Paroxetine

By Medically reviewed by hellodoktor

Generic Name: Paroxetine Brand Name(s): Paroxetine.

Uses

What is paroxetine used for?

Paroxetine is used to treat depression, panic attacks, obsessive-compulsive disorder (OCD), anxiety disorders, and post-traumatic stress disorder. It works by helping to restore the balance of a certain natural substance (serotonin) in the brain.

Paroxetine is known as a selective serotonin reuptake inhibitor (SSRI). This medication may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. It may also reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, and checking) that interfere with daily living.

This medication may also be used to treat a severe form of premenstrual syndrome (premenstrual dysphoric disorder). It may also be used to treat hot flashes that occur with menopause.

How should I take paroxetine?

Take paroxetine exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not crush, chew, or break an extended-release paroxetine tablet. Swallow it whole.

Shake the paroxetine oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using paroxetine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using paroxetine. Follow your doctor’s instructions about tapering your dose.

How do I store paroxetine?

Paroxetine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store paroxetine in the bathroom or the freezer. There may be different brands of paroxetine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush paroxetine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using paroxetine?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of paroxetine or other medications.
  • You have any other illnesses, disorders, or medical conditions.

Do not use an MAO inhibitor within 14 days before or 14 days after you take paroxetine. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking paroxetine you must wait at least 14 days before you start taking an MAO inhibitor.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Is it safe during pregnancy or breastfeeding?

There isn’t enough information about the safety of using paroxetine during pregnancy and breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking paroxetine.

Side effects

What side effects can occur from paroxetine?

Get emergency medical help if you have signs of an allergic reaction to paroxetine: skin rash or hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • Racing thoughts, decreased need for sleep, unusual risk-taking behavior, feelings of extreme happiness or sadness, being more talkative than usual
  • Blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
  • Unusual bone pain or tenderness, swelling or bruising
  • Changes in weight or appetite
  • Easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), coughing up blood
  • High levels of serotonin in the body – agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting
  • Low levels of sodium in the body – headache, confusion, slurred speech, severe weakness, loss of coordination, feeling unsteady
  • Severe nervous system reaction – very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, fainting; or
  • Severe skin reaction – fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling

Common side effects may include:

  • Vision changes
  • Weakness, drowsiness, dizziness
  • Sweating, anxiety, shaking
  • Sleep problems (insomnia)
  • Loss of appetite, constipation
  • Dry mouth, yawning
  • Decreased sex drive, impotence, or difficulty having an orgasm

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with paroxetine?

Paroxetine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

  • Cimetidine (Tagamet), St. John’s wort, tamoxifen, tryptophan (sometimes called L-tryptophan), warfarin (Coumadin, Jantoven)
  • Heart rhythm medicine
  • HIV or AIDS medications
  • Certain medicines to treat narcolepsy or ADHD – amphetamine, atomoxetine, dextroamphetamine, Adderall, Dexedrine, Evekeo, Vyvanse, and others
  • Narcotic pain medicine – fentanyl, tramadol
  • Medicine to treat anxiety, mood disorders, thought disorders, or mental illness – such as buspirone, lithium, other antidepressants, or antipsychotics
  • Migraine headache medicine – sumatriptan, rizatriptan, zolmitriptan, and others
  • Seizure medicine – phenobarbital, phenytoin

Does food or alcohol interact with paroxetine?

Paroxetine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with paroxetine?

Paroxetine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

  • Heart disease, high blood pressure, history of stroke
  • Liver or kidney disease
  • A bleeding or blood clotting disorder
  • Seizures or epilepsy
  • Bipolar disorder (manic depression), or a history of drug abuse or suicidal thoughts
  • Narrow-angle glaucoma
  • Low levels of sodium in your blood

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using paroxetine.

What is the dose of paroxetine for an adult?

Usual Adult Dose for Depression

Immediate release tablets and suspension:

  • Initial dose: 20 mg orally once a day with or without food, usually in the morning.
  • Maintenance dose: 20 to 50 mg orally once a day with or without food, usually in the morning.
  • Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Extended release tablets:

  • Initial dose: Paroxetine- naive patients: 25 mg orally once a day with or without food, usually in the morning.
  • Conversion: 30 mg immediate release paroxetine corresponds to 37.5 mg extended release tablets.
  • Maintenance dose: The initial dose may be increased to a maximum of 62.5 mg per day.
  • Dosage change: Dose may be increased in 12.5 mg per day increments at intervals of at least one week.
  • Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

Usual Adult Dose for Anxiety

Immediate release tablets and suspension:

  • Initial dose: 20 mg orally once a day with or without food, usually in the morning.
  • Maintenance dose: Doses up to 60 mg orally once a day with or without food, usually in the morning, can be used.
  • Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Extended release tablets:

  • Initial dose: 12.5 mg orally once a day with or without food, usually in the morning.
  • Maintenance dose: The initial dose may be increased in 12.5 mg increments weekly, to a maximum of 37.5 mg per day.
  • Dosage change: May occur at intervals of at least one week.
  • Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

Usual Adult Dose for Panic Disorder

Immediate release tablets and suspension:

  • Initial dose: 10 mg orally once a day with or without food, usually in the morning.
  • Maintenance dose: 40 mg orally once daily with or without food, usually in the morning. Doses up to 60 mg orally once a day in the morning can be used.
  • Dosage change: May occur in 10 mg per day increments at intervals of at least one week.

Extended release tablets:

  • Initial dose: Paroxetine naive patients: 12.5 mg orally once a day with or without food, usually in the morning.
  • Maintenance dose: The initial dose may be increased in 12.5 mg per day increments at intervals of at least one week, to a maximum of 75 mg per day.
  • Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

Usual Adult Dose for Premenstrual Dysphoric Disorder

Extended release tablets:

  • Initial: 12.5 mg orally once a day with or without food, usually in the morning continuously, or alternatively, 12.5 mg orally once a day with or without food, usually in the morning during the luteal phase of the menstrual cycle (the 14 days prior to the anticipated start of menses).
  • Maintenance: Doses up to 25 mg once a day with or without food, usually in the morning, have been shown to be effective in clinical trials. Effectiveness for a period exceeding 3 menstrual cycles has not been evaluated in controlled trials. However, it is reasonable to consider continuation in a responding patient.
  • Dosage change: May occur at intervals of at least one week.
  • Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

Usual Adult Dose for Obsessive Compulsive Disorder

Immediate release tablets and suspension:

  • Initial dose: 20 mg orally once a day with or without food, usually in the morning.
  • Maintenance dose: 40 mg orally once a day with or without food, usually in the morning. Doses up to 60 mg orally once a day in the morning can be used.
  • Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Usual Adult Dose for Post-Traumatic Stress Disorder

Immediate release tablets and suspension:

  • Initial dose: 20 mg orally once a day with or without food, usually in the morning.
  • Maintenance dose: 20 to 50 mg orally once a day with or without food, usually in the morning.
  • Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Usual Adult Dose for Postmenopausal Symptoms

Approved indication for paroxetine marketed as Brisdelle (R) only: Treatment of moderate to severe vasomotor symptoms associated with menopause: 7.5 mg orally once daily at bedtime with or without food

What is the dose of paroxetine for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is paroxetine available?

Paroxetine is available in the following dosage forms and strengths:

  • Capsule 7.5 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of paroxetine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: July 26, 2017 | Last Modified: September 13, 2019

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