trifluoperazine (Rx)

Brand and Other Names:Stelazine

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 1mg
  • 2mg
  • 5mg
  • 10mg

Schizophrenia

Outpatient

  • 1-2 mg PO q12hr

Inpatient

  • Initial: 2-5 mg PO q12hr
  • Maintenance Dose: 15-20 mg/day
  • Not to exceed 40mg/day

Non Psychotic Anxiety

1-2 mg PO q12hr

Maximum Dose: 6 mg/day; not to exceed 12 weeks

Renal Impairment

Dose adjustment not necessary following dialysis

Dosage Forms & Strengths

tablet

  • 2mg
  • 5mg
  • 10mg

Schizophrenia/Psychosis

Inpatient

  • <6 years: Safety and efficacy not established
  • 6-12 years old: 1 mg PO qDay or q12hr; not to exceed 15 mg/day
  • 12 years old: 2-5 mg PO q12hr

Initiate dosing at the low end of the range; titrate gradually

Schizophrenia

Outpatient

- 1-2 mg PO q12hr

Inpatient

- Initial: 2-5 mg PO q12hr

- Maintenance Dose: 15-20 mg/day

- Not to exceed 40mg/day

Non Psychotic Anxiety

1-2 mg PO q12hr

Maximum Dose: 6 mg/day; not to exceed 12 weeks

Next:

Interactions

Interaction Checker

and trifluoperazine

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            Contraindicated (11)

            • amisulpride

              amisulpride, trifluoperazine. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.

            • disopyramide

              trifluoperazine and disopyramide both increase QTc interval. Contraindicated.

            • fezolinetant

              trifluoperazine will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitors

            • ibutilide

              trifluoperazine and ibutilide both increase QTc interval. Contraindicated.

            • indapamide

              trifluoperazine and indapamide both increase QTc interval. Contraindicated.

            • metrizamide

              trifluoperazine, metrizamide. Mechanism: unknown. Contraindicated. Risk of seizure. D/C phenothiazine 24h before admin. of metrizamide.

            • pentamidine

              trifluoperazine and pentamidine both increase QTc interval. Contraindicated.

            • pimozide

              trifluoperazine and pimozide both increase QTc interval. Contraindicated.

            • procainamide

              trifluoperazine and procainamide both increase QTc interval. Contraindicated.

            • quinidine

              trifluoperazine and quinidine both increase QTc interval. Contraindicated.

            • sotalol

              trifluoperazine and sotalol both increase QTc interval. Contraindicated.

            Serious - Use Alternative (80)

            • abametapir

              abametapir will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP1A2 substrates. If not feasible, avoid use of abametapir.

            • aminolevulinic acid oral

              aminolevulinic acid oral, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

            • aminolevulinic acid topical

              trifluoperazine increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.

            • amiodarone

              trifluoperazine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

            • amitriptyline

              trifluoperazine and amitriptyline both increase QTc interval. Avoid or Use Alternate Drug.

            • amoxapine

              trifluoperazine and amoxapine both increase QTc interval. Avoid or Use Alternate Drug.

            • apomorphine

              trifluoperazine decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • arsenic trioxide

              trifluoperazine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether/lumefantrine

              trifluoperazine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).

            • bromocriptine

              trifluoperazine decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • buprenorphine buccal

              buprenorphine buccal and trifluoperazine both decrease QTc interval. Avoid or Use Alternate Drug.

            • cabergoline

              trifluoperazine decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.

            • calcium/magnesium/potassium/sodium oxybates

              trifluoperazine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • chlorpromazine

              chlorpromazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • clarithromycin

              trifluoperazine and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.

            • clomipramine

              trifluoperazine and clomipramine both increase QTc interval. Avoid or Use Alternate Drug.

            • degarelix

              degarelix and trifluoperazine both decrease QTc interval. Avoid or Use Alternate Drug.

            • desipramine

              trifluoperazine and desipramine both increase QTc interval. Avoid or Use Alternate Drug.

            • dofetilide

              trifluoperazine and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

            • dopamine

              trifluoperazine decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.

            • dosulepin

              trifluoperazine and dosulepin both increase QTc interval. Avoid or Use Alternate Drug.

            • doxepin

              trifluoperazine and doxepin both increase QTc interval. Avoid or Use Alternate Drug.

            • dronedarone

              trifluoperazine and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.

            • droperidol

              trifluoperazine and droperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • epinephrine

              epinephrine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • epinephrine racemic

              epinephrine racemic and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin base

              trifluoperazine and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin ethylsuccinate

              trifluoperazine and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin lactobionate

              trifluoperazine and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin stearate

              trifluoperazine and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.

            • fentanyl

              fentanyl, trifluoperazine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl intranasal

              fentanyl intranasal, trifluoperazine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl transdermal

              fentanyl transdermal, trifluoperazine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl transmucosal

              fentanyl transmucosal, trifluoperazine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fluconazole

              trifluoperazine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • fluphenazine

              fluphenazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • formoterol

              trifluoperazine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.

            • givosiran

              givosiran will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. If unavoidable, decrease the CYP1A2 substrate dosage in accordance with approved product labeling.

            • haloperidol

              trifluoperazine and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

            • hydrocodone

              hydrocodone, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).

            • imipramine

              trifluoperazine and imipramine both increase QTc interval. Avoid or Use Alternate Drug.

            • itraconazole

              trifluoperazine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • ketoconazole

              trifluoperazine and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • levodopa

              trifluoperazine decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.

            • levodopa inhaled

              trifluoperazine decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Phenothiazine/1st generation antipsychotics inhibit dopamine D2 receptors in varying degrees.

            • levoketoconazole

              trifluoperazine and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

            • lisuride

              trifluoperazine decreases effects of lisuride by pharmacodynamic antagonism. Contraindicated.

            • lofepramine

              trifluoperazine and lofepramine both increase QTc interval. Avoid or Use Alternate Drug.

            • lumefantrine

              trifluoperazine and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

            • maprotiline

              trifluoperazine and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.

            • methyl aminolevulinate

              trifluoperazine, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

            • methyldopa

              trifluoperazine decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.

            • metoclopramide intranasal

              trifluoperazine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

              trifluoperazine increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome.

            • moxifloxacin

              trifluoperazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • nilotinib

              trifluoperazine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

            • nortriptyline

              trifluoperazine and nortriptyline both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide

              trifluoperazine and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide (Antidote)

              trifluoperazine and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

            • olopatadine intranasal

              trifluoperazine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

            • perphenazine

              perphenazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • pramipexole

              trifluoperazine decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.

            • prochlorperazine

              prochlorperazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • promazine

              promazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • promethazine

              promethazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • protriptyline

              trifluoperazine and protriptyline both increase QTc interval. Avoid or Use Alternate Drug.

            • quinidine

              quinidine, trifluoperazine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive cardiac effects.

            • ropinirole

              trifluoperazine decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.

            • safinamide

              trifluoperazine decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.

            • selinexor

              selinexor, trifluoperazine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

            • sodium oxybate

              trifluoperazine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • sufentanil SL

              sufentanil SL, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • tetrabenazine

              tetrabenazine and trifluoperazine both decrease QTc interval. Avoid or Use Alternate Drug.

            • thioridazine

              thioridazine and trifluoperazine both increase QTc interval. Avoid or Use Alternate Drug.

            • trazodone

              trifluoperazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

            • tretinoin

              trifluoperazine, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

            • tretinoin topical

              trifluoperazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

            • trimipramine

              trifluoperazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.

            • yohimbe

              yohimbe decreases effects of trifluoperazine by pharmacodynamic antagonism. Contraindicated.

            • ziprasidone

              trifluoperazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (335)

            • abobotulinumtoxinA

              abobotulinumtoxinA increases effects of trifluoperazine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

            • aclidinium

              aclidinium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • acrivastine

              acrivastine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • albiglutide

              trifluoperazine, albiglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

            • albuterol

              trifluoperazine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alfentanil

              alfentanil and trifluoperazine both increase sedation. Use Caution/Monitor.

            • almotriptan

              almotriptan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • alprazolam

              alprazolam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • amifampridine

              trifluoperazine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

            • amisulpride

              trifluoperazine and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.

            • amitriptyline

              trifluoperazine and amitriptyline both increase sedation. Use Caution/Monitor.

            • amobarbital

              amobarbital and trifluoperazine both increase sedation. Use Caution/Monitor.

            • amoxapine

              trifluoperazine and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

              trifluoperazine and amoxapine both increase sedation. Use Caution/Monitor.

            • anagrelide

              anagrelide and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • anticholinergic/sedative combos

              anticholinergic/sedative combos decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              anticholinergic/sedative combos decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • apomorphine

              trifluoperazine and apomorphine both increase sedation. Use Caution/Monitor.

            • arformoterol

              trifluoperazine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • aripiprazole

              aripiprazole and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              aripiprazole and trifluoperazine both increase sedation. Use Caution/Monitor.

            • armodafinil

              trifluoperazine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • artemether/lumefantrine

              artemether/lumefantrine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • asenapine

              asenapine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • asenapine transdermal

              asenapine transdermal and trifluoperazine both increase sedation. Use Caution/Monitor.

            • atracurium

              atracurium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              atracurium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • atropine

              atropine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              atropine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • atropine IV/IM

              trifluoperazine increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              atropine IV/IM decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              atropine IV/IM decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

            • avapritinib

              avapritinib and trifluoperazine both increase sedation. Use Caution/Monitor.

            • azelastine

              azelastine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • azithromycin

              trifluoperazine and azithromycin both increase QTc interval. Use Caution/Monitor.

            • baclofen

              baclofen and trifluoperazine both increase sedation. Use Caution/Monitor.

            • belladonna alkaloids

              belladonna alkaloids decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              belladonna alkaloids decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • belladonna and opium

              belladonna and opium and trifluoperazine both increase sedation. Use Caution/Monitor.

              belladonna and opium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              belladonna and opium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • benperidol

              benperidol and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              benperidol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen and trifluoperazine both increase sedation. Use Caution/Monitor.

            • benzphetamine

              trifluoperazine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, benzphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • benztropine

              trifluoperazine increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .

            • brexanolone

              brexanolone, trifluoperazine. Either increases toxicity of the other by sedation. Use Caution/Monitor.

            • brexpiprazole

              brexpiprazole and trifluoperazine both increase sedation. Use Caution/Monitor.

            • brimonidine

              brimonidine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • brivaracetam

              brivaracetam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • brompheniramine

              brompheniramine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • buprenorphine

              buprenorphine and trifluoperazine both increase sedation. Use Caution/Monitor.

              buprenorphine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal and trifluoperazine both increase sedation. Use Caution/Monitor.

            • buprenorphine subdermal implant

              buprenorphine subdermal implant and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

              buprenorphine subdermal implant and trifluoperazine both increase sedation. Use Caution/Monitor.

            • buprenorphine transdermal

              buprenorphine transdermal and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

              buprenorphine transdermal and trifluoperazine both increase sedation. Use Caution/Monitor.

            • buprenorphine, long-acting injection

              trifluoperazine increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

              buprenorphine, long-acting injection and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • bupropion

              bupropion will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • butabarbital

              butabarbital and trifluoperazine both increase sedation. Use Caution/Monitor.

            • butalbital

              butalbital and trifluoperazine both increase sedation. Use Caution/Monitor.

            • butorphanol

              butorphanol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • caffeine

              trifluoperazine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cannabidiol

              cannabidiol, trifluoperazine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.

            • carbinoxamine

              carbinoxamine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • carisoprodol

              carisoprodol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • cenobamate

              cenobamate, trifluoperazine. Either increases effects of the other by sedation. Use Caution/Monitor.

            • chloral hydrate

              chloral hydrate and trifluoperazine both increase sedation. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide and trifluoperazine both increase sedation. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              chlorpromazine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • chlorzoxazone

              chlorzoxazone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • cigarette smoking

              cigarette smoking decreases levels of trifluoperazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.

            • cinnarizine

              cinnarizine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • cisatracurium

              cisatracurium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              cisatracurium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • clemastine

              clemastine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • clomipramine

              trifluoperazine and clomipramine both increase sedation. Use Caution/Monitor.

            • clonazepam

              clonazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • clonidine

              clonidine, trifluoperazine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.

            • clorazepate

              clorazepate and trifluoperazine both increase sedation. Use Caution/Monitor.

            • clozapine

              clozapine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              clozapine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • codeine

              codeine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • cyclizine

              cyclizine and trifluoperazine both increase sedation. Use Caution/Monitor.

              cyclizine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              cyclizine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • cyclobenzaprine

              cyclobenzaprine and trifluoperazine both increase sedation. Use Caution/Monitor.

              cyclobenzaprine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              cyclobenzaprine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • cyproheptadine

              cyproheptadine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • dantrolene

              dantrolene and trifluoperazine both increase sedation. Use Caution/Monitor.

            • daridorexant

              trifluoperazine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

            • darifenacin

              darifenacin decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              darifenacin decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • dasatinib

              trifluoperazine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.

            • desflurane

              desflurane and trifluoperazine both increase sedation. Use Caution/Monitor.

              desflurane and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • desipramine

              trifluoperazine and desipramine both increase sedation. Use Caution/Monitor.

            • desvenlafaxine

              desvenlafaxine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg

            • deutetrabenazine

              trifluoperazine and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.

              trifluoperazine and deutetrabenazine both increase sedation. Use Caution/Monitor.

              deutetrabenazine and trifluoperazine both decrease QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

            • dexchlorpheniramine

              dexchlorpheniramine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • dexfenfluramine

              trifluoperazine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, dexfenfluramine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • dexmedetomidine

              dexmedetomidine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • dexmethylphenidate

              trifluoperazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • dextroamphetamine

              trifluoperazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • dextromethorphan

              dextromethorphan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • dextromoramide

              dextromoramide and trifluoperazine both increase sedation. Use Caution/Monitor.

            • diamorphine

              diamorphine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • diazepam

              diazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • dicyclomine

              dicyclomine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              dicyclomine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • diethylpropion

              trifluoperazine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, diethylpropion. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • difelikefalin

              difelikefalin and trifluoperazine both increase sedation. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl and trifluoperazine both increase sedation. Use Caution/Monitor.

            • dihydroergotamine

              dihydroergotamine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • dimenhydrinate

              dimenhydrinate and trifluoperazine both increase sedation. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine and trifluoperazine both increase sedation. Use Caution/Monitor.

              diphenhydramine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              diphenhydramine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • diphenoxylate hcl

              diphenoxylate hcl and trifluoperazine both increase sedation. Use Caution/Monitor.

            • dipipanone

              dipipanone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • dobutamine

              trifluoperazine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, dobutamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • dolasetron

              trifluoperazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • donepezil

              donepezil and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • donepezil transdermal

              donepezil transdermal, trifluoperazine. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.

            • dopamine

              trifluoperazine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, dopamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • dopexamine

              trifluoperazine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dosulepin

              trifluoperazine and dosulepin both increase sedation. Use Caution/Monitor.

            • doxepin

              trifluoperazine and doxepin both increase sedation. Use Caution/Monitor.

            • doxylamine

              doxylamine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • droperidol

              droperidol and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              droperidol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • efavirenz

              efavirenz and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • eletriptan

              eletriptan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • eliglustat

              eliglustat and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • encorafenib

              encorafenib and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • entrectinib

              entrectinib and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • ephedrine

              trifluoperazine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, ephedrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • epinephrine

              trifluoperazine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, epinephrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

              trifluoperazine decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • epinephrine racemic

              trifluoperazine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. Block pressor response to epinephrine, which may result in severe hypotension and tachycardia.

            • ergoloid mesylates

              ergoloid mesylates, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • ergotamine

              ergotamine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • eribulin

              eribulin and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • esketamine intranasal

              esketamine intranasal, trifluoperazine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

            • estazolam

              estazolam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • ethanol

              trifluoperazine and ethanol both increase sedation. Use Caution/Monitor.

            • etomidate

              etomidate and trifluoperazine both increase sedation. Use Caution/Monitor.

            • fenfluramine

              trifluoperazine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, fenfluramine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • fentanyl

              fentanyl, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • fesoterodine

              fesoterodine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              fesoterodine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of fesoterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • fexinidazole

              fexinidazole will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

            • fingolimod

              fingolimod and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • flavoxate

              flavoxate decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              flavoxate decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of flavoxate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • flecainide

              trifluoperazine and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.

            • flibanserin

              flibanserin, trifluoperazine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • fluoxetine

              fluoxetine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              trifluoperazine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

            • fluphenazine

              fluphenazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              fluphenazine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • flurazepam

              flurazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • fluvoxamine

              fluvoxamine and trifluoperazine both increase QTc interval. Modify Therapy/Monitor Closely.

            • formoterol

              trifluoperazine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • foscarnet

              trifluoperazine and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

            • frovatriptan

              frovatriptan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • ganaxolone

              trifluoperazine and ganaxolone both increase sedation. Use Caution/Monitor.

            • gemifloxacin

              gemifloxacin and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • gilteritinib

              gilteritinib and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • glycopyrrolate

              trifluoperazine increases effects of glycopyrrolate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • glycopyrrolate inhaled

              glycopyrrolate inhaled decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              glycopyrrolate inhaled decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • glycopyrronium tosylate topical

              glycopyrronium tosylate topical, trifluoperazine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

            • granisetron

              granisetron and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • guanfacine

              guanfacine, trifluoperazine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.

            • haloperidol

              haloperidol and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              haloperidol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • henbane

              henbane decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              henbane decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • homatropine

              homatropine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              homatropine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • hydromorphone

              hydromorphone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine and trifluoperazine both increase sedation. Use Caution/Monitor.

              hydroxyzine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • hyoscyamine

              hyoscyamine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              hyoscyamine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • hyoscyamine spray

              trifluoperazine increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              hyoscyamine spray decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              hyoscyamine spray decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

            • iloperidone

              iloperidone and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              trifluoperazine and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              iloperidone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • imipramine

              trifluoperazine and imipramine both increase sedation. Use Caution/Monitor.

            • incobotulinumtoxinA

              trifluoperazine increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • indacaterol, inhaled

              indacaterol, inhaled, trifluoperazine. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

            • insulin degludec

              trifluoperazine decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase blood glucose concentrations.

            • insulin degludec/insulin aspart

              trifluoperazine decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase blood glucose concentrations.

            • insulin inhaled

              trifluoperazine decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase blood glucose concentrations.

            • ipratropium

              ipratropium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              ipratropium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • isoflurane

              isoflurane and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • isoproterenol

              trifluoperazine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, isoproterenol. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • ketamine

              ketamine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • ketotifen, ophthalmic

              trifluoperazine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

            • lapatinib

              trifluoperazine and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.

            • lasmiditan

              lasmiditan, trifluoperazine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

            • lemborexant

              lemborexant, trifluoperazine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

            • levalbuterol

              trifluoperazine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • levofloxacin

              trifluoperazine and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • levomilnacipran

              levomilnacipran, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • levorphanol

              levorphanol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • linezolid

              linezolid, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • liraglutide

              trifluoperazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

            • lisdexamfetamine

              trifluoperazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • lithium

              lithium, trifluoperazine. Other (see comment). Use Caution/Monitor. Comment: Risk of neurotoxicity. Multiple mechanisms involved.

              lithium, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

              lithium and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • lofepramine

              trifluoperazine and lofepramine both increase sedation. Use Caution/Monitor.

            • lofexidine

              trifluoperazine and lofexidine both increase sedation. Use Caution/Monitor.

            • loprazolam

              loprazolam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • lorazepam

              lorazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • lorcaserin

              lorcaserin, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • lormetazepam

              lormetazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • loxapine

              loxapine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              loxapine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              loxapine inhaled and trifluoperazine both increase sedation. Use Caution/Monitor.

            • lumefantrine

              lumefantrine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • lurasidone

              lurasidone, trifluoperazine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

            • maprotiline

              trifluoperazine and maprotiline both increase sedation. Use Caution/Monitor.

            • marijuana

              trifluoperazine and marijuana both increase sedation. Use Caution/Monitor.

            • meclizine

              meclizine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              meclizine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of meclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • melatonin

              trifluoperazine and melatonin both increase sedation. Use Caution/Monitor.

            • meperidine

              meperidine and trifluoperazine both increase sedation. Use Caution/Monitor.

              meperidine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • meprobamate

              trifluoperazine and meprobamate both increase sedation. Use Caution/Monitor.

            • metaproterenol

              trifluoperazine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaxalone

              metaxalone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • metformin

              trifluoperazine decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor. Patient should be closely observed for loss of blood glucose control; when drugs are withdrawn from a patient receiving metformin, patient should be observed closely for hypoglycemia.

            • methadone

              trifluoperazine and methadone both increase QTc interval. Modify Therapy/Monitor Closely.

              methadone and trifluoperazine both increase sedation. Use Caution/Monitor.

              methadone, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • methamphetamine

              trifluoperazine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, methamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • methocarbamol

              methocarbamol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • methoxsalen

              methoxsalen, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive photosensitizing effects.

            • methscopolamine

              methscopolamine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              methscopolamine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of methscopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • methylenedioxymethamphetamine

              trifluoperazine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, methylenedioxymethamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • methylergonovine

              methylergonovine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • methylphenidate

              trifluoperazine, methylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

              trifluoperazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.

            • metoclopramide

              trifluoperazine and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

            • midazolam

              midazolam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • midazolam intranasal

              midazolam intranasal, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

            • midodrine

              trifluoperazine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, midodrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • milnacipran

              milnacipran, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • mirtazapine

              trifluoperazine and mirtazapine both increase sedation. Use Caution/Monitor.

              mirtazapine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • modafinil

              trifluoperazine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • morphine

              morphine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • motherwort

              trifluoperazine and motherwort both increase sedation. Use Caution/Monitor.

            • moxonidine

              trifluoperazine and moxonidine both increase sedation. Use Caution/Monitor.

            • nabilone

              trifluoperazine and nabilone both increase sedation. Use Caution/Monitor.

            • nalbuphine

              nalbuphine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • naratriptan

              naratriptan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • norepinephrine

              trifluoperazine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, norepinephrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • nortriptyline

              trifluoperazine and nortriptyline both increase sedation. Use Caution/Monitor.

            • ofloxacin

              trifluoperazine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • olanzapine

              olanzapine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              olanzapine and trifluoperazine both increase sedation. Use Caution/Monitor.

              olanzapine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • oliceridine

              oliceridine, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. Increased risk of hypotension if ability to maintain blood pressure has been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (eg, phenothiazines or general anesthetics).

            • olodaterol inhaled

              trifluoperazine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

            • onabotulinumtoxinA

              onabotulinumtoxinA decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              onabotulinumtoxinA decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • opium tincture

              opium tincture and trifluoperazine both increase sedation. Use Caution/Monitor.

            • orphenadrine

              orphenadrine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • oxaliplatin

              oxaliplatin and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • oxazepam

              oxazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • oxybutynin

              oxybutynin decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              oxybutynin decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • oxybutynin topical

              oxybutynin topical decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              oxybutynin topical decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • oxybutynin transdermal

              oxybutynin transdermal decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              oxybutynin transdermal decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • oxycodone

              oxycodone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • oxymorphone

              oxymorphone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • paliperidone

              paliperidone and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              trifluoperazine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              paliperidone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • pancuronium

              pancuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              pancuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • papaveretum

              papaveretum and trifluoperazine both increase sedation. Use Caution/Monitor.

            • papaverine

              trifluoperazine and papaverine both increase sedation. Use Caution/Monitor.

            • paroxetine

              paroxetine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              trifluoperazine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

              paroxetine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • pazopanib

              trifluoperazine and pazopanib both increase QTc interval. Use Caution/Monitor.

            • pentazocine

              pentazocine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • pentobarbital

              pentobarbital and trifluoperazine both increase sedation. Use Caution/Monitor.

            • perphenazine

              perphenazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              perphenazine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • phendimetrazine

              trifluoperazine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, phendimetrazine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • phenelzine

              phenelzine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • phenobarbital

              phenobarbital and trifluoperazine both increase sedation. Use Caution/Monitor.

            • phentermine

              trifluoperazine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, phentermine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • phenylephrine

              trifluoperazine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, phenylephrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • phenylephrine PO

              trifluoperazine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              trifluoperazine, phenylephrine PO. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • pholcodine

              trifluoperazine and pholcodine both increase sedation. Use Caution/Monitor.

            • pimozide

              pimozide and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              pimozide and trifluoperazine both increase sedation. Use Caution/Monitor.

            • pirbuterol

              trifluoperazine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • porfimer

              trifluoperazine, porfimer. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced photosensitivity.

            • posaconazole

              trifluoperazine and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • pralidoxime

              pralidoxime decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              pralidoxime decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • primaquine

              primaquine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • primidone

              primidone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • procarbazine

              procarbazine, trifluoperazine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Excessive sedation.

              procarbazine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • prochlorperazine

              prochlorperazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              prochlorperazine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • promethazine

              promethazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              promethazine and trifluoperazine both increase sedation. Use Caution/Monitor.

              promethazine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • propafenone

              propafenone will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • propantheline

              propantheline decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              propantheline decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • propofol

              propofol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • propylhexedrine

              trifluoperazine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, propylhexedrine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • protriptyline

              trifluoperazine and protriptyline both increase sedation. Use Caution/Monitor.

            • pseudoephedrine

              trifluoperazine, pseudoephedrine. Mechanism: unknown. Use Caution/Monitor. Consider avoiding use of pseudoephedrine in patients receiving phenothiazines (especially thioridazine) due to the potential risk of cardiac arrhythmia or sudden death. Monitor for evidence of ventricular arrhythmias during concomitant use.

            • quazepam

              quazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • quetiapine

              quetiapine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              quetiapine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • quinidine

              quinidine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • ramelteon

              trifluoperazine and ramelteon both increase sedation. Use Caution/Monitor.

            • ranolazine

              trifluoperazine and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

            • rapacuronium

              rapacuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              rapacuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • remimazolam

              remimazolam, trifluoperazine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

            • rimabotulinumtoxinB

              trifluoperazine, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

            • risperidone

              risperidone and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              trifluoperazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.

              risperidone and trifluoperazine both increase sedation. Use Caution/Monitor.

            • rizatriptan

              rizatriptan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • rocuronium

              rocuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              rocuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • romidepsin

              trifluoperazine and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.

            • rucaparib

              rucaparib will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP1A2 substrates, if clinically indicated.

            • salmeterol

              trifluoperazine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • scopolamine

              scopolamine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              scopolamine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • scullcap

              trifluoperazine and scullcap both increase sedation. Use Caution/Monitor.

            • secobarbital

              secobarbital and trifluoperazine both increase sedation. Use Caution/Monitor.

            • selegiline

              selegiline, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • serdexmethylphenidate/dexmethylphenidate

              trifluoperazine, serdexmethylphenidate/dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • sertraline

              sertraline and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • sevoflurane

              sevoflurane and trifluoperazine both increase sedation. Use Caution/Monitor.

              sevoflurane and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • shepherd's purse

              trifluoperazine and shepherd's purse both increase sedation. Use Caution/Monitor.

            • siponimod

              siponimod and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • smoking

              smoking decreases levels of trifluoperazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.

            • sodium sulfate/?magnesium sulfate/potassium chloride

              sodium sulfate/?magnesium sulfate/potassium chloride increases effects of trifluoperazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

            • sodium sulfate/potassium sulfate/magnesium sulfate

              sodium sulfate/potassium sulfate/magnesium sulfate increases effects of trifluoperazine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.

            • solifenacin

              solifenacin decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              solifenacin decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              solifenacin and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • stiripentol

              stiripentol, trifluoperazine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP1A2 inhibitor and inducer. Monitor CYP1A2 substrates coadministered with stiripentol for increased or decreased effects. CYP1A2 substrates may require dosage adjustment.

            • sufentanil

              sufentanil and trifluoperazine both increase sedation. Use Caution/Monitor.

            • sulfamethoxazole

              trifluoperazine and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • sumatriptan

              sumatriptan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • sumatriptan intranasal

              sumatriptan intranasal, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • sunitinib

              sunitinib and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • tacrolimus

              tacrolimus and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • tapentadol

              tapentadol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • teduglutide

              teduglutide increases levels of trifluoperazine by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.

            • telavancin

              trifluoperazine and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

            • temazepam

              temazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • terbutaline

              trifluoperazine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • teriflunomide

              teriflunomide decreases levels of trifluoperazine by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

            • tetrabenazine

              trifluoperazine and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.

            • thioridazine

              thioridazine and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              thioridazine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • thiothixene

              thiothixene and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              thiothixene and trifluoperazine both increase sedation. Use Caution/Monitor.

            • tiotropium

              tiotropium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              tiotropium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • tobacco use

              tobacco use decreases levels of trifluoperazine by increasing metabolism. Use Caution/Monitor. Interaction mainly seen w/chlorpromazine & thioridazine, but may occur w/other phenothiazines.

            • tolterodine

              tolterodine decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              tolterodine decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • topiramate

              trifluoperazine and topiramate both increase sedation. Modify Therapy/Monitor Closely.

            • tramadol

              tramadol and trifluoperazine both increase sedation. Use Caution/Monitor.

            • tranylcypromine

              tranylcypromine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • trazodone

              trifluoperazine and trazodone both increase sedation. Use Caution/Monitor.

            • triazolam

              triazolam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • triclofos

              triclofos and trifluoperazine both increase sedation. Use Caution/Monitor.

            • trihexyphenidyl

              trihexyphenidyl decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of trihexyphenidyl by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive anticholinergic effects.

            • trimethoprim

              trifluoperazine and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

            • trimipramine

              trifluoperazine and trimipramine both increase sedation. Use Caution/Monitor.

            • triprolidine

              triprolidine and trifluoperazine both increase sedation. Use Caution/Monitor.

            • tropisetron

              trifluoperazine and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • trospium chloride

              trospium chloride decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              trospium chloride decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • valbenazine

              valbenazine and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • vecuronium

              vecuronium decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              vecuronium decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

              trifluoperazine increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

            • venlafaxine

              venlafaxine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              trifluoperazine and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

              venlafaxine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • vilazodone

              vilazodone, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • voriconazole

              trifluoperazine and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • vorinostat

              vorinostat and trifluoperazine both decrease QTc interval. Use Caution/Monitor.

            • xylometazoline

              trifluoperazine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, xylometazoline. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • yohimbine

              trifluoperazine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, yohimbine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • ziconotide

              trifluoperazine and ziconotide both increase sedation. Use Caution/Monitor.

            • ziprasidone

              trifluoperazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              trifluoperazine and ziprasidone both increase sedation. Use Caution/Monitor.

            • zolmitriptan

              zolmitriptan, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).

            • zolpidem

              trifluoperazine will increase the level or effect of zolpidem by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Additive effect of decreased alertness and psychomotor performance

            • zotepine

              trifluoperazine and zotepine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.

              trifluoperazine and zotepine both increase sedation. Use Caution/Monitor.

            Minor (61)

            • amiodarone

              amiodarone will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • amitriptyline

              amitriptyline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amitriptyline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • amoxapine

              amoxapine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              amoxapine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • asenapine

              asenapine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • atropine

              trifluoperazine increases toxicity of atropine by unknown mechanism. Minor/Significance Unknown.

            • atropine IV/IM

              trifluoperazine increases toxicity of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.

            • benazepril

              trifluoperazine increases effects of benazepril by unspecified interaction mechanism. Minor/Significance Unknown. Enhanced hypotensive effects.

            • brimonidine

              brimonidine increases effects of trifluoperazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

            • bupropion

              trifluoperazine increases toxicity of bupropion by unspecified interaction mechanism. Minor/Significance Unknown. May lower seizure threshold; keep bupropion dose as low as possible.

            • captopril

              trifluoperazine increases effects of captopril by unspecified interaction mechanism. Minor/Significance Unknown. Both drugs lower blood pressure. Monitor blood pressure.

            • celecoxib

              celecoxib will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • chasteberry

              chasteberry decreases effects of trifluoperazine by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).

            • chloroquine

              chloroquine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              chloroquine increases levels of trifluoperazine by decreasing metabolism. Minor/Significance Unknown.

            • cimetidine

              cimetidine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • clomipramine

              clomipramine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              clomipramine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • darifenacin

              darifenacin will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • desipramine

              desipramine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              desipramine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • diphenhydramine

              diphenhydramine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • doxepin

              doxepin, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              doxepin, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • dronedarone

              dronedarone will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • duloxetine

              duloxetine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • enalapril

              trifluoperazine increases effects of enalapril by unspecified interaction mechanism. Minor/Significance Unknown.

            • ethanol

              ethanol, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

            • eucalyptus

              trifluoperazine and eucalyptus both increase sedation. Minor/Significance Unknown.

            • fosinopril

              trifluoperazine increases effects of fosinopril by unspecified interaction mechanism. Minor/Significance Unknown.

            • glycopyrrolate

              trifluoperazine increases toxicity of glycopyrrolate by unknown mechanism. Minor/Significance Unknown.

            • glycopyrrolate inhaled

              trifluoperazine increases toxicity of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

            • haloperidol

              haloperidol will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • imatinib

              imatinib will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • imidapril

              trifluoperazine increases effects of imidapril by unspecified interaction mechanism. Minor/Significance Unknown.

            • imipramine

              imipramine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              imipramine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • lisinopril

              trifluoperazine increases effects of lisinopril by unspecified interaction mechanism. Minor/Significance Unknown.

            • lofepramine

              lofepramine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              lofepramine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • maprotiline

              maprotiline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              maprotiline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • maraviroc

              maraviroc will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • marijuana

              marijuana will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • metyrapone

              trifluoperazine decreases effects of metyrapone by unspecified interaction mechanism. Minor/Significance Unknown.

            • metyrosine

              metyrosine increases toxicity of trifluoperazine by pharmacodynamic synergism. Minor/Significance Unknown. Increased extrapyramidal symptoms.

            • moexipril

              trifluoperazine increases effects of moexipril by unspecified interaction mechanism. Minor/Significance Unknown.

            • nilotinib

              nilotinib will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • nortriptyline

              nortriptyline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              nortriptyline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • oxybutynin

              oxybutynin increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.

            • oxybutynin topical

              oxybutynin topical increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.

            • oxybutynin transdermal

              oxybutynin transdermal increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.

            • parecoxib

              parecoxib will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • perindopril

              trifluoperazine increases effects of perindopril by unspecified interaction mechanism. Minor/Significance Unknown.

            • perphenazine

              perphenazine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • protriptyline

              protriptyline, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              protriptyline, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

            • pyrimethamine

              pyrimethamine increases levels of trifluoperazine by decreasing metabolism. Minor/Significance Unknown.

            • quinacrine

              quinacrine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • quinapril

              trifluoperazine increases effects of quinapril by unspecified interaction mechanism. Minor/Significance Unknown.

            • ramipril

              trifluoperazine increases effects of ramipril by unspecified interaction mechanism. Minor/Significance Unknown.

            • ranolazine

              ranolazine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • ritonavir

              ritonavir will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • sage

              trifluoperazine and sage both increase sedation. Minor/Significance Unknown.

            • sertraline

              sertraline will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • thioridazine

              thioridazine will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • tipranavir

              tipranavir will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • trandolapril

              trifluoperazine increases effects of trandolapril by unspecified interaction mechanism. Minor/Significance Unknown.

            • trazodone

              trazodone, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.

              trazodone, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

            • trimipramine

              trimipramine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

              trimipramine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

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            Adverse Effects

            Frequency Not Defined

            EPS (60%; muscle stiffness, dystonia, parkinsonism, tardive dyskinesia, akathisia)

            NMS (infrequent but serious)

            Sedation

            Anticholinergic effects

            Weight gain

            Oligomenorrhea/amenorrhea

            Erectile dysfunction

            Insomnia

            Restlessness

            Anxiety

            Euphoria

            Agitation

            Depression

            Weakness

            Headache

            Cerebral edema

            Poikilothermia

            Orthostatic hypotension

            Tachycardia

            Dizziness

            Lens opacities (prolonged use)Anorexia

            Dyspepsia

            Constipation

            Ileus

            Blood dyscrasia

            ECG changes

            Photosensitivity

            Pruritis

            Diarrhea

            Galactorrhea

            Ejaculatory d/o

            Seizure (rare)

            Priapism (rare)

            Cholestatic jaundice (rare)

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            Warnings

            Black Box Warnings

            Patients with dementia-related psychosis who are treated with antipsychotic drugs are at an increased risk of death as shown in short-term controlled trials. The deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature.

            This drug is not approved for the treatment of patients with dementia-related psychosis.

            Contraindications

            Hypersensitivity to phenothiazines or excipients

            Comatose or greatly depressed states due to central nervous system depressants, existing blood dyscrasias, bone marrow depression, and preexisting liver damage

            Cautions

            Thrombocytopenia and anemia reported in patients receiving therapy; agranulocytosis and pancytopenia also reported; warn patients to report sudden appearance of sore throat or other signs of infection; if white blood cell and differential counts indicate cellular depression, stop treatment and start antibiotic and other suitable therapy

            Jaundice of cholestatic type of hepatitis or liver damage reported; if fever with grippe-like symptoms occurs, appropriate liver studies should be conducted; if tests indicate an abnormality, stop treatment

            One result of therapy may be an increase in mental and physical activity; for example, a few patients with angina pectoris have complained of increased pain while taking the drug; patients with angina should be observed carefully and, if an unfavorable response noted, the drug should be withdrawn

            Because hypotension has occurred, large doses and parenteral administration should be avoided in patients with impaired cardiovascular systems; to minimize occurrence of hypotension after injection, keep patient lying down and observe for at least 1/2 hour; if hypotension occurs from parenteral or oral dosing, place patient in head-low position with legs raised

            If a vasoconstrictor is required, norepinephrine bitartrate and phenylephrine hydrochloride are suitable; other pressor agents, including epinephrine, should not be used as they may cause a paradoxical further lowering of blood pressure

            Since certain phenothiazines reported to produce retinopathy, the drug should be discontinued if ophthalmoscopic examination or visual field studies should demonstrate retinal changes; an antiemetic action of this drug may mask signs and symptoms of toxicity or overdosage of other drugs and may obscure diagnosis and treatment of other conditions such as intestinal obstruction, brain tumor, and Reye’s syndrome

            With prolonged administration at high dosages, the possibility of cumulative effects, with sudden onset of severe central nervous system or vasomotor symptoms, should be kept in mind

            Antipsychotic drugs elevate prolactin levels; the elevation persists during chronic administration; tissue culture experiments indicate that approximately 1/3 of human breast cancers are prolactin-dependent in vitro, a factor of potential importance if the prescribing of these drugs is contemplated in a patient with a previously detected breast cancer

            Although disturbances such as galactorrhea, amenorrhea, gynecomastia and impotence reported, the clinical significance of elevated serum prolactin levels is unknown for most patients; an increase in mammary neoplasms has been found in rodents after chronic administration of antipsychotic drugs

            Neither clinical nor epidemiologic studies conducted to date, have shown an association between chronic administration of these drugs and mammary tumorigenesis; the available evidence is considered too limited to be conclusive at this time

            Chromosomal aberrations in spermatocytes and abnormal sperm demonstrated in rodents treated with certain antipsychotics

            Because phenothiazines may interfere with thermoregulatory mechanisms, use caution in persons who will be exposed to extreme heat

            As with all drugs which exert an anticholinergic effect, and/or cause mydriasis, trifluoperazine should be used with caution in patients with glaucoma; phenothiazines may diminish effect of oral anticoagulants

            Phenothiazines can produce alpha-adrenergic blockade; concomitant administration of propranolol with phenothiazines results in increased plasma levels of both drugs

            Antihypertensive effects of guanethidine and related compounds may be counteracted when phenothiazines are used concurrently; thiazide diuretics may accentuate orthostatic hypotension that may occur with phenothiazines

            Phenothiazines may lower convulsive threshold; dosage adjustments of anticonvulsants may be necessary; potentiation of anticonvulsant effects does not occur; however, it has been reported that phenothiazines may interfere with metabolism of phenytoin and thus precipitate phenytoin toxicity; drugs which lower seizure threshold, including phenothiazine derivatives, should not be used with metrizamide

            As with other phenothiazine derivatives, trifluoperazine hydrochloride should be discontinued at least 48 hours before myelography, should not be resumed for at least 24 hours post-procedure, and should not be used for control of nausea and vomiting occurring either prior to myelography or post-procedure with metrizamide

            To lessen likelihood of adverse reactions related to cumulative drug effects, patients with a history of long-term therapy with trifluoperazine hydrochloride and/or other antipsychotics should be evaluated periodically to decide whether maintenance dosage could be lowered, or drug therapy discontinued

            The presence of phenothiazines may produce false-positive phenylketonuria (PKU) test results

            Leukopenia, neutropenia, and agranulocytosis

            • In clinical trial and post-marketing experience, events of leukopenia/neutropenia and agranulocytosis reported temporally related to antipsychotic agents
            • Possible risk factors for leukopenia/neutropenia include preexisting low white blood cell count (WBC) and history of drug-induced leukopenia/neutropenia; patients with a preexisting low WBC or a history of drug-induced leukopenia/neutropenia should have their complete blood count (CBC) monitored frequently during first few months of therapy and should discontinue therapy at first sign of a decline in WBC in the absence of other causative factors
            • Patients with neutropenia should be carefully monitored for fever or other symptoms or signs of infection and treated promptly if such symptoms occur
            • Patients with severe neutropenia (absolute neutrophil count < 1000/mm ) should discontinue therapy and have their WBC followed until recovery

            Tardive dyskinesia

            • Given the likelihood that some patients exposed chronically to antipsychotics will develop tardive dyskinesia, it is advised that all patients in whom chronic use is contemplated be given, if possible, full information about this risk; the decision to inform patients and/or their guardians must obviously take into account clinical circumstances and competency of patient to understand information provided
            • Tardive dyskinesia, a syndrome consisting of potentially irreversible, involuntary, dyskinetic movements, may develop in patients treated with antipsychotic drugs; although the prevalence of the syndrome appears to be highest among the elderly, especially elderly women, it is impossible to rely upon prevalence estimates to predict, at inception of antipsychotic treatment, which patients are likely to develop the syndrome
            • Whether antipsychotic drug products differ in their potential to cause tardive dyskinesia is unknown; both risk of developing the syndrome and likelihood that it will become irreversible are believed to increase as duration of treatment and the total cumulative dose of antipsychotic drugs administered to the patient increase
            • However, the syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses; there is no known treatment for established cases of tardive dyskinesia, although the syndrome may remit, partially or completely, if antipsychotic treatment is withdrawn
            • Antipsychotic treatment itself, however, may suppress (or partially suppress) signs and symptoms of the syndrome and thereby may possibly mask the underlying disease process; the effect that symptomatic suppression has on long-term course of the syndrome is unknown
            • Given these considerations, antipsychotics should be prescribed in a manner that is most likely to minimize occurrence of tardive dyskinesia; chronic antipsychotic treatment should generally be reserved for patients who suffer from a chronic illness that is known to respond to antipsychotic drugs, and, for whom alternative, equally effective, but potentially less harmful treatments are not available or appropriate
            • In patients who do require chronic treatment, the smallest dose and shortest duration of treatment producing a satisfactory clinical response should be sought; the need for continued treatment should be reassessed periodically
            • If signs and symptoms of tardive dyskinesia appear in a patient on antipsychotics, consider drug discontinuation; however, some patients may require treatment despite presence of syndrome

            Neuroleptic malignant syndrome (NMS)

            • A potentially fatal symptom complex sometimes referred to as neuroleptic malignant syndrome (NMS) reported in association with antipsychotic drugs; clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmias)
            • The diagnostic evaluation of patients with this syndrome is complicated; in arriving at a diagnosis, it is important to identify cases where clinical presentation includes both serious medical illness (eg, pneumonia, systemic infection, etc) and untreated or inadequately treated extrapyramidal signs and symptoms (EPS)
            • Other important considerations in differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology; the management of NMS should include immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy, intensive symptomatic treatment and medical monitoring, and treatment of any concomitant serious medical problems for which specific treatments are available
            • There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS; if a patient requires antipsychotic drug treatment after recovery from NMS, the potential reintroduction of drug therapy should be carefully considered
            • The patient should be carefully monitored; recurrences of NMS reported; an encephalopathic syndrome (characterized by weakness, lethargy, fever, tremulousness and confusion, extrapyramidal symptoms, leukocytosis, elevated serum enzymes, BUN, and FBS) has occurred in a few patients treated with lithium plus an antipsychotic
            • In some instances, the syndrome was followed by irreversible brain damage; because of a possible causal relationship between these events and concomitant administration of lithium and antipsychotics, patients receiving such combined therapy should be monitored closely for early evidence of neurologic toxicity and treatment discontinued promptly if such signs appear
            • This encephalopathic syndrome may be similar to or the same as neuroleptic malignant syndrome (NMS); patients who have demonstrated a hypersensitivity reaction (eg, blood dyscrasias, jaundice) with a phenothiazine should not be reexposed to any phenothiazine, including trifluoperazine hydrochloride unless in judgment of physician the potential benefits of treatment outweigh possible hazard
            • This drug may impair mental and/or physical abilities, especially during first few days of therapy; therefore, caution patients about activities requiring alertness (eg, operating vehicles or machinery); if agents such as sedatives, narcotics, anesthetics, tranquilizers, or alcohol are used either simultaneously or successively with the drug, the possibility of an undesirable additive depressant effect should be considered
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            Pregnancy & Lactation

            Pregnancy

            Safety for use during pregnancy not established; not recommended that the drug be given to pregnant patients except when, in judgment of physician, it is essential; potential benefits should clearly outweigh possible hazards

            There are reported instances of prolonged jaundice, extrapyramidal signs, hyperreflexia, or hyporeflexia in newborn infants whose mothers received phenothiazines

            Neonates exposed to antipsychotic drugs, during third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery; there have been reports of agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding disorder in these neonates; these complications have varied in severity

            While in some cases symptoms have been self-limited, in other cases neonates have required intensive care unit support and prolonged hospitalization; this drug should be used during pregnancy only if potential benefit justifies potential risk to fetus

            Animal data

            • Reproductive studies in rats given over 600 times human dose showed increased incidence of malformations above controls and reduced litter size and weight linked to maternal toxicity; these effects were not observed at half this dosage; no adverse effect on fetal development was observed in rabbits given 700 times human dose nor in monkeys given 25 times human dose

            Lactation

            There is evidence that phenothiazines are excreted in breast milk of nursing mothers; because of potential for serious adverse reactions in nursing infants from this drug, a decision should be made whether to discontinue nursing or to discontinue drug, taking into account importance of drug to mother

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Piperazine phenothiazine agent; antagonist for the postsynaptic mesolimbic dopaminergic D2 receptors in the brain; decreases the release of hypothalamic and hypophyseal hormones

            Pharmacokinetics

            Half-Life elimination: 24 hr

            Metabolism: Liver

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            trifluoperazine oral
            -
            5 mg tablet
            trifluoperazine oral
            -
            5 mg tablet
            trifluoperazine oral
            -
            1 mg tablet
            trifluoperazine oral
            -
            10 mg tablet
            trifluoperazine oral
            -
            2 mg tablet
            trifluoperazine oral
            -
            1 mg tablet
            trifluoperazine oral
            -
            10 mg tablet
            trifluoperazine oral
            -
            2 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            trifluoperazine oral

            TRIFLUOPERAZINE TABLET - ORAL

            (TRYE-floo-oh-PER-a-zeen)

            COMMON BRAND NAME(S): Stelazine

            WARNING: There may be a slightly increased risk of serious, possibly fatal side effects (such as heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.

            USES: This medication is used to treat certain mental/mood disorders (such as schizophrenia, psychotic disorders). Trifluoperazine helps you to think more clearly, feel less nervous, and take part in everyday life. It can reduce aggressive behavior and the desire to hurt yourself/others. It may also help to decrease hallucinations (hearing/seeing things that are not there). Trifluoperazine is a psychiatric medication that belongs to the class of drugs called phenothiazine antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.This medication has also been used for the short-term treatment of anxiety. However, there are safer drugs to treat anxiety that should be used first before trifluoperazine.

            HOW TO USE: Take this medication by mouth with or without food, usually once or twice daily or as directed by your doctor.Dosage is based on your medical condition, age, and response to treatment. In children, the dosage is also based on weight. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.Although you may notice some medication effects soon after starting, it may take 2 to 3 weeks before you get the full benefit of this drug.Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as upset stomach, nausea, vomiting, dizziness, and shakiness. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.Tell your doctor if your condition does not improve or if it worsens.

            SIDE EFFECTS: Drowsiness, dizziness, lightheadedness, dry mouth, blurred vision, tiredness, constipation, weight gain, and trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.This drug may cause muscle/nervous system problems (extrapyramidal symptoms-EPS). Your doctor may prescribe another medication to decrease these side effects. Tell your doctor right away if you notice any of the following side effects: feelings of anxiety/agitation/jitteriness, drooling/trouble swallowing, restlessness/constant need to move, shaking (tremor), shuffling walk, stiff muscles, severe muscle spasms/cramping (such as twisting neck, arching back, eyes rolling up), mask-like expression of the face.Remember that this medication has been prescribed because your doctor 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.Tell your doctor right away if you have any serious side effects, including: difficulty urinating, decreased cough reflex, swelling of the feet/ankles, butterfly-shaped rash on nose and cheeks, joint pain, skin discoloration, eye/vision changes, feeling unusually cold or hot, signs of liver problems (such as nausea that doesn't stop, yellowing eyes/skin, vomiting, stomach/abdominal pain), signs of infection (such as sore throat that doesn't go away, fever), easy bruising/bleeding, signs of anemia (such as severe tiredness, fast breathing, pale skin, fast heartbeat), mental/mood changes (such as worsening psychosis, unresponsive/catatonic state).Rarely, this medication may cause face/muscle twitching and uncontrollable movements (tardive dyskinesia). In some cases, this condition may be permanent. Tell your doctor right away if you develop any uncontrollable movements such as lip smacking, mouth puckering, tongue thrusting, chewing, or unusual arm/leg movements.In rare cases, trifluoperazine 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 right away.Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.Get medical help right away if you have any very serious side effects, including: slowed breathing, chest pain, seizures.This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: See also Warning section.Before taking trifluoperazine, tell your doctor or pharmacist if you are allergic to it; or to other phenothiazines (such as chlorpromazine, perphenazine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.This medication should not be used in people who are intoxicated with alcohol/opioids/other drugs that cause drowsiness/slowed breathing.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, kidney problems, heart problems (such as mitral valve insufficiency, abnormal heart rhythm, angina), low blood pressure, blockage of the intestines, glaucoma, seizures, enlarged prostate, breathing problems (such as severe asthma, emphysema, lung infections), blood disorders (such as bone marrow depression, low red/white/platelet blood cell counts), low levels of calcium in the blood, dehydration, breast cancer, brain disorder/tumor/injury, exposure to organophosphate insecticides, pheochromocytoma, drug/alcohol/substance abuse, Parkinson's disease.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery or imaging procedures (such as certain X-rays, CT scans) requiring the use of contrast dye (such as metrizamide), tell your doctor or dentist that you are using this medication and about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Children may be more sensitive to the side effects of this drug, especially uncontrolled movements. They may be at greater risk when they are sick (such as having viral infection, dehydration).Older adults may be more sensitive to the side effects of this drug, especially dizziness, lightheadedness, drowsiness, confusion, uncontrollable movements, constipation, difficulty urinating, or blurred vision. Dizziness, lightheadedness, drowsiness, and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.Since untreated mental/mood problems (such as schizophrenia, psychotic disorders) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: anticholinergic/antispasmodic drugs (such as atropine, dicyclomine, scopolamine), drugs that increase the amount of dopamine in your body (such as cabergoline, levodopa, pergolide, ropinirole), guanethidine, lithium, phenytoin, propranolol, warfarin, other drugs that cause dizziness upon standing (including alpha blockers such as prazosin).Tell your doctor or pharmacist if you are taking other products that cause drowsiness or may slow your breathing including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or 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 (such as phenylketonuria tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness/deep sleep, loss of consciousness, agitation, restlessness, seizures, irregular heartbeat.

            NOTES: Do not share this medication with others.Lab and/or medical tests (such as liver function, blood counts, eye exams) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

            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. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

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            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.