Monograph Details
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Central Nervous System
> Anxiety/OCD
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PAXIL |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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SSRI. |
| Generic Name |
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Paroxetine (as HCl) 10mg+, 20mg+, 30mg, 40mg; tabs; +scored. |
| Also |
• PAXIL CR
• PAXIL SUSPENSION
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| Indications |
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Panic disorder. Social anxiety disorder. Obsessive-compulsive disorder (OCD). Generalized anxiety disorder (GAD). Posttraumatic stress disorder (PTSD). |
| Children |
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Not recommended. |
| Adults |
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Give once daily. Adjust by 10mg/day at 1-week intervals. Panic disorder: initially 10mg/day; usual 40mg/day; max 60mg/day. Social anxiety disorder: 20mg/day; max 60mg/day. OCD: initially 20mg/day, usual 40mg/day; max 60mg/day. GAD or PTSD: 20mg/day; max 50mg/day. Elderly, debilitated, severe renal or hepatic impairment: initially 10mg/day; max 40mg/day. |
| Contraindications |
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Concomitant pimozide, thioridazine (may cause QTc prolongation). During or within 14 days of MAOIs (including linezolid). |
| Precautions |
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History of seizures (discontinue if occurs), mania/hypomania. Conditions that affect metabolism or hemodynamic response. Cardiac disease. ECT. Narrow angle glaucoma. Suicidal tendencies (monitor). Write Rx for smallest practical amount. Avoid abrupt cessation; reduce dose gradually. Reevaluate periodically. Elderly. Labor & delivery. Pregnancy (Cat.D); avoid use. Nursing mothers. |
| Interactions |
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See Contraindications. Do not start MAOI until at least 2 weeks after discontinuing paroxetine. Concomitant SSRIs, SNRIs, tryptophan: not recommended. Avoid alcohol. Potentiation with other protein bound drugs. Caution with drugs that affect coagulation (eg, warfarin, NSAIDs). Potentiated by cimetidine. Antagonized by fosamprenavir/ritonavir. May affect, or be affected by, drugs metabolized by CYP2D6, including tricyclic antidepressants, fluoxetine, phenothiazines, risperidone, atomoxetine, tamoxifen, Class 1C antiarrhythmics, quinidine. Monitor digoxin, phenytoin, phenobarbital, theophylline, warfarin. Reduce procyclidine dose if anticholinergic effects occur. Caution with triptans, linezolid, lithium, tramadol, St. John's wort; may cause serotonin syndrome (eg, weakness, incoordination, hyperreflexia). Hormonal contraceptives and PMDD treatment: see literature. |
| Adverse Reactions |
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GI upset, asthenia, sweating, decreased appetite, somnolence, dizziness, insomnia, nervousness, headache, decreased libido, tremor, akathisia, dry mouth, abnormal ejaculation, genital disorders, impotence, hyponatremia, abnormal bleeding, others; serious discontinuation symptoms (monitor). |
| How Supplied |
CR—30
Tabs 10mg, 30mg, 40mg—30
20mg—30, 90
Susp—250mL |
| Additional Resources |
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• Related Prescribing Note |
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