Drug & supplement interaction

European Mandrake + Perphenazine

Perphenazine brand name: Trilafon.

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

Perphenazine falls into 2 drug categories that European Mandrake can interact with; the most serious is rated moderate. Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.

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

European Mandrake and Perphenazine

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

Why Are There 2 Interactions?

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

Moderate

ORAL DRUGS

1 of 2

Why this applies to Perphenazine

Perphenazine falls under ORAL DRUGS — the group European Mandrake interacts with.

Theoretically, concurrent use might increase absorption of some drugs because of inhibited gastrointestinal (GI) motility caused by European mandrake.
Severity Moderate Likelihood Probable Evidence D

Interaction 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..

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

First things first: European mandrake is genuinely toxic, and we never recommend taking it in any form. Putting that aside to explain the listed interaction with perphenazine (Trilafon), the concern is about gut speed. Mandrake's tropane alkaloids (atropine-like chemicals) can slow down how fast your stomach and intestines move things along.

When your gut slows, a drug like perphenazine can sit there longer and potentially be absorbed more fully, which theoretically means more of it reaching your bloodstream. That could mean stronger sedation, dizziness, a faster heartbeat, dry mouth, constipation, or stiff muscles. Keep in mind this is only a theoretical, pharmacology-based concern, not something proven in studies. Still, the bigger worry is mandrake's toxicity itself. Please talk with your pharmacist or doctor before combining anything.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Moderate

ANTICHOLINERGIC DRUGS

2 of 2

Perphenazine also falls under ANTICHOLINERGIC DRUGS.

Concurrent use may cause additive anticholinergic effects and adverse effects. Anticholinergic drugs include conventional medications containing tropane alkaloids such as atropine, as well as phenothiazines, amantadine, some antiparkinson drugs, glutethimide, meperidine, tricyclic antidepressants, antiarrhythmic agents, and antihistamines.
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 simple version: perphenazine already has mild anticholinergic activity of its own, meaning it can dry you out and slow down certain body functions. European mandrake is loaded with tropane alkaloids (atropine, scopolamine, hyoscyamine) that hit the very same nervous system pathway. Stack the two together and those effects can pile up.

In practice that could mean a very dry mouth, blurry vision, constipation, trouble emptying the bladder, a racing heartbeat, confusion, or feeling overheated because you can't sweat normally. This warning is theoretical, based on how these chemicals work rather than reported cases, but mandrake is genuinely poisonous and I'd urge you not to use it at all. Please check with your pharmacist or doctor before combining anything with your perphenazine.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

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

European Mandrake Also Interacts With Other Medications

European Mandrake has 2,041 moderate known drug interactions in our database — the Perphenazine one above is among them. If you take anything else, check it against the full list below.

Moderate 2,041 No known interaction 789 (incl. Perphenazine)
Taking anything else?

Check Another of Your Medications Against European Mandrake

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

Everything else you take

See Every Supplement That Interacts With Perphenazine

This page covers European Mandrake 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

How much people look this up

Where European Mandrake 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 European Mandrake
Top 25%

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

29 days ago today
Medication Perphenazine
Top 25%

#668 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 European Mandrake

What is European Mandrake?

European Mandrake
  • Insomnia (traditional)
  • Pain relief (historical)
  • Anxiety or depression (folk use)
  • Gout and aches (traditional)
  • Sedation or anesthesia (historical)

European mandrake is a highly toxic plant from the nightshade family that was used in ancient and medieval times as a sedative and pain reliever. It contains powerful poisons that can cause serious harm or death, and there is no proof it safely treats any condition. We strongly recommend you do not consume mandrake in any form.

Read the full European Mandrake 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 & European Mandrake

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

0Major
2,041Moderate
0Minor
788No known interaction
2,041 Moderate 788 No interaction
Moderate

2,041 interactions

Showing 60 of 2,041 moderate interactions — see all 2,041 on the European Mandrake page.

No interaction 788 drugs checked — show the list

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

Showing the 60 most looked-up of 788 medications checked with no known interaction — see the full European Mandrake list.

See the full European Mandrake 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
European Mandrake 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 European Mandrake and Perphenazine Together: Common Questions

Can you take European Mandrake 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.
Why are there 2 interactions listed for European Mandrake and Perphenazine?
Perphenazine belongs to more than one drug category, and European Mandrake 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 European Mandrake 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

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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.