eye pain
• Hallucinations (seeing, hearing, or feeling things that are not there)
• Increased skin sensitivity to sun
• Shakiness
• Slow pulse or irregular heartbeat

• Abdominal or stomach pain
• Aching muscles or joints
• Back or leg pain
• Fever and chills
• Hair loss
• Hot, dry skin or lack of sweating
• Irritability
• Loss of appetite
• Muscle weakness or twitching
• Nausea, vomiting, or diarrhea
• Nosebleeds
• Prolonged, painful, inappropriate penile erection
• Ringing, buzzing, or other unexplained noises in ears
• Skin discoloration
• Skin rash and itching
• Sore throat and fever
• Swelling of face and tongue
• Swelling of testicles
• Unusual bleeding or bruising
• Yellow eyes or skin

• Agitation
• Confusion
• Convulsions (seizures)
• Drowsiness (severe)
• Enlarged pupils
• Fast, slow, or irregular heartbeat
• Fever
• Hallucinations (seeing, hearing, or feeling things that are not there)
• Shortness of breath or troubled breathing
• Unusual tiredness or weakness (severe)
• Vomiting (severe)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Decreased sweating
• Dizziness
• Drowsiness
• Dryness of mouth
• Headache
• Increased appetite for sweets
• Nasal congestion
• Tiredness or weakness (mild)
• Unpleasant taste
• Weight gain (unusual)

• Changes in menstrual period
• Decreased sexual ability
• Heartburn
• Increased sweating
• Swelling or pain in breasts or unusual secretion of milk

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

• Dizziness
• Nausea or vomiting
• Stomach pain
• Trembling of fingers and hands
• Symptoms of tardive dyskinesia, including lip smacking or puckering, puffing of cheeks, rapid or fine, worm-like movements of tongue, uncontrolled chewing movements, or uncontrolled movements of arms or legs

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

• Diarrhea
• Headache
• Irritability
• Restlessness
• Trouble in sleeping, with vivid dreams
• Unusual excitement

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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