Drug & supplement interaction

Borage + Perphenazine

Perphenazine brand name: Trilafon.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Borage has a moderate interaction with Perphenazine. Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Borage and Perphenazine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

PHENOTHIAZINES

Why this applies to Perphenazine

Perphenazine falls under PHENOTHIAZINES — the group Borage interacts with.

Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Borage seed oil contains gamma-linolenic acid (GLA). There is concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. This is based on limited data from two reports published in the 1980s. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with evening primrose, another source of GLA. However, none experienced an actual seizure. In the other report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose had any additive epileptogenic effects with the phenothiazines, but there is no evidence that taking GLA-containing supplements alone can cause seizures.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with perphenazine (Trilafon) and borage seed oil. Perphenazine, like other phenothiazines, can already lower the brain's seizure threshold a little. The worry is that the GLA (gamma-linolenic acid) in borage oil might nudge that threshold down a touch more, theoretically raising the small chance of a seizure if the two are combined.

Honestly, this is built on very thin evidence, a couple of old case reports from the 1980s involving evening primrose oil, not borage itself. So I don't want to alarm you. Still, if you take perphenazine, especially if you have any history of seizures, please check with your pharmacist or doctor before adding borage. And only ever use a product clearly labeled PA-free to avoid the liver-toxic alkaloids in the plant.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Holman CP and Bell AF. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orhtomolecular Psych 1983;12:302-304.
  2. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6(4):375-379. PubMed
  3. Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukotrienes Essential Fatty Acids 2007;77:101-3. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Borage Also Interacts With Other Medications

Borage has 225 moderate known drug interactions in our database — the Perphenazine one above is one of them. If you take anything else, check it against the full list below.

Moderate 225 No known interaction 2,605 (incl. Perphenazine)
Taking anything else?

Check Another of Your Medications Against Borage

Covers the 2,830 medications we’ve checked against Borage. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Perphenazine

This page covers Borage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Perphenazine page lists 147 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Henbane (major), Indian Snakeroot (major), Rauvolfia Vomitoria (major) and Scopolia (major).

By severity: 5 major · 108 moderate · 34 minor.

From our pharmacist’s overview on the Perphenazine page

“Perphenazine (Trilafon) treats schizophrenia and severe nausea, and this list deserves real care. Five of the 147 ingredients on file rate major, and those five are the ones to understand first.”

Reviewed by 2 · Jul 18, 2026

Open the Perphenazine interaction page

One more smart check

Taking Borage as Part of a Dietary Supplement Product? Check It for Interactions

We hold 122 real supplement products containing Borage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Borage. Your product may carry other ingredients that interact with Perphenazine too, on top of Borage — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Borage and Perphenazine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Borage
Top 25%

#350 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Perphenazine
Top 25%

#598 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Borage

What is Borage?

Borage
  • Eczema and dry skin
  • Rheumatoid arthritis
  • Inflammation
  • Respiratory complaints
  • Mood and stress

Borage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arthritis with mixed results. The plant's leaves and flowers can contain liver-toxic pyrrolizidine alkaloids, so only use products clearly labeled 'PA-free' and talk to your pharmacist or doctor before taking it.

Read the full Borage monograph & all interactions
Medication

About Perphenazine

What Is Perphenazine Used For?

Brand name: Trilafon

Perphenazine tablets are approved to treat schizophrenia in adults. They are also used to control severe nausea and vomiting in adults when other measures are not enough.

Perphenazine has not been shown effective for managing behavioral problems in patients with intellectual disabilities, and it is not approved for dementia-related psychosis in elderly patients.

See full Perphenazine drug information
Keep checking

Other Drugs & Borage

Browse every other medication we’ve checked against Borage — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
225Moderate
0Minor
2,604No known interaction
225 Moderate 2,604 No interaction
Moderate

225 interactions

Showing 60 of 225 moderate interactions — see all 225 on the Borage page.

No interaction 2,604 drugs checked — show the list

We also checked Borage against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,604 medications checked with no known interaction — see the full Borage list.

See the full Borage interactions page
See every supplement checked against Perphenazine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Borage monograph › Uses, safety, and every drug interaction in one place Perphenazine supplement interactions › Every supplement checked against Perphenazine, ranked by severity Perphenazine drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Borage and Perphenazine Together: Common Questions

Can you take Borage with Perphenazine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Borage and Perphenazine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Perphenazine and Borage?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.