Monograph Details

Central Nervous System > Mood disorders
PAXIL
Manufacturer
GlaxoSmithKline Pharmaceuticals
Legal Classification
Rx
Pharmacological Class
SSRI.
Generic Name
Paroxetine (as HCl) 10mg+, 20mg+, 30mg, 40mg; tabs; +scored.
Also
PAXIL CR
PAXIL SUSPENSION
Indications
Depression.
Children
Not recommended.
Adults
Give once daily. Adjust by 10mg/day at 1-week intervals. Initially 20mg/day; max 50mg/day. Elderly, debilitated, severe hepatic or renal impairment: initially 10mg/day; max 40mg/day.
Contraindications
Concomitant pimozide, thioridazine (may cause QTc prolongation). During or within 14 days of MAOIs (including linezolid).
Precautions
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
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
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
Related Prescribing Note