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

Details

Stereochemistry ACHIRAL
Molecular Formula C21H26ClN3OS
Molecular Weight 403.969
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of PERPHENAZINE

SMILES

OCCN1CCN(CCCN2C3=C(SC4=C2C=C(Cl)C=C4)C=CC=C3)CC1

InChI

InChIKey=RGCVKNLCSQQDEP-UHFFFAOYSA-N
InChI=1S/C21H26ClN3OS/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/h1-2,4-7,16,26H,3,8-15H2

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
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
Drug-induced dystonia.
1975 May
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
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
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
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
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
A case of progressive hemichorea responsive to high-dose reserpine.
1986 Mar
The relationship between blood perphenazine levels, early resolution of psychotic symptoms, and side effects.
1990 Aug
Neurologic approach to drug-induced movement disorders: a study of 125 patients.
1990 May
The efficacy of prophylactic ondansetron, droperidol, perphenazine, and metoclopramide in the prevention of nausea and vomiting after major gynecologic surgery.
1995 Jul
Olanzapine use in women with antipsychotic-induced hyperprolactinemia.
1998 Oct
Perphenazine-induced hiccups.
1999 Mar
Quercetin potentiates L-Dopa reversal of drug-induced catalepsy in rats: possible COMT/MAO inhibition.
2003 Jun
Survey on schizophrenia treatment in Mexico: perception and antipsychotic prescription patterns.
2004 Apr 27
An unexpected increase of troponin I after perphenazine depot injection.
2004 Feb
Induction of the rabbit syndrome following coadministration of paroxetine, perphenazine, and amitriptyline.
2004 Nov-Dec
Prediction of genotoxicity of chemical compounds by statistical learning methods.
2005 Jun
Stable expression of constitutively activated mutant h5HT6 and h5HT7 serotonin receptors: inverse agonist activity of antipsychotic drugs.
2005 May
[Trazodone for the treatment of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease: a retrospective study focused on the aggression and negativism in caregiving situations].
2006 Jun
Acute dystonia induced by the combination of midodrine and perphenazine.
2008 May
BL-1020: a novel antipsychotic drug with GABAergic activity and low catalepsy, is efficacious in a rat model of schizophrenia.
2009 Jan
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
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
EP   HSDB   INN   MART.   MI   ORANGE BOOK   USP   USP-RS   VANDF   WHO-DD  
INN  
Official Name English
PERPHENAZINE COMPONENT OF ETRAFON-A
Common Name English
PIPERAZINEETHANOL, 4-(3-(2-CHLORO-10H-PHENOTHIAZIN-10-YL)PROPYL)-
Systematic Name English
PERPHENAZINE [HSDB]
Common Name English
4-[3-(2-Chlorophenothiazin-10-yl)propyl]-1-piperazineethanol
Systematic Name English
TRILAFON
Brand Name English
PERPHENAZINE [VANDF]
Common Name English
PERPHENAZINE [USP MONOGRAPH]
Common Name English
PERPHENAZINE [MART.]
Common Name English
Perphenazine [WHO-DD]
Common Name English
PERPHENAZINE MALEATE [JAN]
Common Name English
PERPHENAZINE [JAN]
Common Name English
NSC-150866
Code English
PERPHENAZINE [EP MONOGRAPH]
Common Name English
ETRAFON-A COMPONENT PERPHENAZINE
Common Name English
perphenazine [INN]
Common Name English
PERPHENAZINE [USP-RS]
Common Name English
FLUPHENAZINE DIHYDROCHLORIDE IMPURITY E [EP IMPURITY]
Common Name English
PERPHENAZINE [ORANGE BOOK]
Common Name English
PERPHENAZINE [MI]
Common Name English
Classification Tree Code System Code
NDF-RT N0000175746
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WHO-VATC QN05AB03
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LIVERTOX NBK548366
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NCI_THESAURUS C29710
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NDF-RT N0000007544
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NDF-RT N0000007544
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NDF-RT N0000007544
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WHO-ATC N05AB03
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Code System Code Type Description
RXCUI
8076
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PRIMARY RxNorm
INN
637
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PRIMARY
EVMPD
SUB09736MIG
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PRIMARY
ChEMBL
CHEMBL567
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PRIMARY
EPA CompTox
DTXSID1023441
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PRIMARY
DRUG BANK
DB00850
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PRIMARY
FDA UNII
FTA7XXY4EZ
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PRIMARY
MESH
D010546
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PRIMARY
DAILYMED
FTA7XXY4EZ
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PRIMARY
WIKIPEDIA
PERPHENAZINE
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PRIMARY
NCI_THESAURUS
C29355
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PRIMARY
CHEBI
8028
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PRIMARY
DRUG CENTRAL
2113
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PRIMARY
NSC
150866
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PRIMARY
RS_ITEM_NUM
1511000
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PRIMARY
PUBCHEM
4748
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PRIMARY
SMS_ID
100000092394
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PRIMARY
CAS
58-39-9
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PRIMARY
ECHA (EC/EINECS)
200-381-5
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PRIMARY
MERCK INDEX
m8567
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PRIMARY Merck Index
HSDB
3379
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PRIMARY
LACTMED
Perphenazine
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PRIMARY
IUPHAR
209
Created by admin on Fri Dec 15 16:27:42 GMT 2023 , Edited by admin on Fri Dec 15 16:27:42 GMT 2023
PRIMARY