U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ACHIRAL
Molecular Formula C21H26ClN3OS.2C4H4O4
Molecular Weight 636.113
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 2
Charge 0

SHOW SMILES / InChI
Structure of PERPHENAZINE DIMALEATE

SMILES

OC(=O)\C=C/C(O)=O.OC(=O)\C=C/C(O)=O.OCCN1CCN(CCCN2C3=C(SC4=C2C=C(Cl)C=C4)C=CC=C3)CC1

InChI

InChIKey=HYYMPXVEPSKZOU-SPIKMXEPSA-N
InChI=1S/C21H26ClN3OS.2C4H4O4/c22-17-6-7-21-19(16-17)25(18-4-1-2-5-20(18)27-21)9-3-8-23-10-12-24(13-11-23)14-15-26;2*5-3(6)1-2-4(7)8/h1-2,4-7,16,26H,3,8-15H2;2*1-2H,(H,5,6)(H,7,8)/b;2*2-1-

HIDE SMILES / InChI
Perphenazine is a relatively high potency phenothiazine that blocks dopamine 2 receptors predominantly, but also may possess antagonist actions at histamine 1 and cholinergic M1 and alpha 1 adrenergic receptors in the vomiting center leading to reduced nausea and vomiting. The drug was approved by FDA for the treatment of schizophrenia and control of severe nausea and vomiting (either alone or in combination with amitriptyline hydrochloride). Perphenazine is extensively hepatic to metabolites via sulfoxidation, hydroxylation, dealkylation, and glucuronidation; primarily metabolized by CYP2D6 to N-dealkylated perphenazine, perphenazine sulfoxide, and 7-hydroxyperphenazine (active metabolite with 70% of the activity of perphenazine) and excreted in the urine and feces.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Target ID: P14416
Gene ID: 1813.0
Gene Symbol: DRD2
Target Organism: Homo sapiens (Human)
0.16 nM [Ki]
Target ID: P35367
Gene ID: 3269.0
Gene Symbol: HRH1
Target Organism: Homo sapiens (Human)
8.0 nM [Kd]
Target ID: P11229
Gene ID: 1128.0
Gene Symbol: CHRM1
Target Organism: Homo sapiens (Human)
1.5 µM [Kd]
10.0 nM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Preventing
PERPHENAZINE

Approved Use

Perphenazine is indicated for use in the treatment of schizophrenia and for the control of severe nausea and vomiting in adults.

Launch Date

1988
Preventing
PERPHENAZINE

Approved Use

Perphenazine is indicated for use in the treatment of schizophrenia and for the control of severe nausea and vomiting in adults.

Launch Date

1988
Primary
PERPHENAZINE

Approved Use

Perphenazine is indicated for use in the treatment of schizophrenia and for the control of severe nausea and vomiting in adults.

Launch Date

1988
Primary
PERPHENAZINE AND AMITRIPTYLINE HYDROCHLORIDE

Approved Use

Perphenazine and amitriptyline hydrochloride tablets are recommended for treatment of (1) patients with moderate to severe anxiety and/or agitation and depressed mood, (2) patients with depression in whom anxiety and/or agitation are severe, and (3) patients with depression and anxiety in association with chronic physical disease. In many of these patients, anxiety masks the depressive state so that, although therapy with a tranquilizer appears to be indicated, the administration of a tranquilizer alone will not be adequate.

Launch Date

1988
Primary
PERPHENAZINE AND AMITRIPTYLINE HYDROCHLORIDE

Approved Use

Perphenazine and amitriptyline hydrochloride tablets are recommended for treatment of (1) patients with moderate to severe anxiety and/or agitation and depressed mood, (2) patients with depression in whom anxiety and/or agitation are severe, and (3) patients with depression and anxiety in association with chronic physical disease. In many of these patients, anxiety masks the depressive state so that, although therapy with a tranquilizer appears to be indicated, the administration of a tranquilizer alone will not be adequate.

Launch Date

1988
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
509 pg/mL
4 mg 3 times / day steady-state, oral
dose: 4 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
7-HYDROXYPERPHENAZINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
0.546 ng/mL
16 mg single, oral
dose: 16 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
PERPHENAZINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
984 pg/mL
4 mg 3 times / day steady-state, oral
dose: 4 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
PERPHENAZINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
6.673 ng × h/mL
16 mg single, oral
dose: 16 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
PERPHENAZINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
18.8 h
4 mg 3 times / day steady-state, oral
dose: 4 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
7-HYDROXYPERPHENAZINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
9.12 h
16 mg single, oral
dose: 16 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
PERPHENAZINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
12 h
4 mg 3 times / day steady-state, oral
dose: 4 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
PERPHENAZINE plasma
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
9%
unknown, unknown
PERPHENAZINE unknown
Homo sapiens
population: UNKNOWN
age: UNKNOWN
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
0.93 g single, oral
Overdose
Dose: 0.93 g
Route: oral
Route: single
Dose: 0.93 g
Co-administed with::
maprotiline, p.o(5.6 g; single)
triazolam, p.o(14 mg; single)
salicylate
Sources: Page: p.2627, 2631
unhealthy, 42
n = 1
Health Status: unhealthy
Condition: Depression
Age Group: 42
Sex: M
Population Size: 1
Sources: Page: p.2627, 2631
Disc. AE: QT interval prolonged, Hypothermia...
AEs leading to
discontinuation/dose reduction:
QT interval prolonged
Hypothermia
Loss of consciousness
PR interval prolonged
QRS prolonged
Sources: Page: p.2627, 2631
200 mg single, oral
Overdose
Dose: 200 mg
Route: oral
Route: single
Dose: 200 mg
Sources: Page: p.104
unhealthy, 48
n = 1
Health Status: unhealthy
Condition: Schizophrenia
Age Group: 48
Sex: F
Population Size: 1
Sources: Page: p.104
Disc. AE: Coma, Hypothermia...
AEs leading to
discontinuation/dose reduction:
Coma
Hypothermia
Tachycardia
Miosis
Sources: Page: p.104
30 mg 1 times / day multiple, intramuscular (total daily dose)
Recommended
Dose: 30 mg, 1 times / day
Route: intramuscular
Route: multiple
Dose: 30 mg, 1 times / day
Sources: Page: p.3
unhealthy
Health Status: unhealthy
Condition: Schizophrenia
Sources: Page: p.3
Disc. AE: Tardive dyskinesia...
AEs leading to
discontinuation/dose reduction:
Tardive dyskinesia
Sources: Page: p.3
30 mg 1 times / day multiple, intramuscular (total daily dose)
Recommended
Dose: 30 mg, 1 times / day
Route: intramuscular
Route: multiple
Dose: 30 mg, 1 times / day
Sources: Page: p.4
unhealthy
Health Status: unhealthy
Condition: Schizophrenia
Sources: Page: p.4
Disc. AE: Neuroleptic malignant syndrome...
AEs leading to
discontinuation/dose reduction:
Neuroleptic malignant syndrome
Sources: Page: p.4
64 mg 1 times / day multiple, oral (total daily dose)
Recommended
Dose: 64 mg, 1 times / day
Route: oral
Route: multiple
Dose: 64 mg, 1 times / day
Sources: Page: p.3
unhealthy
Health Status: unhealthy
Condition: Schizophrenia
Sources: Page: p.3
Disc. AE: Tardive dyskinesia...
AEs leading to
discontinuation/dose reduction:
Tardive dyskinesia
Sources: Page: p.3
64 mg 1 times / day multiple, oral (total daily dose)
Recommended
Dose: 64 mg, 1 times / day
Route: oral
Route: multiple
Dose: 64 mg, 1 times / day
Sources: Page: p.4
unhealthy
Health Status: unhealthy
Condition: Schizophrenia
Sources: Page: p.4
Disc. AE: Neuroleptic malignant syndrome...
AEs leading to
discontinuation/dose reduction:
Neuroleptic malignant syndrome
Sources: Page: p.4
20 mg single, intramuscular
Studied dose
Dose: 20 mg
Route: intramuscular
Route: single
Dose: 20 mg
Sources:
unhealthy
n = 1
Health Status: unhealthy
Condition: Schizophrenia
Population Size: 1
Sources:
Disc. AE: Neuroleptic malignant syndrome...
AEs leading to
discontinuation/dose reduction:
Neuroleptic malignant syndrome
Sources:
AEs

AEs

AESignificanceDosePopulation
Hypothermia Disc. AE
0.93 g single, oral
Overdose
Dose: 0.93 g
Route: oral
Route: single
Dose: 0.93 g
Co-administed with::
maprotiline, p.o(5.6 g; single)
triazolam, p.o(14 mg; single)
salicylate
Sources: Page: p.2627, 2631
unhealthy, 42
n = 1
Health Status: unhealthy
Condition: Depression
Age Group: 42
Sex: M
Population Size: 1
Sources: Page: p.2627, 2631
Loss of consciousness Disc. AE
0.93 g single, oral
Overdose
Dose: 0.93 g
Route: oral
Route: single
Dose: 0.93 g
Co-administed with::
maprotiline, p.o(5.6 g; single)
triazolam, p.o(14 mg; single)
salicylate
Sources: Page: p.2627, 2631
unhealthy, 42
n = 1
Health Status: unhealthy
Condition: Depression
Age Group: 42
Sex: M
Population Size: 1
Sources: Page: p.2627, 2631
PR interval prolonged Disc. AE
0.93 g single, oral
Overdose
Dose: 0.93 g
Route: oral
Route: single
Dose: 0.93 g
Co-administed with::
maprotiline, p.o(5.6 g; single)
triazolam, p.o(14 mg; single)
salicylate
Sources: Page: p.2627, 2631
unhealthy, 42
n = 1
Health Status: unhealthy
Condition: Depression
Age Group: 42
Sex: M
Population Size: 1
Sources: Page: p.2627, 2631
QRS prolonged Disc. AE
0.93 g single, oral
Overdose
Dose: 0.93 g
Route: oral
Route: single
Dose: 0.93 g
Co-administed with::
maprotiline, p.o(5.6 g; single)
triazolam, p.o(14 mg; single)
salicylate
Sources: Page: p.2627, 2631
unhealthy, 42
n = 1
Health Status: unhealthy
Condition: Depression
Age Group: 42
Sex: M
Population Size: 1
Sources: Page: p.2627, 2631
QT interval prolonged Disc. AE
0.93 g single, oral
Overdose
Dose: 0.93 g
Route: oral
Route: single
Dose: 0.93 g
Co-administed with::
maprotiline, p.o(5.6 g; single)
triazolam, p.o(14 mg; single)
salicylate
Sources: Page: p.2627, 2631
unhealthy, 42
n = 1
Health Status: unhealthy
Condition: Depression
Age Group: 42
Sex: M
Population Size: 1
Sources: Page: p.2627, 2631
Coma Disc. AE
200 mg single, oral
Overdose
Dose: 200 mg
Route: oral
Route: single
Dose: 200 mg
Sources: Page: p.104
unhealthy, 48
n = 1
Health Status: unhealthy
Condition: Schizophrenia
Age Group: 48
Sex: F
Population Size: 1
Sources: Page: p.104
Hypothermia Disc. AE
200 mg single, oral
Overdose
Dose: 200 mg
Route: oral
Route: single
Dose: 200 mg
Sources: Page: p.104
unhealthy, 48
n = 1
Health Status: unhealthy
Condition: Schizophrenia
Age Group: 48
Sex: F
Population Size: 1
Sources: Page: p.104
Miosis Disc. AE
200 mg single, oral
Overdose
Dose: 200 mg
Route: oral
Route: single
Dose: 200 mg
Sources: Page: p.104
unhealthy, 48
n = 1
Health Status: unhealthy
Condition: Schizophrenia
Age Group: 48
Sex: F
Population Size: 1
Sources: Page: p.104
Tachycardia Disc. AE
200 mg single, oral
Overdose
Dose: 200 mg
Route: oral
Route: single
Dose: 200 mg
Sources: Page: p.104
unhealthy, 48
n = 1
Health Status: unhealthy
Condition: Schizophrenia
Age Group: 48
Sex: F
Population Size: 1
Sources: Page: p.104
Tardive dyskinesia Disc. AE
30 mg 1 times / day multiple, intramuscular (total daily dose)
Recommended
Dose: 30 mg, 1 times / day
Route: intramuscular
Route: multiple
Dose: 30 mg, 1 times / day
Sources: Page: p.3
unhealthy
Health Status: unhealthy
Condition: Schizophrenia
Sources: Page: p.3
Neuroleptic malignant syndrome Disc. AE
30 mg 1 times / day multiple, intramuscular (total daily dose)
Recommended
Dose: 30 mg, 1 times / day
Route: intramuscular
Route: multiple
Dose: 30 mg, 1 times / day
Sources: Page: p.4
unhealthy
Health Status: unhealthy
Condition: Schizophrenia
Sources: Page: p.4
Tardive dyskinesia Disc. AE
64 mg 1 times / day multiple, oral (total daily dose)
Recommended
Dose: 64 mg, 1 times / day
Route: oral
Route: multiple
Dose: 64 mg, 1 times / day
Sources: Page: p.3
unhealthy
Health Status: unhealthy
Condition: Schizophrenia
Sources: Page: p.3
Neuroleptic malignant syndrome Disc. AE
64 mg 1 times / day multiple, oral (total daily dose)
Recommended
Dose: 64 mg, 1 times / day
Route: oral
Route: multiple
Dose: 64 mg, 1 times / day
Sources: Page: p.4
unhealthy
Health Status: unhealthy
Condition: Schizophrenia
Sources: Page: p.4
Neuroleptic malignant syndrome Disc. AE
20 mg single, intramuscular
Studied dose
Dose: 20 mg
Route: intramuscular
Route: single
Dose: 20 mg
Sources:
unhealthy
n = 1
Health Status: unhealthy
Condition: Schizophrenia
Population Size: 1
Sources:
Overview

Overview

Drug as perpetrator​Drug as victimTox targets

Tox targets

PubMed

PubMed

TitleDatePubMed
The bucco-linguo-masticatory syndrome as a side-effect of neuroleptics therapy.
1967
Side-effects of phenothiazines.
1967 Apr 1
Phenothiazines in early labour.
1967 Feb 11
Drug-induced extrapyramidal symptoms: their incidence and treatment.
1967 Jan
Oculogyric crises due to phenothiazines.
1967 Jul 22
Specific therapeutic actions of acetophenazine, perphenazine, and benzquinamide in newly admitted schizophrenic patients.
1967 Mar-Apr
Phenothiazines and diabetes in hospitalized women.
1968 Jan
Dystonic reaction to perphenazine.
1969 Aug 9
Perphenazine dystonia presenting as recurrent dislocation of the jaw.
1969 Jan
Iatrogenic epilepsy due to antidepressant drugs.
1969 Oct 11
Increased sensitivity to neuroleptics in rats with lesions of the central nervous system.
1972
Idiosyncratic responses to phenothiazines.
1972 Jan 22
The mechanism of the potentiating effect of antidepressant drugs on the protective influenc oe of diphenhydramine in experimental catatonia. The role of histamine.
1974
Letter: Side-effects of perphenazine.
1975 Jun 21
Asymptomatic idiopathic syndrome of prolonged Q-T interval in a 45-year-old woman. Ventricular tachyarrhythmias precipitated by hypokalemia and therapy with amitriptyline and prephenazine.
1977 Feb
Drug-induced anaphylaxis, convulsions, deafness, and extrapyramidal symptoms.
1977 Mar 12
[Acute dystonia in children. 2 cases caused by perphenazine (Trilafon)].
1978 Mar 10
Death attributed to ventricular arrhythmia induced by thioridazine in combination with a single Contac C capsule.
1978 Oct 7
Electrophysiologic studies of perphenazine and protriptyline in a patient with psychotropic drug-induced ventricular fibrillation.
1979 Aug
Seven cases of somnambulism induced by drugs.
1979 Jul
Metoclopramide and dystonic reactions in Sardinians.
1979 Jun 23
Toxic psychosis with cimetidine.
1979 May
Pituitary sensitivity to LHRH in hyperprolactinemia induced by perphenazine and renal pituitary transplants in female rats.
1980 Apr
Plasma levels of perphenazine (Trilafon) related to development of extrapyramidal side effects.
1981
Actions of clonidine on convulsions and behaviour.
1981 Jul
Prolactin and the small intestine. Effect of hyperprolactinaemia on mucosal structure in the rat.
1981 Jul
Tricyclic antidepressants and alcoholic blackouts.
1981 Jun
Dose-response relationships of perphenazine in the treatment of acute psychoses.
1982
Cerebellar syndrome following neuroleptic induced heat stroke.
1983 Feb
Unique sensitivity of Hb Zürich to oxidative injury by phenazopyridine: reversal of the effects by elevating carboxyhemoglobin levels in vivo and in vitro.
1983 Jun
Sigma opiates and certain antipsychotic drugs mutually inhibit (+)-[3H] SKF 10,047 and [3H]haloperidol binding in guinea pig brain membranes.
1984 Sep
Pharmacology in vivo of the phenylindan derivative, Lu 19-005, a new potent inhibitor of dopamine, noradrenaline and 5-hydroxytryptamine uptake in rat brain.
1985 Apr
GABAergic, dopaminergic and cholinergic interactions in perphenazine-induced catatonia in rats.
1985 Dec
Effect of different neuroleptics in tardive dyskinesia and parkinsonism. A video-controlled multicenter study with chlorprothixene, perphenazine, haloperidol and haloperidol + biperiden. Nordic Dyskinesia Study Group.
1986
A case of progressive hemichorea responsive to high-dose reserpine.
1986 Mar
Tourette-like syndrome following low dose short-term neuroleptic treatment.
1986 May
L-tryptophan in drug-induced movement disorders with insomnia.
1986 May 8
Zuclopenthixol and perphenazine in patients with acute psychotic states. A double-blind multicentre study.
1987 Jul
Neuroleptic malignant syndrome during perphenazine treatment.
1987 Mar
The relationship between blood perphenazine levels, early resolution of psychotic symptoms, and side effects.
1990 Aug
Risperidone versus perphenazine in the treatment of chronic schizophrenic patients with acute exacerbations.
1993 Dec
Binding of typical and atypical antipsychotic agents to 5-hydroxytryptamine-6 and 5-hydroxytryptamine-7 receptors.
1994 Mar
The efficacy of prophylactic ondansetron, droperidol, perphenazine, and metoclopramide in the prevention of nausea and vomiting after major gynecologic surgery.
1995 Jul
BMY-14802 reversed the sigma receptor agonist-induced neck dystonia in rats.
1996
Association of plasma homovanillic acid with behavioral symptoms in patients diagnosed with dementia: a preliminary report.
1997 Dec 1
Induction of mania by risperidone resistant to mood stabilizers.
1997 Feb
Olanzapine use in women with antipsychotic-induced hyperprolactinemia.
1998 Oct
Profiling of a prescription drug library for potential renal drug-drug interactions mediated by the organic cation transporter 2.
2011 Jul 14
Antitubercular pharmacodynamics of phenothiazines.
2013 Apr
Selective inhibition of hepatitis C virus infection by hydroxyzine and benztropine.
2014 Jun
Patents

Sample Use Guides

Moderately disturbed nonhospitalized patients with schizophrenia: 4 to 8 mg t.i.d. initially; reduce as soon as possible to minimum effective dosage. Hospitalized patients with schizophrenia: 8 to 16 mg b.i.d. to q.i.d.; avoid dosages in excess of 64 mg daily. Severe nausea and vomiting in adults: 8 to 16 mg daily in divided doses; 24 mg occasionally may be necessary; early dosage reduction is desirable.
Route of Administration: Oral
Perphenazine (10-100 microM) was administered, either alone or combined with dopamine, to primary mouse neuronal or intact brain culture and to a human neuroblastoma (NB) cell line (SK-N-SH). Cell viability (measured by neutral red and alamar blue), DNA fragmentation (flow cytometry-NB) were determined. Neuroblastoma: perphenazine decreased viability by 87%.
Name Type Language
PERPHENAZINE DIMALEATE
Common Name English
1-PIPERAZINEETHANOL, 4-(3-(2-CHLORO-10H-PHENOTHIAZIN-10-YL)PROPYL)-, (2Z)-2-BUTENEDIOATE (1:2) (SALT)
Systematic Name English
Perphenazine maleate [WHO-DD]
Common Name English
PERPHENAZINE MALEATE
WHO-DD  
Common Name English
Code System Code Type Description
CAS
3534-08-5
Created by admin on Sat Dec 16 01:26:51 GMT 2023 , Edited by admin on Sat Dec 16 01:26:51 GMT 2023
PRIMARY
PUBCHEM
6444477
Created by admin on Sat Dec 16 01:26:51 GMT 2023 , Edited by admin on Sat Dec 16 01:26:51 GMT 2023
PRIMARY
SMS_ID
100000085679
Created by admin on Sat Dec 16 01:26:51 GMT 2023 , Edited by admin on Sat Dec 16 01:26:51 GMT 2023
PRIMARY
FDA UNII
7K96LZ09JI
Created by admin on Sat Dec 16 01:26:51 GMT 2023 , Edited by admin on Sat Dec 16 01:26:51 GMT 2023
PRIMARY
EVMPD
SUB03718MIG
Created by admin on Sat Dec 16 01:26:51 GMT 2023 , Edited by admin on Sat Dec 16 01:26:51 GMT 2023
PRIMARY
ChEMBL
CHEMBL567
Created by admin on Sat Dec 16 01:26:51 GMT 2023 , Edited by admin on Sat Dec 16 01:26:51 GMT 2023
PRIMARY
CHEBI
34912
Created by admin on Sat Dec 16 01:26:51 GMT 2023 , Edited by admin on Sat Dec 16 01:26:51 GMT 2023
PRIMARY
CAS
5352-90-9
Created by admin on Sat Dec 16 01:26:51 GMT 2023 , Edited by admin on Sat Dec 16 01:26:51 GMT 2023
NON-SPECIFIC STOICHIOMETRY