Drug & supplement interaction

English Ivy + Amitriptyline, Perphenazine

Amitriptyline, Perphenazine brand names: Triavil, Etrafon, Etrafon-A, Etrafon-Forte.

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

Amitriptyline, Perphenazine falls into 2 drug categories that English Ivy can interact with; the most serious is rated moderate. Theoretically, English ivy might increase the levels of drugs metabolized by CYP2C19.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

English Ivy and Amitriptyline, Perphenazine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

English Ivy interacts with whole categories of medication. Amitriptyline, Perphenazine falls into 2 of those categories, so it can interact with English Ivy in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 2

Why this applies to Amitriptyline, Perphenazine

Amitriptyline, Perphenazine falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group English Ivy interacts with.

Theoretically, English ivy might increase the levels of drugs metabolized by CYP2C19.
In vitro research shows that English ivy inhibits CYP2C19 enzymes. So far, this interaction has not been reported in humans.
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 basic idea with this combo (Triavil, which pairs the antidepressant amitriptyline with the antipsychotic perphenazine). Both of these get partly broken down by a liver enzyme called CYP2C19. Lab studies suggest English ivy can slow that enzyme down, which in theory could let these medicines build up a little higher than usual.

If that happened, you might notice more of their typical side effects: drowsiness, dry mouth, blurry vision, constipation, dizziness when standing, or a faster heartbeat. I want to be honest though, this is only a test-tube finding and has never actually been reported in real people, so the concern is mild. Still, since these are sedating drugs, it's worth a quick chat with your pharmacist or doctor before adding an ivy-based cough product.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Rehman SU, Kim IS, Choi MS, Kim SH, Zhang Y, Yoo HH. Time-dependent Inhibition of CYP2C8 and CYP2C19 by Hedera helix Extracts, A Traditional Respiratory Herbal Medicine. Molecules. 2017;22(7). PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 2

Amitriptyline, Perphenazine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, English ivy might increase the levels of drugs metabolized by CYP2D6.
In vitro research shows that English ivy inhibits CYP2D6 enzymes. So far, this interaction has not been reported in humans.
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

Triavil combines two active medicines, amitriptyline (an older antidepressant) and perphenazine (an antipsychotic), and both lean on a liver enzyme called CYP2D6 to be cleared from your body. The thinking here is that English ivy may slow that enzyme down a little. If it does, these medicines could build up and their effects could feel stronger.

With this combo, that might mean more drowsiness, dizziness, dry mouth, constipation, blurry vision, or a faster heartbeat. Here's the reassuring part: this is only based on lab studies, and it has never actually been reported in people. So I wouldn't panic over a cough syrup. Still, since both drugs can be sensitive to changes, just run it by your pharmacist or doctor before adding an ivy product.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Rehman SU, Kim IS, Choi MS, Kim SH, Zhang Y, Yoo HH. Time-dependent Inhibition of CYP2C8 and CYP2C19 by Hedera helix Extracts, A Traditional Respiratory Herbal Medicine. Molecules. 2017;22(7). 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

English Ivy Also Interacts With Other Medications

English Ivy has 279 moderate known drug interactions in our database — the Amitriptyline, Perphenazine one above is among them. If you take anything else, check it against the full list below.

Moderate 279 No known interaction 2,551 (incl. Amitriptyline, Perphenazine)
Taking anything else?

Check Another of Your Medications Against English Ivy

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

Everything else you take

See Every Supplement That Interacts With Amitriptyline, Perphenazine

This page covers English Ivy only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amitriptyline, Perphenazine page lists 311 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), American Hellebore (major), Arsenic (major) and Beer (major).

By severity: 19 major · 235 moderate · 57 minor.

From our pharmacist’s overview on the Amitriptyline, Perphenazine page

“Alcohol is the risk I'd flag first for anyone taking amitriptyline with perphenazine (Triavil, Etrafon). Beer and wine both carry major ratings here, and 78 of the 311 ingredients on file deepen the drowsiness this antidepressant and antipsychotic combination already causes, sometimes to the point of slowed breathing.”

Reviewed by 2 · Jul 18, 2026

Open the Amitriptyline, Perphenazine interaction page

One more smart check

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

We hold 118 real supplement products containing English Ivy, each one broken down to its full ingredient list — and combination products often carry several ingredients besides English Ivy. Your product may carry other ingredients that interact with Amitriptyline, Perphenazine too, on top of English Ivy — 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 English Ivy and Amitriptyline, 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 English Ivy
Steady interest

#1,036 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Amitriptyline, Perphenazine
Top half

#1,068 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 English Ivy

What is English Ivy?

English Ivy
  • Cough and chest congestion
  • Bronchitis
  • Asthma symptoms
  • Sore throat
  • Skin irritation

English ivy leaf extract is most commonly used in cough and cold syrups to help loosen mucus and ease coughing, and it is a popular ingredient in many European herbal products. Some research suggests it may help with certain coughs, but the evidence is still limited and mixed. The raw plant is poisonous if eaten and can irritate skin, so only use properly prepared commercial products and check with your pharmacist first.

Read the full English Ivy monograph & all interactions
Keep checking

Other Drugs & English Ivy

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

0Major
279Moderate
0Minor
2,550No known interaction
279 Moderate 2,550 No interaction
Moderate

279 interactions

Showing 60 of 279 moderate interactions — see all 279 on the English Ivy page.

No interaction 2,550 drugs checked — show the list

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

Showing the 60 most looked-up of 2,550 medications checked with no known interaction — see the full English Ivy list.

See the full English Ivy interactions page
See every supplement checked against Amitriptyline, 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
English Ivy monograph › Uses, safety, and every drug interaction in one place Amitriptyline, Perphenazine supplement interactions › Every supplement checked against Amitriptyline, Perphenazine, ranked by severity 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 English Ivy and Amitriptyline, Perphenazine Together: Common Questions

Can you take English Ivy with Amitriptyline, 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.
Why are there 2 interactions listed for English Ivy and Amitriptyline, Perphenazine?
Amitriptyline, Perphenazine belongs to more than one drug category, and English Ivy interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the English Ivy and Amitriptyline, 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

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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.