Drug & supplement interaction

Scopolia + Amitriptyline, Perphenazine

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

Major Interaction
The bottom line Major

Amitriptyline, Perphenazine falls into 2 drug categories that Scopolia can interact with; the most serious is rated major. The alkaloid constituents of scopolia, including hyoscyamine, scopolamine, and atropine, could potentiate the effects and adverse effects of anticholinergic drugs.

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

Scopolia and Amitriptyline, Perphenazine

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

Why Are There 2 Interactions?

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

Major

ANTICHOLINERGIC DRUGS

1 of 2

Why this applies to Amitriptyline, Perphenazine

Amitriptyline, Perphenazine falls under ANTICHOLINERGIC DRUGS — the group Scopolia interacts with.

The alkaloid constituents of scopolia, including hyoscyamine, scopolamine, and atropine, could potentiate the effects and adverse effects of anticholinergic drugs.
Severity Major 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

Here's the thing about this combo pill: amitriptyline and perphenazine both already carry their own anticholinergic punch. Amitriptyline (a tricyclic antidepressant) and perphenazine (an antipsychotic) both block acetylcholine on their own. Scopolia is loaded with anticholinergic alkaloids like atropine and scopolamine, so layering it on top is like stacking the same effect again and again.

When you pile these together, the predictable result is more of the same side effects: dry mouth, blurry vision, constipation, trouble urinating, a racing heartbeat, confusion, and overheating. In older folks especially, that can tip over into delirium. This concern is based on how these drugs work rather than hard studies, but the logic is solid and the risk is serious enough that I'd urge you to talk with your doctor or pharmacist before combining them.

References
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
Major

TRICYCLIC ANTIDEPRESSANTS (TCAs)

2 of 2

Amitriptyline, Perphenazine also falls under TRICYCLIC ANTIDEPRESSANTS (TCAs).

Concomitant use of TCAs with scopolia can increase the risk for anticholinergic effects and adverse effects.
Severity Major 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

Here's the thing about combining Scopolia with this medication. Triavil contains amitriptyline, a tricyclic antidepressant, and perphenazine, an antipsychotic. Both already have strong anticholinergic activity, meaning they block the messenger acetylcholine. Scopolia's alkaloids (atropine, hyoscyamine, scopolamine) do the very same thing. Stack them together and you're piling one anticholinergic on top of two more.

That can really add up. You might notice a very dry mouth, blurry vision, constipation, trouble urinating, a racing heartbeat, confusion, or feeling overheated. In older folks especially, this can tip into serious confusion or delirium. This warning is based on how these drugs work rather than hard studies, but the logic is solid. Please don't pair them without checking with your doctor or pharmacist first.

References
  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 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

Scopolia Also Interacts With Other Medications

Scopolia has 199 major, 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.

Taking anything else?

Check Another of Your Medications Against Scopolia

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

Everything else you take

See Every Supplement That Interacts With Amitriptyline, Perphenazine

This page covers Scopolia 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 Scopolia 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 Scopolia
Steady interest

#1,038 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Amitriptyline, Perphenazine
Steady interest

#2,060 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 Scopolia

What is Scopolia?

Scopolia
  • Stomach and intestinal cramps
  • Motion sickness
  • Spasms and colic
  • Excess saliva or secretions
  • Pain relief (traditional)

Scopolia is a poisonous plant in the nightshade family that contains powerful anticholinergic alkaloids like atropine, hyoscyamine, and scopolamine. While these compounds are used in carefully measured prescription medicines, the raw plant is dangerous for self-treatment and should never be used without a doctor's supervision.

Read the full Scopolia monograph & all interactions
Keep checking

Other Drugs & Scopolia

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

199Major
0Moderate
0Minor
2,630No known interaction
Major

199 interactions

Showing 60 of 199 major interactions — see all 199 on the Scopolia page.

No interaction 2,630 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Scopolia and Amitriptyline, Perphenazine Together: Common Questions

Can you take Scopolia with Amitriptyline, Perphenazine?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Scopolia and Amitriptyline, Perphenazine?
Amitriptyline, Perphenazine belongs to more than one drug category, and Scopolia 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 Scopolia and Amitriptyline, Perphenazine interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

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.