Paroxetine

💊 What is Paroxetine used for?

• •Major depressive disorder (MDD)
• •Obsessive compulsive disorder (OCD)
• •Panic disorder (PD)
• •Social anxiety disorder (SAD)
• •Generalized anxiety disorder (GAD)
• •Posttraumatic stress disorder (PTSD)

How it works

The label describes paroxetine as an SSRI, a selective serotonin reuptake inhibitor. It does not give further detail about how the medicine works.

How it is usually taken

• •The label says to take paroxetine exactly as prescribed, once a day in the morning, with or without food. Your prescriber may change the dose until it is right for you. The label says the dose should be lowered gradually when the medicine is stopped, and that stopping suddenly may cause serious side effects. Follow the instructions from your prescriber or pharmacist.

Comes as

• •30 mg beige to light brown, capsule-shaped film-coated tablets, marked '712' on one side and 'HH' on the other

⚠️ Paroxetine side effects

🛑 Who should not take Paroxetine, and who should be careful

The label says not to take it if

• 🚨You take a monoamine oxidase inhibitor (MAOI), or you have stopped an MAOI within the last 14 days. The label says not to start an MAOI for at least 14 days after stopping paroxetine.
• 🚨You are being treated with the antibiotic linezolid or intravenous methylene blue.
• 🚨You are taking pimozide.
• 🚨You are taking thioridazine.
• 🚨You are allergic to paroxetine or any of its ingredients.

Tell your doctor before taking it if

• •Tell your provider about any heart problems.
• •Tell your provider if you have or had bleeding problems.
• •Tell your provider if you have or had bipolar disorder, mania, or hypomania, or a family history of these. Your provider should screen for bipolar disorder before you start.
• •Tell your provider if you have or had seizures or convulsions.
• •Tell your provider if you have glaucoma (high pressure in the eye).
• •Tell your provider if you have low sodium levels in your blood.
• •Tell your provider if you have bone problems.
• •Tell your provider if you have kidney or liver problems.
• •Tell your provider if you are pregnant, may become pregnant, or are breastfeeding.
• •Tell your provider about all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

🔀 Paroxetine with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •MAOIs, including selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, and methylene blue (not to be used with paroxetine).
• •Pimozide and thioridazine (not to be used with paroxetine). The label says these may increase the risk of heart rhythm problems.
• •Other serotonin-related medicines, such as other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids (including tramadol, fentanyl, meperidine, and methadone), lithium, tryptophan, buspirone, and amphetamines. These may increase the risk of serotonin syndrome.
• •St. John's Wort.
• •Blood thinners and bleeding-risk medicines, such as aspirin, NSAIDs, clopidogrel, heparin, and warfarin. The label says to watch for bleeding and, for warfarin, to monitor the international normalized ratio closely.
• •Diuretics and tamoxifen, which are listed in the patient guide as medicines to tell your provider about.
• •Other medicines that are highly bound to blood proteins. The label says these may change how much paroxetine or the other drug is active in the blood.

Alcohol and food

The label says paroxetine can be taken with or without food. The label does not give general guidance about drinking alcohol during treatment. It mentions alcohol only in the overdose section, where it says alcohol can be involved in cases of low blood pressure or high blood pressure after an overdose. Ask your provider or pharmacist about alcohol.

🤰 Paroxetine in pregnancy and breastfeeding

Pregnancy

The label says paroxetine may harm an unborn baby. Taking it in the first trimester may increase the risk of heart problems in the baby (cardiac malformations). Taking it in the third trimester may cause breathing, temperature, and feeding problems, low muscle tone, and irritability after birth, and an increased risk of a serious lung problem at birth. The label also notes that untreated depression during pregnancy carries its own risks. Talk with your provider about these risks, and tell your provider right away if you become pregnant or think you may be pregnant.

Breastfeeding

The label says paroxetine passes into breast milk. Talk with your healthcare provider about the best way to feed your baby during treatment.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store the tablets at 20 to 25 degrees C (68 to 77 degrees F), which is controlled room temperature.

If a dose is missed

The label does not say.

If too much is taken

The label lists these effects after an overdose: seizures (which may be delayed), altered mental status including coma, heart problems (which may be delayed), high blood pressure (most common), rarely low blood pressure, and serotonin syndrome. The label says activated charcoal may be considered if the person comes in early after an overdose. Contact a poison center at 1-800-222-1222 or get emergency medical help right away.

🗒️ Questions to ask about Paroxetine

• Am I taking any medicines that the label says should not be used with paroxetine, such as an MAOI or pimozide?
• Should I be screened for bipolar disorder before starting this medicine?
• What warning signs of suicidal thoughts or behavior should my family members watch for?
• What is the plan for lowering my dose if I need to stop this medicine?
• Does paroxetine affect my plans for pregnancy or breastfeeding, and what other treatment options are there?
• What should I do if I notice signs of serotonin syndrome or unusual bleeding?
• Which of my current medicines, vitamins, or herbal products, such as St. John's Wort, could interact with paroxetine?

❓ Paroxetine: frequently asked questions