Generic Name: Paxil
What is Paxil?
Interactions between vilazodone and serotonergic agents can lead to serotonin syndrome. Patients receiving vilazodone and paroxetine should be monitored for the emergence of serotonin syndrome, particularly during treatment initiation and during dosage increases.
Vilazodone and paroxetine should be discontinued if serotonin syndrome occurs and supportive symptomatic treatment should be initiated. Vorapaxar: Because vorapaxar inhibits platelet aggregation, a potential additive risk for bleeding exists if vorapaxar is given in combination with other agents that affect hemostasis such as selective serotonin reuptake inhibitors SSRIs.
Platelet aggregation may be impaired by SSRIs due to platelet serotonin depletion. In addition, fluoxetine and fluvoxamine are CYP3A4 inhibitors and coadministration with vorapaxar, a CYP3A4 substrate, may result in increased serum concentrations of vorapaxar. Increased exposure to vorapaxar may increase the risk of bleeding complications. Patients should be instructed to monitor for signs and symptoms of bleeding while taking a SSRI with vorapaxar and to promptly report any bleeding events.
Vortioxetine: Due to similarity of pharmacology and the potential for additive adverse effects, including serotonin syndrome, vortioxetine should generally not be co-administered with selective serotonin reuptake inhibitors SSRIs.
Although clinical evidence of interactions is lacking, plasma concentrations of SSRIs metabolized by CYP2D6 may be increased if bupropion is added. In addition, in vitro studies suggest that paroxetine inhibit the hydroxylation of bupropion. Buspirone: Because of the potential risk and severity of serotonin syndrome or neuroleptic malignant syndrome-like reactions, caution should be observed when administering selective serotonin reuptake inhibitors SSRIs with other drugs that have serotonergic properties such as buspirone.
The addition of fluoxetine to a regimen consisting of buspirone and trazodone was reported to result in an increase in anxiety-type symptoms in one patient. Subsequent dosage adjustments should be based on clinical response. Patients receiving these combinations should be monitored for the emergence of serotonin syndrome, neuroleptic malignant syndrome-like reactions, or other adverse effects. Cabergoline: Because of the potential risk and severity of serotonin syndrome or neuroleptic malignant syndrome-like reactions, caution should be observed when administering selective serotonin reuptake inhibitors SSRIs with other drugs that have serotonergic properties such as cabergoline.
Patients receiving cabergoline with an SSRI should be monitored for the emergence of serotonin syndrome or neuroleptic malignant syndrome-like reactions. Cangrelor: Platelet aggregation may be impaired by selective serotonin reuptake inhibitors SSRIs due to platelet serotonin depletion, possibly increasing the risk of a bleeding complication e. Carvedilol: Inhibitors of the hepatic CYP450 isozyme CYP 2D6, such as paroxetine, may inhibit the hepatic oxidative metabolism of carvedilol.
In addition, chloroquine is a moderate inhibitor of CYP2D6 and paroxetine is a potent inhibitor of CYP2D6. One or both medications may inhibit the metabolism of the other.
How should I take Paxil?
The complete text of the Medication Guide is reprinted at the end of this document. Patients should be advised of the following issues and asked to alert their prescriber if these occur while taking Paxil.
Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia psychomotor restlessnesshypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down.
Families and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt. Symptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medication.
What should I avoid while taking Paxil?
Amoxapine: Paroxetine is a potent inhibitor of CYP2D6, the isoenzyme partially responsible for the metabolism of amoxapine. In several cases, symptoms of toxicity, including seizures, have been reported when the structurally related tricyclic antidepressants were co-administered with an SSRI.
At least one case report exists of a death thought to be due to impaired clearance of the amoxapine-related tricyclic antidepressant amitriptyline by fluoxetine. Patients receiving amoxapine should be monitored closely for toxicity if paroxetine is added. The MAOI activity of amphetamines may also be of concern with SSRI use.
Paxil side effects
Adverse effects of olanzapine that may become evident include fatigue, dizziness, weight gain, prolactin elevation, orthostatic hypotension, sedation, or extrapyramidal symptoms.
In addition, olanzapine is associated with a possible risk of QT prolongation and should be used cautiously with strong CYP2D6 inhibitors such as paroxetine.
Fluphenazine: Substantial increases in concentrations of phenothiazines, such as fluphenazine, may occur due to CYP2D6 inhibition by paroxetine, which may increase the risk of adverse effects, such as extrapyramidal symptoms. In addition, because fluphenazine is a CYP2D6 substrate and has a possible risk of QT prolongation and torsade de pointes, concurrent use of a potent CYP2D6 inhibitor such as paroxetine may increase the risk of such events.
Additive anticholinergic effects are also possible. Fluvoxamine: Due to the similarity in pharmacology of paroxetine and fluvoxamine and the potential for serious adverse reactions, including serotonin syndrome, these selective serotonin reuptake inhibitors SSRIs should not be administered together.
Fondaparinux: Platelet aggregation may be impaired by selective serotonin reuptake inhibitors SSRIs due to platelet serotonin depletion, possibly increasing the risk of a bleeding complication in patients receiving anticoagulants, like fondaparinux.
Common Paxil ide effects may include:
Every effort has been made to ensure that the information provided by on this page is accurate, up-to-date, and complete, but no guarantee is made to that effect.
The frequencies presented, therefore, represent the proportion of the 9,089 patients exposed to multiple doses of PAXIL who experienced an event of the type cited on at least 1 occasion while receiving PAXIL.
NDC 60505-3663-3 Bottles of 3020-mg pink, scored tablets engraved on the front with PAXIL and on the back with 20.
If you or a loved one has been injured as a result of using the dangerous drug Paxil, you need an experienced Paxil injury attorney.
Paxil can also interact with a number of drugs. You should also avoid the antipsychotic drug pimozide Orap. All of these drugs can cause severe side effects when you take them with Paxil.
You should let your doctor know about all drugs you take, including over-the-counter drugs as well as herbal remedies, vitamins, and supplements. If your doctor has prescribed Paxil or another antidepressant, ask about all the possible side effects and interactions it can cause.
Where can I get more information?
Taking Paxil may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks.
We coded adverse events using MedDRA, which has replaced COSTART for the FDA because it is by far the most commonly used coding system today.