Triavil 4-25Oral - Drug Information and Side Effects on Drug3k.com


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Overview

Photos

How To Use

Side Effects

Precautions

Missed Dose

Drug Interactions

Triavil 4-25

Uses
This medication is used to treat depression occurring with anxiety/agitation or with certain mental/mood disorders (e.g., schizophrenia). This medication is a combination of a tricyclic antidepressant (amitriptyline) and an antipsychotic medication (perphenazine). Together, they restore the balance of certain natural chemicals in the brain (neurotransmitters such as dopamine, norepinephrine, and serotonin). This medication helps you to have a better mood and sense of well-being, think more clearly, and feel less nervous, so that you can take part in everyday life.
Notes

Do not share this medication with others.Laboratory and/or medical tests (e.g., complete blood count, liver function, eye exams) should be performed periodically to monitor your progress or check for side effects.
Consult your doctor for more details.

Storage

Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture.
Do not store in the bathroom.
Keep all medicines away from children and pets.

Overdose

Symptoms of overdose may include: fast/irregular heartbeat, jerking movements, slow/shallow breathing, seizures, inability to wake up (coma).

How To Use

Read the Medication Guide provided by your pharmacist before you start using this medication and each time you get a refill.
If you have any questions, consult your doctor or pharmacist.Take this medication by mouth as directed by your doctor.
When you begin treatment, frequent visits to your doctor may be needed to find the best dose for you.
Keep all medical/lab appointments.Dosage is based on your medical condition and response to treatment.
Your doctor may direct you to take a low dose at first, gradually increasing the dose to lower the chance of side effects such as muscle spasms.
Follow your doctor's directions carefully.
The manufacturer recommends that you do not take more than 16 milligrams of perphenazine or 200 milligrams of amitriptyline per day.Use this medication regularly to get the most benefit from it.
To help you remember, take it at the same times each day.
Do not stop taking this medication without consulting your doctor.
Your condition may become worse when the drug is suddenly stopped.
Muscle aches, headaches, and worsening anxiety may also occur.
Your dose may need to be gradually decreased.Although you may notice some medication effects soon after starting, it may take as much as 4 to 6 weeks of regular use to see the full benefit.
Tell your doctor if your condition persists or worsens after this period (e.g., your feelings of sadness get worse, or you have thoughts of suicide).

Side Effects

See also Warning section.Drowsiness, tiredness, dizziness, blurred vision, dry mouth, nausea, vomiting, constipation, change in taste, loss of appetite, or unexplained weight gain/loss may occur.
If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To relieve dry mouth, suck on hard candy or ice chips, chew gum, drink water, or use a saliva substitute.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects.
Many people using this medication do not have serious side effects.The perphenazine in this medication may cause muscle/nervous system problems (extrapyramidal symptoms-EPS).
Your doctor may prescribe another medication to decrease these side effects.
Therefore, tell your doctor immediately if you notice any of the following side effects: increased anxiety, drooling/trouble swallowing, restlessness/constant need to move, shaking (tremor), shuffling walk, stiff muscles.Perphenazine may also cause a condition known as tardive dyskinesia.
In some cases, this condition may be permanent.
Tell your doctor immediately if you develop any involuntary/repetitive muscle movements such as lip smacking/puckering, tongue thrusting, chewing, or finger/toe movements.In rare cases, perphenazine may increase your level of a certain chemical made by the body (prolactin).
For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant.
For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts.
If you develop any of these symptoms, tell your doctor immediately.Perphenazine may rarely cause a serious (sometimes fatal) nervous system problem (neuroleptic malignant syndrome-NMS).
Seek immediate medical attention if you notice any of the following rare but very serious side effects: fever, stiff muscles, increased sweating, fast heartbeat, mental/mood changes, change in the amount of urine.Tell your doctor immediately if any of these unlikely but serious side effects occur: numbness/tingling of the hands/feet, ringing in the ears, black tongue, unusual hunger, fainting, persistent heartburn, mental/mood changes (e.g., confusion, restlessness, nervousness) loss of coordination, shaking, sweating, trouble urinating, increased thirst/urination, muscle weakness/spasms.Tell your doctor immediately if any of these rare but very serious side effects occur: seizures, easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), yellowing eyes/skin, severe stomach/abdominal pain, dark urine, persistent nausea/vomiting, pain/redness/swelling of arms or legs, weakness on one side of the body, slurred speech, vision changes, chest pain, severe muscle spasm/cramping (e.g., twisting neck, arching back, eyes rolling up), slow/fast/irregular heartbeat.A very serious allergic reaction to this drug is rare.
However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching, swelling, severe dizziness, trouble breathing.If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Before taking amitriptyline with perphenazine, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (e.g., nortriptyline); or to other phenothiazines (e.g., chlorpromazine, fluphenazine); or if you have any other allergies.This medication should not be used if you have certain medical conditions.
Before using this medicine, consult your doctor or pharmacist if you have: decreased bone marrow function, recent heart attack, serious head injury, severe liver problems, severe nervous system problems (e.g., coma, drug/alcohol overdose, shock), Parkinson's disease.Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal/family history of suicide attempts, personal/family history of bipolar disorder, alcohol/substance abuse, a certain severe reaction to other medications (neuroleptic malignant syndrome), low blood pressure, breast cancer, problems urinating (e.g., due to enlarged prostate, bladder problems), glaucoma (closed-angle), seizures, heart disease, fast/slow/irregular heartbeat, heart valve problems, a certain adrenal gland tumor (pheochromocytoma), restless legs syndrome, overactive thyroid (hyperthyroidism), breast cancer, liver disease, diabetes, eating disorders (e.g., bulimia), lung disease (e.g., asthma, emphysema, pulmonary insufficiency), conditions that may increase your risk of seizures (e.g., other brain disease, alcohol withdrawal).This drug may make you drowsy or dizzy or cause blurred vision.
Use caution while driving, using machinery, or doing any activity that requires alertness or clear vision.
Avoid alcoholic beverages.To reduce dizziness, get up slowly when rising from a sitting or lying position.This medication may make you more sensitive to the sun.
Avoid prolonged sun exposure, tanning booths, and sunlamps.
Use a sunscreen (SPF 30 or greater) and wear protective clothing when outdoors.Before having surgery, tell your doctor or dentist that you are taking this medication.Caution is advised during hot weather because the perphenazine in this product can reduce sweating, increasing your risk for a severe reaction to too much heat (heatstroke).
Drink plenty of fluids.
Avoid strenuous exercise in hot weather.
If you become overheated, promptly seek cooler shelter and/or stop exercising.
Seek immediate medical attention if your body temperature is above normal or if you have mental/mood changes, headache, or dizziness.Avoid exposure to certain chemicals used in gardening (organic phosphate insecticides).
Seek immediate medical attention if you are exposed to garden chemicals and have an unusual headache, heavy sweating, or difficulty breathing.If you have diabetes, this drug may increase your blood sugar levels.
Check your blood sugar levels regularly as directed by your doctor.
Tell your doctor immediately if you have symptoms such as increased thirst/urination, shakiness, unusual sweating, or hunger.
Your anti-diabetic medication or diet may need to be adjusted.Depression can lead to thoughts/attempts of suicide.
Tell your doctor immediately if you have any suicidal thoughts, worsening depression, or any other mental/mood changes (including new or worsening anxiety, agitation, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, rapid speech).
Keep all medical appointments so your doctor can monitor your progress closely and adjust your medication if needed.Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially dizziness, drowsiness, confusion, difficulty urinating, and muscle/nervous system problems such as extrapyramidal symptoms and tardive dyskinesia (see also Side Effects).During pregnancy, this medication should be used only when clearly needed.
Discuss the risks and benefits with your doctor.This drug may pass into breast milk and could have undesirable effects on a nursing infant.
Therefore, breast-feeding is not recommended while using this drug.
Consult your doctor before breast-feeding.

Missed Dose

If you miss a dose, take it as soon as you remember.
If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule.
Do not double the dose to catch up.

Drug Interactions

See also How to Use section.Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.
Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.This drug should not be used with the following medications because very serious interactions may occur: drugs with effects on dopamine (e.g., cabergoline, pergolide), lumefantrine, sibutramine, iomeprol, metrizamide.Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) within 2 weeks before, during, and after treatment with this medication.
In some cases a serious (possibly fatal) drug interaction may occur.If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting amitriptyline.Other drugs besides amitriptyline that may affect the heart rhythm (QT prolongation in the EKG) include pimozide, cisapride, halofantrine, disopyramide, grepafloxacin and sparfloxacin, among others.
Before using this drug, report all medications you are currently using to your doctor or pharmacist.
QT prolongation can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (e.g., severe dizziness, fainting) that require immediate medical attention.
Ask your doctor or pharmacist for more details and for instructions on how you may reduce the risk of this effect.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: anticholinergic medications (e.g., dicyclomine, scopolamine), certain antihypertensive medications (clonidine, guanadrel, guanethidine), "blood thinners" (e.g., warfarin), certain anti-HIV drugs (amprenavir, fosamprenavir, ritonavir), barbiturates (e.g., phenobarbital), disulfiram, drugs affecting liver enzymes that remove amitriptyline or perphenazine from your body (e.g., amiodarone, cimetidine, SSRI antidepressants including fluoxetine/paroxetine), drugs for heart rhythm (e.g., flecainide, propafenone, quinidine), drugs that increase the risk for seizures (e.g., alcohol, bupropion, isoniazid, tramadol, other antipsychotic medications such as haloperidol/quetiapine), drugs for Parkinson's disease (e.g., bromocriptine, levodopa), ethchlorvynol, lithium, St John's wort, stimulants (e.g., amphetamines, methylphenidate), certain sympathomimetics (e.g., albuterol, epinephrine, phenylephrine), terbinafine, thyroid supplements, other tricyclic antidepressants (e.g., nortriptyline).If you have been taking fluoxetine, wait at least 5 weeks before starting amitriptyline.Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., phenytoin, carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., other phenothiazines including chlorpromazine, other antidepressants including trazodone/risperidone).Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness.
Ask your pharmacist about using those products safely.This medication may interfere with certain laboratory tests (including pregnancy tests), possibly causing false test results.
Make sure laboratory personnel and all your doctors know you use this drug.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.