Drug & supplement interaction

Puravive + Amitriptyline, Perphenazine

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

Moderate Interaction
Medically reviewed by · Updated February 2024
The bottom line Moderate

Amitriptyline, Perphenazine falls into 4 drug categories that Puravive can interact with; the most serious is rated moderate. Puravive contains quercetin, which has been shown in studies to mildly inhibit the CYP2C9 metabolizing enzyme.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Puravive and Amitriptyline, Perphenazine

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Puravive interacts with whole categories of medication. Amitriptyline, Perphenazine falls into 4 of those categories, so it can interact with Puravive in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

Cytochrome P450 2C9 (Cyp2C9) Substrates

1 of 4

Why this applies to Amitriptyline, Perphenazine

Amitriptyline, Perphenazine falls under Cytochrome P450 2C9 (Cyp2C9) Substrates — the group Puravive interacts with.

Puravive contains quercetin, which has been shown in studies to mildly inhibit the CYP2C9 metabolizing enzyme. This inhibition could potentially increase the risk of side effects from drugs. A small clinical trial with healthy volunteers found that taking 500 mg of quercetin twice daily for 10 days before using diclofenac, a drug metabolized by CYP2C9, increased diclofenac plasma levels by 75% and extended its half-life by 32.5% (source: https://pubmed.ncbi.nlm.nih.gov/29168292/). Combining quercetin with drugs metabolized by CYP2C9 could increase the risk of side effects, so caution is advised.
Severity Moderate Likelihood Possible Evidence C

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 this combo product (Triavil, which pairs amitriptyline with perphenazine) and Puravive. The supplement contains quercetin, which can mildly slow down a liver enzyme called CYP2C9. When that enzyme is partly blocked, certain medicines it helps clear can build up a bit higher than usual. Amitriptyline is mainly handled by other enzymes (CYP2D6 and CYP2C19), so the CYP2C9 link here is on the weaker, more theoretical side and the evidence is limited.

Still, if levels did edge up, you might notice more of amitriptyline's usual effects: drowsiness, dry mouth, constipation, blurry vision, dizziness on standing, or a faster heartbeat. None of these drugs are something to start or stop on your own, so please run Puravive by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
Moderate

Qt Interval-Prolonging Drugs

2 of 4

Amitriptyline, Perphenazine also falls under Qt Interval-Prolonging Drugs.

Puravive contains Panax ginseng. Panax ginseng is thought to have an additive effect with drugs that prolong the QT interval, potentially increasing the risk of ventricular arrhythmias. However, research findings on this matter are conflicting. Clinical studies indicate that short-term use of Panax ginseng can increase the QT interval (source: https://pubmed.ncbi.nlm.nih.gov/27240158/). However, no changes in the QT interval have been observed with prolonged use (source: https://pubmed.ncbi.nlm.nih.gov/11978148/).
Severity Moderate Likelihood Possible Evidence C

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 thing to know about Triavil (a combination of amitriptyline and perphenazine): both ingredients can already nudge the heart's electrical timing, what we call the QT interval. Puravive includes Panax ginseng, which some studies suggest can also lengthen that interval. Stacking them together could, in theory, add up and slightly raise the risk of an irregular heartbeat.

I'll be honest, the evidence here is mixed and fairly weak. One short study showed a small QT change with ginseng, while longer use showed none. For most people this is a low-level concern, but if you ever feel a racing, pounding, or fluttering heartbeat, dizziness, or fainting, take it seriously. Please run Puravive by your pharmacist or doctor first, especially if you have any heart history.

Contact Dr. Brian directly if you have additional questions on this interaction
Minor

Cytochrome P450 2D6 (Cyp2D6) Substrates

3 of 4

Amitriptyline, Perphenazine also falls under Cytochrome P450 2D6 (Cyp2D6) Substrates.

Puravive contains Panax ginseng. Some research suggests that Panax ginseng might slow down the activity of an enzyme called CYP2D6 by about 6%. This enzyme plays a role in breaking down drugs in our system. One study (https://pubmed.ncbi.nlm.nih.gov/32557706/) found that Panax ginseng slows down the breakdown of dextromethorphan, a drug that is processed by CYP2D6, but only to a small extent. It is important to note that not all studies agree on these effects, and some suggest that Panax ginseng might not have a significant impact on CYP2D6 at all. Nevertheless, it's important to be cautious if you're taking medications that are processed by CYP2D6 and consider discussing it with your healthcare provider.
Severity Minor 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

This combo pill pairs amitriptyline (a tricyclic antidepressant) with perphenazine (an antipsychotic), and both lean on your liver's CYP2D6 enzyme to be cleared from your body. Puravive contains Panax ginseng, which might slow that enzyme a little. If it does, these two medicines could hang around slightly longer, nudging up familiar side effects like drowsiness, dry mouth, constipation, blurred vision, dizziness on standing, or in rare cases, heart rhythm or movement-related effects.

Honestly, the evidence here is weak. Studies showed only about a 6% slowdown, and not all of them even agree it happens. So for most people this is a minor, mostly theoretical concern. Still, since this medicine affects mood and the heart, it is worth a quick chat with your pharmacist or doctor before adding Puravive.

Contact Dr. Brian directly if you have additional questions on this interaction
Minor

Cytochrome P450 3A4 (Cyp3A4) Substrates

4 of 4

Amitriptyline, Perphenazine also falls under Cytochrome P450 3A4 (Cyp3A4) Substrates.

Puravive contains Panax ginseng. Panax ginseng has the potential to affect the breakdown of drugs that are metabolized by an enzyme called CYP3A4. One example of such a drug is imatinib. There was a case where imatinib was thought to have caused liver damage, and it was believed that this might have been due to Panax ginseng inhibiting CYP3A4, which is involved in imatinib's metabolism (https://pubmed.ncbi.nlm.nih.gov/20332334/). On the other hand, Panax ginseng has been found to increase the breakdown of another drug called midazolam, which is also metabolized by CYP3A4 (https://pubmed.ncbi.nlm.nih.gov/21646440/), suggesting Panax ginseng induces CYP3A4 in some cases (i.e., makes more potent). Given these contradictory findings, it is important to use Panax ginseng cautiously if you are taking medications that are metabolized by CYP3A4, as the interaction between Panax ginseng and these drugs is not fully understood.
Severity Minor 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

This combo pill pairs amitriptyline (an older antidepressant) with perphenazine (an antipsychotic). Both rely partly on liver enzymes, including CYP3A4, to clear them from your body. Puravive contains Panax ginseng, which in lab and small studies has shown mixed effects on CYP3A4, sometimes slowing it and sometimes speeding it up. Because the science points in both directions, no one can say for sure which way this would tip.

If it slowed clearance, you might notice more of the usual effects: drowsiness, dry mouth, constipation, dizziness on standing, or a faster heartbeat. If it sped clearance, the medicine could work less well. Honestly, this is a minor, mostly theoretical concern, but please run it by your pharmacist or doctor before starting Puravive.

Contact Dr. Brian directly if you have additional questions on this interaction

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

Puravive Also Interacts With Other Medications

Puravive has 356 moderate, 881 minor 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 356 Minor 881 No known interaction 1,593 (incl. Amitriptyline, Perphenazine)
Taking anything else?

Check Another of Your Medications Against Puravive

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

From our Q&A

Questions About Puravive or Amitriptyline, Perphenazine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Puravive or Amitriptyline, Perphenazine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Amitriptyline, Perphenazine

This page covers Puravive 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

How much people look this up

Where Puravive 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 Puravive
Top half

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

29 days ago today
Medication Amitriptyline, Perphenazine
Steady interest

#2,040 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 Puravive

What is Puravive?

Puravive
  • Weight management
  • Metabolism support
  • Energy levels
  • General wellness
  • Stress and brain health

Puravive is a branded, multi-ingredient capsule marketed mainly for weight loss by claiming to boost brown fat activity, but there is no published, independent clinical research showing the product itself works for this purpose. Some individual ingredients have been studied in laboratory or small human studies, but those results do not prove the finished blend is safe or effective. Talk to a pharmacist or doctor before trying it, especially if you have health conditions or take medications.

Read the full Puravive monograph & all interactions
Keep checking

Other Drugs & Puravive

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

0Major
356Moderate
881Minor
1,592No known interaction
356 Moderate 881 Minor 1,592 No interaction
Moderate

356 interactions

Showing 60 of 356 moderate interactions — see all 356 on the Puravive page.

Minor

881 interactions

Showing 60 of 881 minor interactions — see all 881 on the Puravive page.

No interaction 1,592 drugs checked — show the list

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

Showing the 60 most looked-up of 1,592 medications checked with no known interaction — see the full Puravive list.

See the full Puravive 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
Puravive 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 Puravive and Amitriptyline, Perphenazine Together: Common Questions

Can you take Puravive 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 4 interactions listed for Puravive and Amitriptyline, Perphenazine?
Amitriptyline, Perphenazine belongs to more than one drug category, and Puravive 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 Puravive 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.