When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to perphenazine or amitriptyline, or if you have a bone marrow disorder.

How to Use This Medicine:
Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take this medicine if you have used a monoamine oxidase (MAO) inhibitor within the past 14 days.
• Some medicines and foods can affect how this medicine works. Tell your doctor if you are using any other medicine that makes you sleepy, such as cold or allergy medicine, sedatives, or narcotic pain medicine.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have heart disease, liver disease, epilepsy, thyroid disease, glaucoma, or a history of urinary retention.
• This medicine may cause the following problems:
  
  • Tardive dyskinesia, a disorder that causes involuntary movements, and that could be permanent
  • Neuroleptic malignant syndrome
  • Sensitivity to hot and cold temperatures
• For some children, teenagers, and young adults, this medicine may increase mental or emotional problems. This may lead to thoughts of suicide and violence. Talk with your doctor right away if you have any thoughts or behavior changes that concern you. Tell your doctor if you or anyone in your family has a history of bipolar disorder or suicide attempts.
• This medicine may raise or lower your blood sugar level.
• Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
• This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate
• Fast, pounding, or uneven heartbeat, dizziness, lightheadedness
• Feeling more excited or energetic than usual, racing thoughts
• Fever, chills, cough, sore throat, and body aches
• Fever, sweating, confusion, uneven heartbeat, muscle stiffness
• Jerky muscle movements that you cannot control (often in your face, tongue, or jaw)
• Seizures
• Severe stomach pain, constipation, vomiting
• Trouble breathing
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Blurred vision
• Constipation
• Dizziness or drowsiness
• Dry mouth, stuffy nose

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088