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Prestwick3_000125
Also known as: 58-39-9, Trilafon, Perphenazin, Etaperazine, Perfenazine, Ethaperazine
Molecular Formula
C21H26ClN3OS
Molecular Weight
404.0  g/mol
InChI Key
RGCVKNLCSQQDEP-UHFFFAOYSA-N
FDA UNII
FTA7XXY4EZ

An antipsychotic phenothiazine derivative with actions and uses similar to those of CHLORPROMAZINE.
Perphenazine is a Phenothiazine.
1 2D Structure

Prestwick3_000125

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
2-[4-[3-(2-chlorophenothiazin-10-yl)propyl]piperazin-1-yl]ethanol
2.1.2 InChI
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
2.1.3 InChI Key
RGCVKNLCSQQDEP-UHFFFAOYSA-N
2.1.4 Canonical SMILES
C1CN(CCN1CCCN2C3=CC=CC=C3SC4=C2C=C(C=C4)Cl)CCO
2.2 Other Identifiers
2.2.1 UNII
FTA7XXY4EZ
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Chlorpiprazine

2. Perfenazine

3. Trilafon

2.3.2 Depositor-Supplied Synonyms

1. 58-39-9

2. Trilafon

3. Perphenazin

4. Etaperazine

5. Perfenazine

6. Ethaperazine

7. Etaperazin

8. Fentazin

9. Chlorpiprazine

10. Perphenan

11. Thilatazin

12. Decentan

13. Chlorperphenazine

14. Emesinal

15. Perfenazina

16. Tranquisan

17. Trifaron

18. Trilifan

19. Triphenot

20. F-mon

21. Perphenazinum

22. 2-(4-(3-(2-chloro-10h-phenothiazin-10-yl)propyl)piperazin-1-yl)ethanol

23. Sch 3940

24. 2-[4-[3-(2-chlorophenothiazin-10-yl)propyl]piperazin-1-yl]ethanol

25. 4-[3-(2-chlorophenothiazin-10-yl)propyl]-1-piperazineethanol

26. 4-(3-(2-chlorophenothiazin-10-yl)propyl)-1-piperazineethanol

27. Pzc

28. Gamma-(4-(beta-hydroxyethyl)piperazin-1-yl)propyl-2-chlorophenothiazine

29. Nsc 150866

30. 4-[3-(2-chloro-10h-phenothiazin-10-yl)propyl]-1-piperazineethanol

31. 1-(2-hydroxyethyl)-4-(3-(2-chloro-10-phenothiazinyl)propyl)piperazine

32. 2-{4-[3-(2-chloro-10h-phenothiazin-10-yl)propyl]piperazin-1-yl}ethan-1-ol

33. Fta7xxy4ez

34. Chembl567

35. Nsc-150866

36. 2-chloro-10-3-(1-(2-hydroxyethyl)-4-piperazinyl)propyl Phenothiazine

37. 2-{4-[3-(2-chloro-10h-phenothiazin-10-yl)propyl]piperazin-1-yl}ethanol

38. 2-chloro-10-(3-(4-(2-hydroxyethyl)piperazin-1-yl)propyl)phenothiazine

39. 2-chloro-10-[3-[4-(2-hydroxyethyl)piperazin-1-yl]propyl]phenothiazine

40. Mls000069637

41. Chebi:8028

42. 1',1-(2-idrossietil)-4,3-(2-cloro-10-fenotiazil)propilpiperazina

43. 1-piperazineethanol, 4-(3-(2-chloro-10h-phenothiazin-10-yl)propyl)-

44. 1-piperazineethanol, 4-[3-(2-chloro-10h-phenothiazin-10-yl)propyl]-

45. 2-(4-[3-(2-chloro-10h-phenothiazin-10-yl)propyl]-1-piperazinyl)ethanol

46. Nsc150866

47. Cas-58-39-9

48. Ncgc00015826-02

49. Perfenil

50. Smr000058180

51. Perfenazina [italian]

52. 1-piperazineethanol, 4-(3-(2-chlorophenothiazin-10-yl)propyl)-

53. 1-(2-hydroxyethyl)-4-[3-(2-chloro-10-phenothiazinyl)propyl]piperazine

54. Dsstox_cid_3441

55. Piperazineethanol, 4-(3-(2-chloro-10h-phenothiazin-10-yl)propyl)-

56. Dsstox_rid_77031

57. Dsstox_gsid_23441

58. Perfenazina [inn-spanish]

59. Perphenazinum [inn-latin]

60. Perphenazine Maleate [jan]

61. 1-piperazineethanol, 4-[3-(2-chlorophenothiazin-10-yl)propyl]-

62. 2-chloro-10-3-[1-(2-hydroxyethyl)-4-piperazinyl]propyl Phenothiazine

63. Hsdb 3379

64. Sr-01000000137

65. Unii-fta7xxy4ez

66. Einecs 200-381-5

67. Mfcd00056798

68. Ai3-50151

69. Piperazineethanol, 4-[3-(2-chloro-10h-phenothiazin-10-yl)propyl]-

70. .gamma.-(4-(.beta.-hydroxyethyl)piperazin-1-yl)propyl-2-chlorophenothiazine

71. .gamma.-[4-(.beta.-hydroxyethyl)piperazin-1-yl]propyl-2-chlorophenothiazine

72. 2-(4-(3-(2-chloro-10h-phenothiazin-10-yl)propyl)piperazin-1-yl)ethan-1-ol

73. Perphenazine [usp:inn:ban:jan]

74. 2-chloro-10-(3-(1-(2-hydroxyethyl)-4-piperazinyl)propyl)phenothiazine

75. Sch-3940

76. Prestwick_536

77. 1',1-(2-idrossietil)-4,3-(2-cloro-10-fenotiazil)propilpiperazina [italian]

78. Etrafon (salt/mix)

79. Spectrum_001610

80. Opera_id_1161

81. Prestwick0_000125

82. Prestwick1_000125

83. Prestwick2_000125

84. Prestwick3_000125

85. Spectrum2_001602

86. Spectrum3_000758

87. Spectrum4_000843

88. Spectrum5_001493

89. Lopac-p-6402

90. Perphenazine [mi]

91. Perphenazine [inn]

92. Perphenazine [jan]

93. P 6402

94. Perphenazine [hsdb]

95. Perphenazine [vandf]

96. Lopac0_000930

97. Oprea1_603835

98. Regid_for_cid_4748

99. Schembl42125

100. Bspbio_000170

101. Bspbio_002376

102. Gtpl209

103. Kbiogr_001445

104. Kbioss_002090

105. Perphenazine [mart.]

106. Mls001146929

107. Mls002548897

108. 5,7-eicosadiynoicacid

109. Bidd:gt0150

110. Divk1c_000880

111. Perphenazine [usp-rs]

112. Perphenazine [who-dd]

113. Spectrum1503934

114. Spbio_001603

115. Spbio_002109

116. Bpbio1_000188

117. Dtxsid1023441

118. Component Of Triavil (salt/mix)

119. Hms502l22

120. Kbio1_000880

121. Kbio2_002090

122. Kbio2_004658

123. Kbio2_007226

124. Kbio3_001596

125. Perphenazine (jp17/usp/inn)

126. Ninds_000880

127. Hms1568i12

128. Hms1922m14

129. Hms2093m15

130. Hms2095i12

131. Hms2232d21

132. Hms3259c09

133. Hms3262j22

134. Hms3370o14

135. Hms3712i12

136. Hms3885h20

137. Perphenazine [orange Book]

138. Pharmakon1600-01503934

139. Perphenazine [ep Monograph]

140. Hy-a0077

141. Perphenazine [usp Monograph]

142. Perphenazine 1.0 Mg/ml In Methanol

143. Tox21_110233

144. Tox21_500930

145. 1-piperazineethanol, Trihydrochloride

146. Bdbm50130273

147. Ccg-39060

148. Nsc758649

149. S4731

150. Stk019818

151. Zinc19228902

152. Akos000664046

153. Tox21_110233_1

154. Cs-5137

155. Db00850

156. Etrafon-a Component Perphenazine

157. Ks-5105

158. Lp00930

159. Nc00472

160. Nsc-758649

161. Sdccgsbi-0050904.p004

162. Idi1_000880

163. Mrf-0000509

164. Ncgc00015826-01

165. Ncgc00015826-03

166. Ncgc00015826-04

167. Ncgc00015826-05

168. Ncgc00015826-06

169. Ncgc00015826-07

170. Ncgc00015826-08

171. Ncgc00015826-09

172. Ncgc00015826-10

173. Ncgc00015826-13

174. Ncgc00015826-20

175. Ncgc00024092-03

176. Ncgc00024092-04

177. Ncgc00024092-05

178. Ncgc00024092-06

179. Ncgc00261615-01

180. Ac-12196

181. Perphenazine Component Of Etrafon-a

182. Sbi-0050904.p003

183. Db-053200

184. Ab00052390

185. Eu-0072164

186. Eu-0100930

187. Ft-0603244

188. P1970

189. C07427

190. D00503

191. D82041

192. Ab00052390_17

193. A831863

194. L000919

195. Q423520

196. Sr-01000000137-2

197. Sr-01000000137-4

198. Sr-01000000137-5

199. Sr-01000000137-8

200. W-105390

201. Brd-k10995081-001-05-5

202. Brd-k10995081-001-15-4

203. Wln: T C666 Bn Isj Eg B3- At6n Dntj D2q

204. Z1945707494

205. Perphenazine, British Pharmacopoeia (bp) Reference Standard

206. Fluphenazine Dihydrochloride Impurity E [ep Impurity]

207. Perphenazine, European Pharmacopoeia (ep) Reference Standard

208. Perphenazine, United States Pharmacopeia (usp) Reference Standard

209. 2-[4-[3-(2-chlorophenothiazin-10-yl)propyl]-piperazin-1-yl]ethanol

210. 2-(4-[3-(2-chloro-10h-phenothiazin-10-yl)propyl]-1-piperazinyl)ethanol #

211. Perphenazine For System Suitability, European Pharmacopoeia (ep) Reference Standard

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 404.0 g/mol
Molecular Formula C21H26ClN3OS
XLogP34.2
Hydrogen Bond Donor Count1
Hydrogen Bond Acceptor Count5
Rotatable Bond Count6
Exact Mass403.1485113 g/mol
Monoisotopic Mass403.1485113 g/mol
Topological Polar Surface Area55.2 Ų
Heavy Atom Count27
Formal Charge0
Complexity463
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NamePerphenazine
PubMed HealthPerphenazine (By mouth)
Drug ClassesAntiemetic, Antipsychotic
Drug LabelPerphenazine (4-[3-(2-chlorophenothiazin-10-yl)propyl]-1-piperazineethanol), a piperazinyl phenothiazine, having the chemical formula, C21H26CIN3OS. It is available as oral tablets containing 2 mg, 4 mg, 8 mg, and 16 mg of perphenazine.Inactive ingre...
Active IngredientPerphenazine
Dosage FormTablet
RouteOral
Strength8mg; 4mg; 2mg; 16mg
Market StatusPrescription
CompanyVintage Pharms; Sandoz

2 of 2  
Drug NamePerphenazine
PubMed HealthPerphenazine (By mouth)
Drug ClassesAntiemetic, Antipsychotic
Drug LabelPerphenazine (4-[3-(2-chlorophenothiazin-10-yl)propyl]-1-piperazineethanol), a piperazinyl phenothiazine, having the chemical formula, C21H26CIN3OS. It is available as oral tablets containing 2 mg, 4 mg, 8 mg, and 16 mg of perphenazine.Inactive ingre...
Active IngredientPerphenazine
Dosage FormTablet
RouteOral
Strength8mg; 4mg; 2mg; 16mg
Market StatusPrescription
CompanyVintage Pharms; Sandoz

4.2 Therapeutic Uses

Antipsychotic Agents, Phenothiazine; Dopamine Antagonists

National Library of Medicine's Medical Subject Headings online file (MeSH, 2009)


Perphenazine is indicated for use in the treatment of schizophrenia and for the control of severe nausea and vomiting in adults. /Included in US product label/

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (April 2010). Available from, as of July 8, 2010 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6633


Perphenazine has not been shown effective for the management of behavioral complications in patients with mental retardation. /Included in US product label/

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (April 2010). Available from, as of July 8, 2010 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6633


The US Food and Drug Administration (FDA) currently advises clinicians that antipsychotic agents are not approved for the treatment of dementia-related psychosis. FDA further advises clinicians that no drugs currently are approved for the treatment of patients with dementia-associated psychosis and that other management options should be considered in such patients. /Phenothiazine General Statement/

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2509


VET: ...To help control intractable animals, relieve pain, control motion sickness, and as preanesthetic agent.

Rossoff, I.S. Handbook of Veterinary Drugs. New York: Springer Publishing Company, 1974., p. 434


4.3 Drug Warning

/BOXED WARNING/ WARNING: Increased Mortality in Elderly Patients with Dementia-Related Psychosis Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Perphenazine is not approved for the treatment of patients with dementia-related psychosis.

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (Updated: August 2012). Available from, as of April 24, 2015: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5fbfe9da-26e8-4705-98f3-42acd3d7b439


... Extrapyramidal reactions ... fairly common, usually 3 types ... Parkinsonian-like syndrome ... dystonia and dyskinesia, including torticollis, tics, and other involuntary muscle movements ... akathisia, shown by restlessness ... hyperreflexia, reported in newborn ... ./Phenothiazines/

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 1021


Perphenazine products are contraindicated in comatose or greatly obtunded patients and in patients receiving large doses of central nervous system depressants (barbiturates, alcohol, narcotics, analgesics, or antihistamines); in the presence of existing blood dyscrasias, bone marrow depression, or liver damage; and in patients who have shown hypersensitivity to perphenazine tablets, their components, or related compounds.

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (April 2010). Available from, as of July 8, 2010 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6633


Perphenazine products are also contraindicated in patients with suspected or established subcortical brain damage, with or without hypothalamic damage, since a hyperthermic reaction with temperatures in excess of 104 F may occur in such patients, sometimes not until 14 to 16 hours after drug administration. Total body ice-packing is recommended for such a reaction; antipyretics may also be useful.

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (April 2010). Available from, as of July 8, 2010 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6633


For more Drug Warnings (Complete) data for Perphenazine (47 total), please visit the HSDB record page.


4.4 Drug Indication

For use in the management of the manifestations of psychotic disorders and for the control of severe nausea and vomiting in adults.


FDA Label


5 Pharmacology and Biochemistry
5.1 Pharmacology

Perphenazine is a piperazinyl phenothiazine, acts on the central nervous system, and has a greater behavioral potency than other phenothiazine derivatives whose side chains do not contain a piperazine moiety. It is a member of a class of drugs called phenothiazines, which are dopamine D1/D2 receptor antagonists. Perphenazine is 10 to 15 times as potent as chlorpromazine; that means perphenazine is a highly potent antipsychotic. In equivalent doses it has approximately the same frequency and severity of early and late extrapypramidal side-effects compared to Haloperidol.


5.2 MeSH Pharmacological Classification

Dopamine Antagonists

Drugs that bind to but do not activate DOPAMINE RECEPTORS, thereby blocking the actions of dopamine or exogenous agonists. Many drugs used in the treatment of psychotic disorders (ANTIPSYCHOTIC AGENTS) are dopamine antagonists, although their therapeutic effects may be due to long-term adjustments of the brain rather than to the acute effects of blocking dopamine receptors. Dopamine antagonists have been used for several other clinical purposes including as ANTIEMETICS, in the treatment of Tourette syndrome, and for hiccup. Dopamine receptor blockade is associated with NEUROLEPTIC MALIGNANT SYNDROME. (See all compounds classified as Dopamine Antagonists.)


Antipsychotic Agents

Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in SCHIZOPHRENIA; senile dementia; transient psychosis following surgery; or MYOCARDIAL INFARCTION; etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus. (See all compounds classified as Antipsychotic Agents.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
PERPHENAZINE
5.3.2 FDA UNII
FTA7XXY4EZ
5.3.3 Pharmacological Classes
Phenothiazines [CS]; Phenothiazine [EPC]
5.4 ATC Code

N - Nervous system

N05 - Psycholeptics

N05A - Antipsychotics

N05AB - Phenothiazines with piperazine structure

N05AB03 - Perphenazine


5.5 Absorption, Distribution and Excretion

Absorption

Absolute bioavailability is 40% following oral administration.


Route of Elimination

Perphenazine is extensively metabolized in the liver to a number of metabolites by sulfoxidation, hydroxylation, dealkylation, and glucuronidation.


Phenothiazines are generally well absorbed from the GI tract and from parenteral sites; however, absorption may be erratic, particularly following oral administration. Considerable interindividual variations in peak plasma concentrations have been reported. The variations in peak plasma concentrations may result from genetic differences in the rate of metabolism, biodegradation of the drug in the GI lumen, and/or metabolism of the drug during absorption (in the GI mucosa) and first pass through the liver. /Phenothiazine General Statement/

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2511


Following oral administration of perphenazine tablets, mean peak plasma perphenazine concentrations were observed between 1 to 3 hours. ... In a study in which normal volunteers (n=12) received perphenazine 4 mg q8h for 5 days, steady-state concentrations of perphenazine were reached within 72 hours.

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (April 2010). Available from, as of July 8, 2010 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6633


Phenothiazines and their metabolites are distributed into most body tissues and fluids, with high concentrations being distributed into the brain, lungs, liver, kidneys, and spleen. /Phenothiazine General Statement/

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2511


Phenothiazines are highly bound to plasma proteins. /Phenothiazine General Statement/

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2511


For more Absorption, Distribution and Excretion (Complete) data for Perphenazine (10 total), please visit the HSDB record page.


5.6 Metabolism/Metabolites

Hepatic.


Perphenazine is extensively metabolized in the liver to a number of metabolites by sulfoxidation, hydroxylation, dealkylation, and glucuronidation.

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (April 2010). Available from, as of July 8, 2010 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6633


Most metabolites of phenothiazines are pharmacologically inactive; however, certain metabolites (eg, 7-hydroxychlorpromazine, mesoridazine) show moderate pharmacologic activity and may contribute to the action of the drugs. There is limited evidence to indicate that some phenothiazines (eg, chlorpromazine) may induce their own metabolism. /Phenothiazine General Statement/

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2511


The pharmacokinetics of a single oral dose of 6 mg perphenazine was studied in a group of six slow and six rapid hydroxylators of debrisoquin. Peak serum concentrations of perphenazine were significantly higher in slow hydroxylators than they were in rapid hydroxylators (2.4 +/- 0.6 versus 0.7 +/- 0.3 nmol/L, p less than 0.001). The AUC(0-12) was also higher in slow hydroxylators than it was in rapid hydroxylators (18.5 +/- 6.2 versus 4.5 +/- 2.5 nmol.L-1.hr, p less than 0.001). The data suggest that the disposition of the antipsychotic drug perphenazine covaries with polymorphic debrisoquin hydroxylation.

PMID:2743709 Dahl-Puustinen ML et al; Clin Pharmacol Ther 46 (1): 78-81 (1989)


After chronic administration of piperazine-substituted phenothiazine drugs ... to rats, tissues contained drug metabolites, in which piperazine ring fission by multiple oxidative n-dealkylation had occurred to give substituted ethylenediamine. Thus, n-[gamma-(2-chlorophenothiazinyl-10)-propyl]ethylenediamine ... from ... perphenazine ...

The Chemical Society. Foreign Compound Metabolism in Mammals Volume 3. London: The Chemical Society, 1975., p. 255


Perphenazine has known human metabolites that include N-Dealkylated perphenazine and Perphenazine sulfoxide.

S73 | METXBIODB | Metabolite Reaction Database from BioTransformer | DOI:10.5281/zenodo.4056560


5.7 Biological Half-Life

8-12 hours, but ranges up to 20 hours.


The plasma elimination half-life of perphenazine was independent of dose and ranged between 9 and 12 hours.

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (April 2010). Available from, as of July 8, 2010 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6633


...The average terminal half-life of PPZ was approximately 9.5 hours. ...

PMID:973987 Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1428936 Eggert Hansen C et al; Br J Clin Pharmacol 3 (5): 915-23 (1976)


Peak 7-hydroxyperphenazine concentrations were observed between 2 to 4 hours with a terminal phase half-life ranging between 9.9 to 18.8 hours.

US Natl Inst Health; DailyMed. Current Medication Information for Perphenazine (perphenazine) tablet, film coated (April 2010). Available from, as of July 8, 2010 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=6633


5.8 Mechanism of Action

Binds to the dopamine D1 and dopamine D2 receptors and inhibits their activity. The mechanism of the anti-emetic effect is due predominantly to blockage of the dopamine D2 neurotransmitter receptors in the chemoreceptor trigger zone and vomiting centre. Perphenazine also binds the alpha andrenergic receptor. This receptor's action is mediated by association with G proteins that activate a phosphatidylinositol-calcium second messenger system.


The principal pharmacologic effects of "perphenazine" are similar to those of chlorpromazine. "Perphenazine" has moderate anticholinergic effects, weak to moderate sedative effects, and strong extrapyramidal effects. "Perphenazine" has strong antiemetic activity.

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2516


The development of phenothiazine derivatives as psychopharmacologic agents resulted from the observation that certain phenothiazine antihistaminic compounds produced sedation. In an attempt to enhance the sedative effects of these drugs, promethazine and chlorpromazine were synthesized. Chlorpromazine is the pharmacologic prototype of the phenothiazines. The pharmacology of phenothiazines is complex, and because of their actions on the central and autonomic nervous systems, the drugs affect many different sites in the body. Although the actions of the various phenothiazines are generally similar, these drugs differ both quantitatively and qualitatively in the extent to which they produce specific pharmacologic effects. /Phenothiazine General Statement/

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2510


In the CNS, phenothiazines act principally at the subcortical levels of the reticular formation, limbic system, and hypothalamus. Phenothiazines generally do not produce substantial cortical depression; however, there is minimal information on the specific effects of phenothiazines at the cortical level. Phenothiazines also act in the basal ganglia, exhibiting extrapyramidal effects. The precise mechanism(s) of action, including antipsychotic action, of phenothiazines has not been determined, but may be principally related to antidopaminergic effects of the drugs. There is evidence to indicate that phenothiazines antagonize dopamine-mediated neurotransmission at the synapses. There is also some evidence that phenothiazines may block postsynaptic dopamine receptor sites. However, it has not been determined whether the antipsychotic effect of the drugs is causally related to their antidopaminergic effects. Phenothiazines also have peripheral and/or central antagonistic activity against alpha-adrenergic, serotonergic, histaminic (H1-receptors), and muscarinic receptors. Phenothiazines also have some adrenergic activity, since they block the reuptake of monoamines at the presynaptic neuronal membrane, which tends to enhance neurotransmission. The effects of phenothiazines on the autonomic nervous system are complex and unpredictable because the drugs exhibit varying degrees of alpha-adrenergic blocking, muscarinic blocking, and adrenergic activity. The antipsychotic activity of phenothiazines may be related to any or all of these effects, but it has been suggested that the drugs' effects on dopamine are probably most important. It has also been suggested that effects of phenothiazines on other amines (eg, gamma-aminobutyric acid [GABA]) or peptides (eg, substance P, endorphins) may contribute to their antipsychotic effect. Further study is needed to determine the role of central neuronal receptor antagonism and of effects on biochemical mediators in the antipsychotic action of the phenothiazines and other antipsychotic agents. /Phenothiazine General Statement/

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2510


Although the exact mechanism(s) of action has not been conclusively determined, phenothiazines have an antiemetic effect. The antiemetic activity may be mediated via a direct effect of the drugs on the medullary chemoreceptor trigger zone (CTZ), apparently by blocking dopamine receptors in the CTZ. Phenothiazines inhibit the central and peripheral effects of apomorphine and ergot alkaloids. Phenothiazines generally do not inhibit emesis caused by the action of drugs at the nodose ganglion or by local action on the GI tract. /Phenothiazine General Statement/

American Society of Health System Pharmacists; AHFS Drug Information 2010. Bethesda, MD. (2010), p. 2511


For more Mechanism of Action (Complete) data for Perphenazine (14 total), please visit the HSDB record page.


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